Daytime Sleepiness and Lack of Enthusiasm May Signal Early Dementia Risk

Updated Nov 9, 2024 | 02:00 AM IST

SummaryPeople with the syndrome walk slowly and report memory problems, but they do not have a mobility handicap or dementia. Motoric cognitive risk syndrome is a condition that can develop before dementia.
Dementia

According to a study published in the November 6, 2024, online issue of Neurology, the medical journal of the American Academy of Neurology, older people who are sleepy during the day or lose interest in activities due to sleep issues may be more likely to develop a syndrome that can lead to dementia.

People with the syndrome walk slowly and report memory problems, but they do not have a mobility handicap or dementia. Motoric cognitive risk syndrome is a condition that can develop before dementia.

What The Study Found?

The study found that people with excessive daytime sleepiness and a lack of enthusiasm to get things done were more likely to develop the syndrome than people without those sleep-related issues. The study does not prove that these sleep-related issues cause the syndrome, it only shows an association.

“Our findings emphasize the need for screening for sleep issues,” said study author Victoire Leroy, MD, PhD, of Albert Einstein College of Medicine in the Bronx, New York. “There’s potential that people could get help with their sleep issues and prevent cognitive decline later in life.”

How Was It Conducted?

The study included 445 participants, with an average age of 76, who did not have dementia. Participants completed sleep surveys at the beginning of the trial. They were queried about memory problems, and their walking pace was measured on a treadmill at the beginning of the study and then once a year for the next three years.

The sleep assessment included questions about how frequently people had difficulties sleeping because they woke up in the middle of the night, couldn't fall asleep within 30 minutes, or felt too hot or cold, as well as whether they used sleep aids. The question to assess excessive daytime drowsiness asks how frequently people have had problems remaining awake when driving, eating meals, or were engaged in any other activity.

The Findings

In total, 177 participants fit the category of bad sleepers, whereas 268 satisfied the definition of good sleepers.

At the outset of the trial, 42 participants had motoric cognitive risk syndrome. Throughout the trial, 36 more persons got the condition.

35.5% of patients who experienced extreme daytime sleepiness and a lack of enthusiasm developed the syndrome, compared to 6.7% who did not. After accounting for other factors that could influence the risk of the syndrome, such as age, depression, and other health conditions, researchers discovered that people with excessive daytime sleepiness and a lack of enthusiasm were more than three times more likely to develop the syndrome than those who did not have those sleep-related issues.

“More research needs to be done to look at the relationship between sleep issues and cognitive decline and the role played by motoric cognitive risk syndrome,” Leroy said. “We also need studies to explain the mechanisms that link these sleep disturbances to motoric cognitive risk syndrome and cognitive decline.”

A limitation of the study is that participants reported their own sleep information, so they may not have remembered everything accurately.

The study was supported by the National Institute on Aging.

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US Cardiologist Explains Why 2026 AHA Cholesterol Guidelines Recommend Starting Young

Updated Mar 24, 2026 | 12:00 AM IST

SummaryOne person might have very high cholesterol for 30–40 years, while another has moderately elevated levels for 60 years. Over time, their total exposure can be similar—and so can their risk, said Dr. Nils P Johnson, Professor of Cardiology, University of Texas, US.
US Cardiologist Explains Why 2026 AHA Cholesterol Guidelines Recommend Starting Young

Credit: iStock

Early monitoring among younger populations has been the primary focus of the recently released American Heart Association (AHA) 2026 cholesterol guidelines.

The deliberate shift is reportedly based on new evidence about how heart disease develops over time.

Speaking exclusively to HealthandMe, Dr. Nils P Johnson, Professor of Cardiology, University of Texas, Houston, US, shared that atherosclerosis, or the buildup of plaque in arteries, doesn’t suddenly appear in middle age; it begins silently in youth.

That is why the AHA guidelines highlighted the importance of early screening.

“Cholesterol risk is really about long-term exposure. Just like years of breathing polluted air can damage your lungs, cholesterol builds up in the body over time. It’s not just about how high your levels are at one moment—it’s about how long you’ve lived with them. For example, one person might have very high cholesterol for 30–40 years, while another has moderately elevated levels for 60 years. Over time, their total exposure can be similar—and so can their risk," Dr. Johnson said.

What this means in practice is that treating cholesterol is about reducing total lifetime exposure.

