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.

Lemon water may help reduce the risk of certain types of kidney stones, particularly calcium oxalate stones, but it is not a guaranteed preventive remedy. Lemons contain citrate, a naturally occurring substance that can bind with calcium in urine and help inhibit the formation and growth of some kidney stones.

Drinking lemon water can also support prevention by encouraging greater fluid intake. Adequate hydration increases urine volume, diluting substances such as calcium and oxalate that can crystallise and form stones. However, the benefit depends on the amount consumed, individual urinary chemistry and the type of stone a person is prone to developing.

What Are the Symptoms of Kidney Stones?

Common symptoms of kidney stones include severe pain in the back or flanks that may radiate to the groin, pain while urinating, blood in the urine, nausea and vomiting. Some small stones may pass without causing noticeable symptoms, while larger stones can obstruct the urinary tract and cause significant pain.

If kidney stone symptoms occur alongside fever, chills or difficulty passing urine, seek urgent medical attention. These symptoms may indicate an obstruction or infection that requires prompt treatment. A healthcare professional may recommend urine tests, blood tests or imaging to determine the stone's size and location.

How Much Lemon Water Should You Drink?

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It is important to understand that lemon water is not a substitute for medical treatment or personalised dietary advice. Adding lemon to water without excessive sugar and salt is a practical option, but commercially prepared lemon drinks may contain added sugar, which is best limited. Lemon water may also aggravate acidity or heartburn in some individuals.

There is no universally established amount of lemon water that guarantees kidney stone prevention. The priority is to drink enough fluids to maintain adequate urine output, with individual requirements varying according to climate, physical activity and medical conditions. People who have been advised to restrict fluids because of kidney or heart conditions should follow their healthcare professional's recommendations rather than increasing their intake independently.

Who Should Take Extra Precautions?

People with a history of recurrent kidney stones should consult a healthcare professional to identify the stone type and understand their specific risk factors. Depending on the findings, they may need tailored fluid intake, dietary modifications or medication. A 24-hour urine test may also help identify substances that contribute to stone formation and guide preventive measures.

Adequate water intake remains the cornerstone of kidney stone prevention, while lemon water can be a useful addition to a balanced hydration routine. However, its effectiveness varies from person to person, and those at high risk of recurrence may need more targeted preventive strategies.

Inputs by Dr. Anupam Roy, Additional Director - Nephrology and Kidney Transplant, Aakash Healthcare Multi-Speciality Hospital, Dwarka

A 43-year-old mother from Northern Ireland got diagnosed with an exceptionally rare cancer after months of pain, continual bleeding and abdominal swelling. She said that these symptoms were initially and inaccurately attributed to perimenopause, anxiety and constipation.

Nicola Crymble’s symptoms started in 2024 after she had a copper intrauterine device (IUD) inserted. The bleeding and pain became so severe that she had the device removed while she was in Kenya doing mission work. “I was constantly bleeding, there was so much pain,” Crymble said.

However, her symptoms persisted even after she returned home. She said doctors initially suggested that perimenopause and anxiety could explain what she was experiencing.

By December 2024, Crymble had noticed a lump in her abdomen. It continued to grow, making everyday activities challenging. She said people even thought she was pregnant because of the swelling. She eventually went to hospital and underwent scans, which revealed a mass near her cervix. Doctors initially thought it might be a cyst.

Crymble Got Diagnosed With FATWO, A Rare Cancer

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Crymble underwent major surgery in February 2025 to remove the tumour. She also chose to have her ovaries and fallopian tubes removed during the procedure. A month later, she received the diagnosis that she had female adnexal tumour of probable Wolffian origin, commonly known as FATWO.

The tumour is believed to develop from remnants of the Wolffian duct, an embryonic structure involved in the development of the reproductive and urinary systems. Although these structures usually regress during female development, residual tissue can sometimes pave the way for tumour growth.

FATWO is an exceptionally rare form of cancer. There are only around 150 documented cases recorded worldwide. While many FATWO tumours do not metastatize, some can behave aggressively. In Crymble’s case, the cancer later spread to her liver and vaginal vault, the upper part of the vaginal canal.

