Experiencing daytime sleepiness is something that is usually perceived as a minor inconvenience, but for older adults, it could be an early warning sign of Dementia. This neurodegenerative disease leads to the progressive decline of brain cells. This eventually

affects memory, cognition, and personality, making everyday tasks more difficult. As one of the fastest-growing neurological disorders across the world, dementia poses a significant health threat to ageing populations.

Is Dementia Linked To Poor Sleep?

For this study, researchers followed 445 older adults (average age 76) over three years, aiming to determine whether poor sleep could increase the risk of mild cognitive impairment (MCI), which often leads to dementia. At the start, none of the participants had MCI, but by the end of the study, 36 individuals had developed the condition.

The researchers discovered that participants with poor sleep were more likely to develop MCI compared to those who slept well. However, when depression symptoms were taken into account, the link between poor sleep and MCI became less pronounced, suggesting that while sleep issues are a concern, mental health also plays a key role in dementia risk.

To assess sleep quality, the Pittsburgh Sleep Quality Index (PSQI) was used, evaluating factors such as sleep duration, disturbances, and daytime alertness. Among these, "daytime dysfunction"—defined as excessive sleepiness and low energy during the day—was most strongly associated with an increased risk of MCI. Those experiencing daytime dysfunction were more than three times as likely to develop MCI as those who didn’t report such symptoms.

There are many types of dementia:

Dementia is not a specific disease. According to the Centers for Disease Control and Prevention (CDC), it is an overall term that describes a decline in mental ability that interferes with daily life. People with dementia often have symptoms like trouble remembering, thinking, or making everyday decisions. These symptoms tend to get worse over time.

Alzheimer’s disease is the most common type of dementia, and it mostly affects the elderly. Each form of dementia has a different cause. Though dementia mostly affects older adults, it is not a part of normal ageing. An estimated 6.7 million older adults have Alzheimer's disease in the United States. That number is expected to double by 2060, as per data from the CDC.

In 2022, 3.8% of men and 4.2% women in US were diagnosed with dementia. The percentage of people increase with age from 1.7% for those aged 65-74 to 13.1% for those aged 85 and older. Alzheimer's accounts for 60 to 80% of all dementia cases and it is most prevalent in California, Florida, and Texas, as these states have the highest number of people.

In a significant breakthrough for faster diagnosis of tuberculosis -- the world’s most infectious disease --, the World Health Organization (WHO) has recommended tongue swab tests.

The new recommendations come as many people with TB do not produce sputum, but are contributing to transmission. The swab tests may not only expand access to testing but also enable early and timely treatment that can help break chains of TB transmission.

The updated guidance also includes recommendations for the use of near point-of-care molecular tests - the nucleic acid amplification tests (NPOC-NAATs) for drug-resistant TB and pooling of sputa as a diagnostic strategy for the initial detection of TB and drug resistance.

“The WHO has just issued recommendations on new near-point-of-care (NPOC) tests for the diagnosis of #TB; easy-to-collect tongue swab samples to expand access to testing; & a cost-saving sputum pooling strategy to increase testing efficiency for TB & RR-TB,” Tereza Kasaeva, Director - WHO department on HIV, Tuberculosis, Hepatitis, in a post on social media platform X.

“These new recommendations mark a major step toward making #TB testing faster and more accessible,” she said, while calling on countries to roll out the guidelines to close diagnostic gaps.

What Are Tongue Swabs

Tongue swabs are new, readily available, and easy-to-collect specimens for use with NPOC-NAATs and low-complexity automated NAATs (LC-aNAATs) for the initial detection of TB, with and without drug resistance.

The global health body recommends using the low-complexity automated NAATs as initial diagnostic tests in adults and adolescents with signs and symptoms of lung TB.

However, in cases where respiratory samples such as sputum (expectorated or induced), tracheal aspirate, and bronchoalveolar lavage (BAL) cannot be obtained, tongue swabs may be used as initial diagnostic tests for TB.

Tongue swabs may be collected by trained personnel or self-collected with guidance from trained personnel.

Dr Rakesh PS, from the International Union Against Tuberculosis and Lung Disease (The Union), in a LinkedIn post mentioned individuals having no or minimal symptoms, and often cannot present respiratory specimens.

"Tongue swabs offer a practical way to include this otherwise “missed” group in the diagnostic pathway. By enabling testing of individuals who would otherwise be excluded, tongue swab–based testing can enhance the efficiency of active systematic screening," Dr. Rakesh said.

"Tongue swabs are a strategic alternative when obtaining a respiratory specimen is difficult or not possible -- and, when used appropriately, they can strengthen our fight against TB," he added.

What Are NPOC-NAATs

NPOC-NAATs are swab-based molecular tests for TB detection that can produce results from a primary sputum or tongue swab sample in less than one hour. These tests use instruments that can be battery-operated and do not require specialized infrastructure for use or storage.

The tests can be done in basic peripheral laboratories, such as those that perform smear microscopy, and health clinics, mobile units, or community sites that do not have laboratories.

They can be performed by health care workers with basic technical skills because they do not require laboratory methods like precision pipetting.

What Is Sputa Pooling

In sputum pooling, samples from several individuals are mixed and tested together. It is a proven strategy to improve testing efficiency and reduce costs in resource-constrained environments.

Global TB burden

While being preventable and curable, TB remains a top infectious killer, with an estimated 10.7 to 10.8 million new cases and 1.23–1.25 million deaths in 2024, as per WHO.

The infectious disease disproportionately affects low- and middle-income countries.

While TB incidence rates have shown a slight, uneven decline since 2015, the overall burden remains high, with 30 countries accounting for 87 percent of global cases, led by India, Indonesia, China, the Philippines, and Pakistan.