The cardiologist explained that there are two ways to do that: lower cholesterol levels or start treatment earlier.

"Both approaches achieve the same goal—shrinking the overall ‘cholesterol burden’ by reducing how much cholesterol is in the body and how long a person is exposed to it,” the expert said.

The AHA 2026 Cholesterol Guidelines

As per the Global Burden of Disease Study 2021, the burden of heart failure in adolescents and young adults aged 10–24 years is increasing globally.

The guidelines call for early intervention through early screening and healthy lifestyle changes, starting from childhood.

It recommends:

  • Children (9-11 years): Cholesterol screening if never done before.
  • Adults (30-79 years): Evaluate 10- and 30-year ASCVD risk to determine the need for early intervention
  • Considering lipid-lowering therapy for young adults with -- persistent LDL of at least 160 mg/dL, strong family history of ASCVD, and/or at least 10 percent 30-year risk for ASCVD

"They encourage us to think beyond the usual 5- or 10-year risk window and consider the long-term picture—what might happen 20 or 30 years down the road for someone in their 40s or 50s,” Dr. Johnson told HealthandMe.

Also read: ACC/AHA Cholesterol Guidelines 2026 Explained: Start Screening For Cardiovascular Diseases Early

Heart Disease: A Long-term Treatment

The heart expert also stated that chronic conditions like heart disease require long-term management—sometimes for decades—unlike an infection, where a two-week antibiotic course resolves the problem.

“One of the biggest challenges I see in clinics is that patients often come in after a dramatic event—chest pain, a heart attack, or a procedure. Alongside immediate treatment, I prescribe medications and recommend lifestyle changes. And then patients ask, ‘How long do I have to do this? This reflects a very different mindset”.

Dr. Johnson urged cardiologists and other healthcare workers to help patients understand, accept, and sustain these changes over the long term.

“Adjusting to the reality that life will be different for years or even a lifetime is not easy, but it’s essential,” he said.

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Tuberculosis in 2026: Why It Still Remains India’s Silent Epidemic

Updated Mar 23, 2026 | 07:00 PM IST

SummaryTuberculosis usually shows up too late. Close to 60 percent of those feeling sick skip early help. Ongoing cough, body heat, weight loss, and night sweats are early signs.
Tuberculosis in 2026: Why It Still Remains India’s Silent Epidemic

Credit: iStock

Step into a busy OPD, and you will see it: people coughing but not paying much attention. Tuberculosis is still around, just quietly spreading. By 2024, one out of every four global TB infections was recorded in India.

More than a number, each case hints at missed chances, tiny failures in spotting or stopping the disease that swell into widespread strain.

In earlier times, TB was common and very hard to recover from. Crowded homes, lack of fresh air, and low income open doors for germs to move fast. When hunger weakens people too, their bodies fail to hold back hidden sickness. But that is only part of what happens now. Conditions like smoking, drinking, high blood sugar, or HIV have slipped into view, tying daily habits closely to how often TB strikes.

After that, finding the right treatment can feel like a struggle. Some people start by visiting private clinics, shifting between different doctors until they finally learn what is wrong. Every wait means more time lost, moments when illness keeps growing without check.

Tuberculosis: What Takes The Biggest Toll?

Adults in their prime work phase feel it most. Males, particularly over the age of fifteen, carry heavier loads - a pattern the World Health Organization keeps pointing out. Yet biology alone doesn’t explain it.

Who shows up for treatment, who waits too long, who gets missed entirely, it's all written into the pattern. Older people, men, and anyone struggling with poor nutrition, using tobacco, or living with diabetes, show up more often in India’s national health data. The numbers tell a consistent story.

Tuberculosis: Late Symptoms

Here’s what happens. Tuberculosis usually shows up too late. Close to 60 percent of those feeling sick skip early help. Ongoing cough, body heat, weight loss, and night sweats are early signs. Some self-treat. For many, money becomes a barrier. Then comes the expected outcome - severe illness, tougher treatments, more time healing.

Still, false beliefs hang on. Air carries TB, not hands. Passing a meal does not pass the disease, yet shame can hold someone back from care. Cough that won’t quit, rising heat in the body, pounds slipping away, sweat at night - these hints show up early but get ignored till chances shrink.

Fighting TB in India isn’t only about medicine; it lives in habits, choices, and how people see illness. If getting help fast stays rare instead of routine, the disease keeps moving quietly through packed houses, buzzing health rooms.

