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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Fibroid Or Rare Cancer? When Common Symptoms Need A Second Opinion

Updated Sep 4, 2026 | 08:00 PM IST

SummaryUterine fibroids are common and benign, but their symptoms can resemble rare uterine sarcoma, highlighting why accurate diagnosis, MRI, monitoring, and second opinions matter.
cancer

Credits: Canva

A uterine growth diagnosis can be very alarming. That said, it is vital to note that such growths are often simple, run-of-the-mill fibroids. They are non-cancerous, very common, and completely harmless. At the same time, it is important to realise what uterine sarcoma is, and why fibroids are often confused with uterine sarcoma. It comes down to anatomy. The uterus consists mainly of smooth muscle tissue. A fibroid is just an overgrowth of this smooth muscle that expands over time. Uterine sarcoma is a rare cancer that originates within that very same muscle wall. Since both develop in the same spot, they tend to trigger identical symptoms—like unexpected bleeding, pelvic aching, or pressure.

Why Accurate Diagnosis Matters Before Surgery

Before starting treatment, it is important to fully understand what the diagnosis is, as that is the first step to safety.

Surgeons often treat routine fibroids with minimally invasive techniques. These methods break or chop the tissue into smaller fragments so it can be pulled through tiny incisions. If a growth, however, turns out to be an unsuspected sarcoma, breaking it apart inside the pelvis can spread malignant cells. A thorough diagnostic workup beforehand makes sure nothing gets disrupted accidentally, so that the surgical team builds the safest possible treatment plan.

What You Need to Know About Fibroids

Here is some genuine peace of mind: benign fibroids don't suddenly turn into cancer. Medical research shows that malignant transformation inside an existing fibroid is exceptionally rare. Because fibroids and sarcomas are biologically different conditions from the start, monitoring a standard fibroid does not put you at risk of it turning into a tumor down the line.

Most fibroids stay completely harmless throughout life. It is, however, important to watch out for a few specific red flags:

Post-menopause changes: Fibroids shrink on their own once hormone levels drop after menopause. Any new growth or spotting at this stage demands a closer look.

Growths that keep expanding on medication: If a mass gets bigger while one is on prescriptions designed to shrink it, the patient must seek out a secondary review.

Ambiguous scans: When a routine ultrasound shows atypical tissue structure, stepping up to advanced imaging helps clear up the picture.

Next Steps and Second Opinions

Following an ultrasound, it is recommended to opt for a dedicated pelvic MRI for a much sharper view of the uterine muscle wall to confirm whether a mass is truly benign.

Getting a second opinion from a specialist is a normal, proactive move. It is especially critical if:

  • A mass grows rapidly after menopause.
  • A patient develops new pelvic symptoms or bleeding years after your period has stopped.
  • The scans are flagged as atypical or difficult to read.

The good news is that uterine sarcomas are remarkably rare, making up just 2% to 5% of all uterine cancers. A patient needs to be cognizant by paying attention to changes in the body and asking questions about the scans.

Dr Bindhu KS - Sr. Consultant Obstetrics, Gynaecology & Robotic Surgery, Apollo Hospitals Navi Mumbai

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From Insulin Resistance to Fertility: Understanding the Metabolic Side of PCOS

Updated Sep 3, 2026 | 01:08 PM IST

SummaryPCOS can involve insulin resistance and metabolic changes that affect hormones, ovulation and fertility, making metabolic health an important part of managing the condition.
From Insulin Resistance to Fertility: Understanding the Metabolic Side of PCOS

Credit: AI

For many women, polycystic ovary syndrome (PCOS) begins with a familiar story—irregular periods, acne, unwanted hair growth or difficulty conceiving. But PCOS is far more than a reproductive disorder. At its core, it is often a complex interplay between metabolism, hormones and reproductive health.

One of the most important, yet frequently overlooked, pieces of this puzzle is insulin resistance. When the body becomes less responsive to insulin, the pancreas compensates by producing more.

Elevated insulin levels can, in turn, contribute to increased androgen production by the ovaries and disrupt the delicate hormonal signals required for regular ovulation. The result may be irregular cycles, fewer ovulations and, for some women, difficulty becoming pregnant.

