How Winter Fatigue And Low Mood Deepen Cognitive Challenges In Elders With Dementia

(By Neha Sinha)

Winter brings more than cold temperatures; it brings a set of subtle but significant challenges for individuals living with dementia. As daylight hours shrink and the environment takes on a near-permanent dusk, the already fragile circadian rhythms of an elder with dementia become further disrupted. Reduced light exposure sends inconsistent signals to the brain, worsening the internal confusion that underlies many behavioural symptoms. This drop in natural light can also trigger low mood, increased anxiety, and emotional withdrawal, changes that closely resemble Seasonal Affective Disorder (SAD).

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The Winter Intensification Of Sundowning And Cognitive Overload

Sundowning, characterised by late-day agitation, irritability, pacing, or heightened confusion, often intensifies during winter. When the brain is unable to clearly distinguish day from night, familiar surroundings can begin to feel unpredictable or even threatening. This mental overload drains cognitive and emotional reserves, making routine activities, dressing, eating, or following simple steps, feel far more demanding than they do earlier in the day. Functional capacity naturally declines when the mind and body are fighting constant internal disorientation.

Sleep Disruption, Fatigue, And The Hidden Neurological Cost Of Winter

On a physiological level, winter adds another layer of strain. Older adults expend more metabolic energy to maintain a steady core body temperature, which can deepen fatigue. However, the greater concern lies in sleep disruption. Fragmented or poor-quality sleep robs the brain of essential deep-sleep processes, such as memory consolidation and activation of the glymphatic 'clean-up' system responsible for clearing neurotoxic waste. Notably, temporary elevations in beta-amyloid, one of the proteins implicated in dementia pathology, have been observed after periods of inadequate sleep. Over the course of winter, cumulative sleep deprivation can significantly impair attention, learning, emotional regulation, and memory retrieval.

What may appear outwardly as resistance, despair, or sudden behavioural shifts is often the brain signalling a need for stabilising cues: light, warmth, predictable routines, and adequate restorative rest.

Supporting an elder through winter requires more than comfort; it requires structured, preventative care. Increasing morning and late-afternoon light exposure, maintaining consistent daily rhythms, offering gentle physical movement, managing noise and visual distractions, and keeping indoor temperatures stable can all help regulate the circadian system. These interventions protect not only cognitive functioning and mobility but also emotional safety and dignity, providing elders with the stability they need to navigate winter’s profound impact on memory and well-being.

Neha Sinha is Dementia Specialist and Clinical Psychologist, Co-founder & CEO, Epoch Elder Care

[Disclaimer: The information provided in the article, including treatment suggestions shared by experts and is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]