She experienced intense pain beneath her ribs before a scan revealed that the cancer had spread. Further surgery was ruled out because the tumour growths were too close to other organs.

Chemotherapy As Surgery Was Not An Option

With surgery no longer an option, Crymble and her doctors decided to proceed with chemotherapy. She began treatment on October 13, 2026, and is expected to undergo six rounds, one every three weeks.

The family is also looking for specialist advice because there is limited information available about the rare disease and the best way to treat it. Her husband, Andrew Crymble, said doctors had little experience with the condition.

“They've never seen it before, they don't know how to treat it,” he said, explaining why the family decided to share her story publicly. They hope it will reach researchers or doctors who may have more information about FATWO.

Crymble has stopped working and has found it difficult to maintain her usual family routines while undergoing treatment. The family is also seeking financial support after discovering that their life insurance coverage will not cover the treatment.

Also read: Amgen & AstraZeneca's New Treatment Combination Cuts Advanced Lung Cancer Death Risk By 58% In Trial

Symptoms That Warrant Immediate Attention

Perimenopause can cause changes in menstrual patterns, like irregular periods. But unexplained bleeding, stubborn abdominal pain, lump or unusual swelling should not automatically be attributed to hormonal changes without seeking medical intervention.

These symptoms can occur due to many causes, and they do not necessarily indicate cancer. But worsening or unusual symptoms demand medical assessment, especially when they do not improve or when new symptoms develop.

The effects of heatwaves, air pollution, noise and overall climate change may extend beyond physical health. According to a new report by the Earth–Brain–Health Commission published in Nature Mental Health recently, they can have a significant impact on mood, cognitive function and overall psychological wellbeing.

The commission warns that environmental changes are altering the conditions in which people live. It also talks about consequences for brain health and mental wellbeing. It also calls for mental health to become a consideration in climate policy, urban planning and environmental decision making, rather than being treated only after symptoms develop.

The findings are relevant to low and middle-income countries, where exposure to environmental hazards can overlap with greater socioeconomic problems like poverty and limited access to healthcare.

“Heat and heatwaves, air and noise pollution, extreme weather and compound events, urbanization, and the loss of green and blue spaces are associated with depression, anxiety, cognitive decline, and impaired emotional and behavioral functioning,” the commission states.

Effects Of Environmental Conditions On Brain

Also read: Lancet Study Finds Air Pollution & Chemical Exposures Could Add To South Asia's Diabetes & Heart Disease Burden

From biological changes like neuroinflammation, disruption of hormones and the body's internal clock to psychological stress and due to isolation and displacement, the commission identifies several ways through which environmental conditions may impact mental health.

Heat exposure is one of the gravest concerns in current times. Heatwaves can disrupt sleep and contribute to physiological stress, while air pollution can lead to cognitive decline. Noise pollution and stressful urban environments may fuel anxiety and depression.

These exposures are compounded by people’s standard of living. A person living in poorly ventilated housing, for example, may face heat, air pollution, financial hardship and limited access to healthcare at the same time. These combined problems can be difficult to measure by studying each exposure separately.

Who Is At Risk?

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Children, older adults, people with disabilities and marginalised communities may face greater exposure to environmental hazards while having fewer resources and help to cope with them.

The commission also highlights low and middle-income countries and small island developing states. These populations may face significant environmental risks but remain underrepresented in research on climate change and mental health.

Dr Vivek Benegal, senior professor of psychiatry and former head of department at the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, is among the commission's members. He said NIMHANS has been examining how climate change affects the human brain.

Benegal also pointed to a 2023 study conducted by researchers from NIMHANS and King's College London. The study found that even low levels of arsenic exposure, below World Health Organization thresholds, were associated with changes in brain structure and impaired cognitive abilities among children, adolescents and young adults.

Commission's Recommendations

The report recommends that governments should incorporate brain and mental health measures into environmental policies. Its recommendations include monitoring environmental exposures, identifying risks early in life, and designing healthier urban environments.

“The principal obstacles to action are organisational and financial rather than evidential,” the commission observes, noting that research cohorts, Earth-observation systems and environmental governance tools already exist but are often maintained separately.