PCOS And Insulin Resistance Can Affect Women Of Any Weight

Importantly, PCOS and insulin resistance are not synonymous with obesity. Women with a healthy body weight can also have significant metabolic abnormalities. This is why judging metabolic health by appearance alone can be misleading.

The 2023 International Evidence-based PCOS Guideline recognises insulin resistance as an important underlying feature and recommends attention to metabolic risk across the weight spectrum.

Also read: Decoding The Fertility Markers

The Metabolic Risks Go Beyond Fertility

The metabolic implications extend well beyond fertility. Women with PCOS have a higher risk of impaired glucose tolerance and type 2 diabetes, making long-term metabolic surveillance an important part of care.

The guideline recommends appropriate glycaemic assessment, particularly when pregnancy is being planned or fertility treatment is being considered.

Also read: Can Regular Consumption of Junk and Processed Food Affect Fertility?

Building A Healthier Foundation For Pregnancy

Yet there is an equally important message of hope: PCOS does not mean infertility, nor does it have to define a woman’s health journey. Lifestyle interventions—including regular physical activity, nutritious eating, adequate sleep and sustainable weight management where appropriate—form the foundation of care and can improve metabolic health.

For a woman planning pregnancy, the goal should not simply be to “get pregnant.” It should be to enter pregnancy metabolically and emotionally healthier, with blood sugar, blood pressure, nutrition, lifestyle and other risk factors appropriately addressed.

Take-home message: PCOS is not merely about irregular periods or cysts on the ovaries. It is a lifelong condition in which metabolic health and reproductive health are deeply connected. Recognising insulin resistance early, looking beyond weight, and providing personalised care can help women protect both their fertility today and their health for years to come.

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How An Inactive Lifestyle Is Damaging Your Knees

Updated Sep 3, 2026 | 09:56 AM IST

SummaryKnees are created for motion, and motion is essential for keeping the flexibility of a joint. The less active various leg muscles are, including quadriceps and other counterparts, the weaker they will be.
How An Inactive Lifestyle Is Damaging Your Knees

Credit: iStock

The view generally is that the occurrence of knee issues is usually associated with age, injury or overexertion. However, there is another reason people ignore: lack of movement. If a person leads an inactive lifestyle, spending long hours sitting at a desk, working from the couch, watching TV or doing nothing physical, the eventual consequences for the knees might arise.

Knees are created for motion, and motion is essential for keeping the flexibility of a joint. Their effective functioning depends on the health of the muscles surrounding your knee. The less active various leg muscles are, including quadriceps and other counterparts, the weaker they will be. The muscles help stabilize the knee and can relieve it from some of the burdens during daily activities performed by the knees.

Remaining seated for an extended time can also lead to stiffness. When you sit for a while, you may feel uncomfortable or stiff in your knees when you finally stand up. While the occasional instance of stiffness may go away with movement, constant stiffness can impact mobility and cause people to wish to move even less.

Another issue is gaining weight. Living a sedentary lifestyle causes individuals to become heavier, and excess weight puts more stress on the knees. In time, this added pressure will lead to increased wear of the joints and the development of knee pain and other problems in the musculoskeletal system.

The positive aspect with respect to your knees is that you don’t have to put in hours at the gym to keep them safe. Small, steady efforts can easily do the trick. You can choose to walk for five minutes after being seated for a long time, stretch regularly, take stairs if you are physically able and do some simple workouts for the legs and thighs to increase strength. Low-impact sports such as swimming, cycling and walking can help you maintain muscle power and flexible joints while avoiding the stress on your knees resulting from extensive workouts.

Persistent pain in the knee, however, cannot be treated as a usual symptom of ageing. Knee swelling or prolonged stiffness, difficulties climbing stairs, instability, or pain that has an impact on routine activities should be addressed by health professionals.

Movement is necessary for knees to be strong and flexible. Therefore, if you want your knees to be strong, you need to use them consistently and perform all activities without remaining still for long.

(By Dr Sujoy Bhattacharjee, Chairman & Chief, Max Institute of Robotic Joint Replacement, Max Super Speciality Hospital, Saket)

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