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Sundowning refers to the exacerbation of symptoms of arousal or impairment in the late afternoon, evening, or night among older adults with dementia. Because sundowning is associated with immense burden on family caregivers and institutional nursing staff, determining its etiology remains an important goal so that appropriate interventions may be developed. The current study examined the association between sundowning and variables representing he primary etiological theories of sundowning in a sample of 20 nursing home patients with Alzheimer's disease. Specifically, theories relating sundowning to circadian rhythm disturbances, sleep disruption, and overstimulation were tested. Sundowners were found to have a later peak in diurnal body temperature peak than nonsundowners, supporting the circadian rhythm theory of sundowning. No relation was found between sundowning status and sleep disruption or ambient sound levels, thereby challenging the validity of these theories. Aimless wandering, pushing, and performing repetitious mannerisms were found to be the most common sundowning behaviors, although very distinct individual patterns of sundowning behavior were present.