Dr. Harish Bhatia is Senior Consultant in Pulmonary Medicine at Yatharth Hospital, New Delhi.

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How Leg Stiffness Impacts Spine Health: Tips For Gen Z Fitness Enthusiasts

Updated Mar 23, 2026 | 01:50 PM IST

SummaryThe muscles in your legs are important for your spine's health. The hamstring, hip flexor, and calf muscles are all significant players in the movement and positioning of your spine. Leg stiffness has the potential to cause unnecessary strain on the spine and back.
How Leg Stiffness Impacts Spine Health: Tips for Gen Z Fitness Enthusiasts

Credit: iStock

Today, the fitness scene has gained much traction among the Gen Z population. With more and more young people spending time in the gym and working out, it is important for fitness enthusiasts to remember the importance of leg stiffness and its impact on spine health. Leg stiffness has the potential to cause unnecessary strain on the spine and back during workouts.

From a neurosurgical point of view, we see that the spine is not just a mechanical support structure but a sensitive pathway through which the spinal cord and nerve roots run. Repeated micro-strain caused by poor flexibility can cause young patients to suffer early degenerative changes that may cause nerve irritation.

We also see that strengthening the abdominal muscles is essential in stabilizing the spine, thereby preventing disc injuries. Early intervention in minor complaints, such as back stiffness or nerve pain, is essential in preventing more serious problems that may need surgical intervention.

The Link Between Leg Stiffness And Spine Health

The muscles in your legs are important for your spine's health. The hamstring, hip flexor, and calf muscles are all significant players in the movement and positioning of your spine. Leg stiffness has the potential to cause unnecessary strain on the spine and back. Leg stiffness limits the movement and positioning of the hips and the spine.

When these muscle groups are tight, they alter pelvic alignment and increase load on the lumbar spine. Over time, this abnormal biomechanics can lead to disc stress and facet joint overload.

In neurosurgical practice, we often see young patients presenting with early symptoms of nerve compression where underlying muscle imbalance and stiffness play a contributory role.

Common Gym Mistakes That Increase The Risk

For young people, the main focus in the gym is on strength training, while flexibility and rest are ignored. This makes the condition of the legs stiffer. Another common error is improper posture while performing certain exercises in the gym. When the legs and hips are inflexible, proper posture is difficult, which causes pressure on the spine.

Sitting for a long time, studying, playing games on gadgets, etc., causes the hip flexors and the hamstring muscles in the legs to become stiffer, which causes pressure on the spine.

From a clinical standpoint, improper lifting techniques combined with stiffness can increase the risk of lumbar disc prolapse and nerve root irritation, conditions frequently encountered in spine clinics.

Tips to Prevent Spine Problems In The Gym

  • Warm-ups: It is important to warm up the body before performing weightlifting exercises in the gym. It is recommended that the warm-up process take at least 5–10 minutes.

  • Flexibility: It is important to include flexibility exercises in the gym routine, as they help in the proper movement of the legs, which in turn helps in preventing spine problems.

  • Proper Posture: It is important to maintain proper posture while performing certain exercises in the gym, like squats, deadlifts, etc.

  • Stretching After Workouts: This will help in the release of tension in the muscles and prevent the buildup of stiffness.

  • Balance of Training and Recovery: This will help in maintaining the flexibility of the muscles and the spine.

Additionally, from a neurosurgical perspective, core strengthening plays a crucial role in stabilizing the spine and reducing the risk of disc-related injuries. Early attention to minor symptoms like back stiffness or radiating pain can prevent progression to more serious conditions requiring intervention.

Common Spine Problems To Avoid

Common spine problems to avoid during gym workouts include Herniated Disc, Sciatica, Spondylolisthesis, and Muscle Strain. These can occur from poor form, heavy lifting, or lack of warm-up.

In advanced cases, such conditions may lead to nerve compression requiring specialized evaluation and, rarely, surgical management. However, most of these issues are preventable with correct technique and conditioning.

Fitness enthusiasts in the Gen Z generation need to understand that it is very important to develop strength in the body while at the same time maintaining flexibility. The solution to the problem of a stiff leg is the foundation of protecting the spine and improving workout performance. This is achievable through the right warm-up, correct workout, and correct lifting.

Dr. Gaurav Batra is a Consultant - Neurosurgeon (Brain & Spine) at Max Hospital, Vaishali.

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