An increasing number of the National Health Service or the NHS UK doctors are now choosing to practise privately. This has happened at the backdrop of mounting pressures and burnout that reshaped the landscape of general practice in England. According to a recent BBC report on Care Quality Commission (CQC), data found a sharp rise in doctors registering to work outside the NHS.

In the five years to the end of 2025, the CQC received 1,238 new registrations for "independent consulting doctors" in England. This is a 212 per cent increase as compared to 396 doctors registering to work independently over the five years. Between 2024 and 2025, registrations rose by 58 per cent.

Independent consulting doctors provide care privately, either in person or online, across a range of specialties including general practice, skin conditions, women’s health and aesthetics.

"You Don't Have Time To Go To The Toilet"

Dr Yvonne Girgis-Hanna is among those dividing her time between NHS and private practice. Speaking to the BBC, she said full-time NHS work had become unsustainable.

“I could not work as a full-time NHS GP,” she said. “The days I do in the NHS, the next day I'm totally wiped out… You might have 30 face-to-face contacts, then extra telephone calls and paperwork. You just don't have time to even go to the toilet.”

She now sees private patients in Essex, charging from £129 for a 20-minute appointment, with options of up to an hour. Longer consultations, she told the BBC, allow for continuity of care reminiscent of the “cradle to grave” model that once defined family medicine.

Demand, she argues, is the central strain on NHS general practice. With practices receiving roughly £120 per patient annually, frequent attenders can stretch resources thin. “If you imagine £120 for somebody that might be presenting 20 times, it is very little,” she said.

Patients Pay For Time And Familiarity

A 2024 LaingBuisson report noted that 13 per cent of GP consultations were private, which is up by 3 per cent two decades ago. This is because, some patients want faster access and longer appointments. Vanessa Ravazzotti, 51, told BBC that NHS wait worsened her symptoms and heightened anxiety. This is when seeing a private GP felt "mentally better". "She knows me; I know her."

Ian Miller, 85, who has arthritis, told the BBC he found short NHS appointments difficult and disliked seeing different clinicians. Private care offered familiarity and focus: “You immediately get down to the problem.”

Greater Autonomy, But Less Affordability

Dr Karen Benson, who works privately from a pharmacy in Hertfordshire, said the environment is calmer. “I haven't got constant interruptions… it's a much more relaxed atmosphere." She said she is better able to offer longer appointments and address the root cause of the illness. However, some patients switch back to NHS for specialist referrals that they cannot afford privately.

Dr Oliver Denton of the British Medical Association (BMA) told the BBC that while it is difficult to pinpoint a single cause, “with growing pressures within the NHS it is no wonder more may be considering looking to work outside the health service.”

The meningococcal B vaccine (4CMenB) is completely ineffective in preventing gonorrhea -- a sexually transmitted infection (STI) --, especially among high-risk groups like gay and bisexual men, according to the results of the world’s largest randomized control trial (RCT).

Gonorrhea is a common bacterial STI caused by the bacterium Neisseria gonorrheae, and is transmitted through unprotected sex.

Even as antimicrobial resistance in gonorrhea has increased rapidly in recent years, Australian researchers explored the efficacy of 4CMenB against the disease.

The large randomized, placebo-controlled trial involving 587 gay and bisexual men showed that the risk of gonorrhea incidence remains essentially the same even after vaccination.

“Across both arms, the gonorrhea incidence was virtually the same -- at around 48 per cent per year, indicating very clearly that the vaccine had no effect on preventing gonorrhea,” said Professor Kate Seib, from Griffith University, in Australia, who led the trial.

In light of the study, the researchers stressed the need to explore other options to combat gonorrhea, such as condoms and regular testing.

The 4CMenB Vaccine

While meningococcal disease (caused by Neisseria meningitidis) and gonorrhea (caused by Neisseria gonorrhoeae) are distinct infections, both are caused by Neisseria bacteria, which share 80-90 percent genetic material.

The bacterium N. meningitidis primarily causes meningitis and septicemia, and observational studies have shown that meningococcal B (MenB) vaccines such as the 4CMenB offer 33-40 percent cross-protection against gonorrhea.

However, the latest study, presented at the Conference on Retroviruses and Opportunistic Infections in Denver, US, found no protection against gonorrhea.

The study “provides strong evidence that the 4CMenB meningococcal vaccine is not effective at preventing gonorrhea in gay and bisexual men who are at high risk of contracting it,” Seib said.

According to the US National Institute of Health, the 4CMenB vaccine is a highly effective, protein-based vaccine designed to protect against invasive meningococcal disease (IMD) serogroup B.

Approved in over 50 countries, it offers 71-95 percent effectiveness in infants and 100 percent in adolescents.

What Is Gonorrhea

Gonorrhea is a common STI, and sexually active people of any age can get the disease and pass it on to partners, and even to their baby during childbirth.

Gonorrhea is the second most common STI caused by bacteria, just behind chlamydia.

As per data from the World Health Organization (WHO), in 2020, there were an estimated 82.4 million new infections among adults globally.

The NIH noted that nearly 1 million new gonorrhea infections occur in the United States every year. About half of these infections occur in people ages 15 to 24.

The symptoms of Gonorrhea in men include:

• White, yellow, or green discharge from the penis
• Pain or burning (possibly severe) when peeing
• Testicular pain and swollen testicles.

Notably, the condition also occurs in women, but up to 50 percent of them won’t experience symptoms. This increases the risk of spread to other partners.

• Common symptoms in women include:
• Unusual vaginal discharge (white or yellow).
• Pain in your lower abdomen or pelvis.
• Pain during sexual intercourse
• Pain when you pee
• Bleeding between periods