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.
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.”
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.
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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When we think of perimenopause, irregular periods, hot flashes and mood changes usually come to mind. But the transition to menopause is not limited to the menstrual cycle. Behind the scenes, changing ovarian hormones—particularly fluctuating and eventually declining estrogen—can influence body composition, insulin sensitivity, cholesterol levels, bone health and cardiovascular risk.
For many women, these metabolic changes begin years before their final menstrual period.
A common concern during perimenopause is: “I haven’t changed my diet, so why am I gaining weight around my abdomen?”
Ageing itself contributes to gradual loss of muscle mass and changes in energy expenditure. At the same time, the menopausal transition is associated with a shift in fat distribution, with a greater tendency to accumulate visceral or abdominal fat.
This matters because visceral fat is metabolically active. An increase in abdominal fat can be associated with insulin resistance, abnormal cholesterol levels and a higher risk of metabolic disease. So, the change in waist circumference may sometimes tell us more about metabolic health than the number on the weighing scale alone.
Also read: After Menopause, These Breast Changes Shouldn’t Be Ignored
Estrogen interacts with several pathways involved in glucose and fat metabolism. During midlife, changes in body composition, reduced physical activity, sleep disturbance and hormonal changes can collectively make insulin sensitivity less favourable.
This does not mean every woman going through perimenopause will develop diabetes. However, women who already have risk factors—such as overweight or obesity, prediabetes, a history of gestational diabetes or a strong family history of type 2 diabetes—should be particularly mindful.
The menopausal transition can also be accompanied by unfavourable changes in the lipid profile, including changes in LDL cholesterol. Cardiovascular risk increases with age, and menopause is an important time to reassess risk factors such as blood pressure, glucose, cholesterol, smoking, physical activity and body composition.
Women often spend years focusing on reproductive health while overlooking these equally important metabolic markers.
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Midlife is also an important period for protecting muscle and bone. Declining estrogen after menopause accelerates bone loss, while ageing contributes to loss of muscle mass.
Resistance training therefore becomes especially valuable. Adequate protein intake, regular weight-bearing exercise, sufficient calcium and vitamin D, good sleep and avoiding smoking can support healthier ageing.
Perimenopause should not be viewed as a disease, nor should every symptom or kilogram gained in midlife automatically be blamed on hormones. Instead, it is an opportunity for a metabolic health check.
Women should discuss appropriate screening for blood pressure, blood glucose or HbA1c, lipid profile, weight and waist circumference monitoring , DEXA scan for bone health, depending on their individual risk factors.
Most importantly, don’t wait for menopause to start thinking about metabolic health. The perimenopausal years can be an important window to build muscle, improve fitness, optimise nutrition and identify metabolic risk early.
Perimenopause is more than a change in periods—it is a transition in whole-body health. Understanding these changes early can help women enter the next phase of life stronger, healthier and better prepared.
(By Dr. Seema Daksh, MBBS, MD (Internal Medicine), DM (Endocrinology), Consultant Endocrinologist,Kailash Hospital, Greater Noida)
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From haunted houses and sudden scares to sweet treats and costumes, Halloween fun can come with hidden health risks, particularly for people with existing heart and lung conditions.
Experts explain how sudden fright, excessive sugar and common activities on Halloween, observed on October 31, can affect heart and lung health.
A sudden scare activates the body's sympathetic nervous system, raising heart rate and blood pressure while constricting blood vessels.
This response is usually harmless in healthy people, but may pose risks for those with arrhythmias, coronary artery disease or a history of stents or heart surgery.
A racing heartbeat should settle after the scare. Persistent palpitations, dizziness, shortness of breath, chest pain or tightness, nausea, sweating or fainting warrant medical attention, says Dr Mohamed Gabr, cardiologist and electrophysiologist at Baylor College of Medicine.
In addition, excessive consumption of sugar candies during Halloween can contribute to obesity, diabetes, high blood pressure and unhealthy cholesterol levels. Cholesterol and plaque buildup in the coronary arteries can begin at a young age.
Also read: You Feel Healthy. But Plaque May Already Be Building In Your Arteries In Your 20s
Halloween activities can expose people with asthma to several triggers. Ragweed pollen, mould on damp fallen leaves and cold, dry air can worsen symptoms during autumn, according to the American Lung Association.
Fog machines and dry ice effects in haunted houses can release water droplets and chemicals, including glycol-based solvents, that may irritate airways. Glitter machines, bonfire smoke, dust from stored costumes and decorations, and strong fragrances can also trigger symptoms.
Dr Rubabin Tooba, a pulmonologist with Northwestern Medicine, says these exposures may cause coughing, wheezing, breathlessness and chest tightness, particularly in people with asthma, severe allergies or COPD. Tight-fitting masks can also make breathing difficult.
Fear, excitement and laughter may trigger asthma symptoms in some people. Trick-or-treating can bring additional exposure to pet dander, scented candles, cigarette smoke and fireplace fumes.
Read More: Why Are Asthma Cases Rising Among Young Kids? Early Symptoms Parents Must Not Ignore
The US Consumer Product Safety Commission (CPSC) estimates that an annual average of 3,200 Halloween-related injuries were treated in US emergency departments over a recent three-year period.
Pumpkin carving accounted for 55% of these injuries, while 25% were related to falls while putting up decorations, tripping on costumes or walking while trick-or-treating. The remaining 20% involved lacerations, ingestions, allergic reactions and other costume- or decoration-related injuries.
Children younger than 18 years accounted for 46% of injuries, with approximately 10% occurring in children aged 6 years or younger.
The Plastic Hand Trauma Unit at Royal Devon and Exeter Hospital has also treated patients with deep cuts, severed tendons and nerve damage from pumpkin carving, BBC reported.
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When women suffer from interrupted sleep, continuous discomfort or mood swings during mid-life, saying “it’s just the aging” must not conclude the conversation. It is true that menopause is a physiological condition, but when there are concerns that disrupt day-to-day activities, these have to be sorted out. This is key to improving the healthcare experience for women.
Midlife healthcare issues must have a place within India’s healthcare debate right along with menstruation, pregnancy, and childbirth. Women need knowledge, support, and care around menopause.
Menopause is usually diagnosed once a woman goes for an entire year without a period, with no other causes involved. However, symptoms of menopause can become evident much earlier during the stage of perimenopause, long before the end of the periods.
These include insomnia, anxiety, difficulties with concentration, vaginal dryness, bladder problems, and pain in the joints that can affect one’s social life, work, and self-esteem. The experiences of women during their menopausal period can be very different since some women experience mild symptoms while others need medical help.
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There is a need for creating an environment that will facilitate such questions, especially regarding painful intercourse, incontinence of urine and psychological status. During a good consultation, a history of menstruation, symptoms, medication being taken and other medical conditions must be discussed. There is also need to define what changes need evaluation.
Postmenopausal bleeding is always an indication for seeking medical care. The access to health services can be facilitated through dissemination of information in local languages and referral process.
There is no such thing as a single treatment for menopause that will be applicable to all women. Treatment includes lifestyle modification, counselling, administration of medications except hormones, and the use of vaginal or menopausal hormones.
While hormone therapy assists in easing certain symptoms, it is necessary to consider this treatment on an individual basis, taking into consideration advantages and disadvantages, as well as the health history of each person. It is vital that women are informed about different kinds of treatment methods and are able to decide on issues related to their health care.
The other use of midlife appointments can be discussing bones, exercise, nutrition, high blood pressure, risk of getting diabetes, and associated tests. This should be a supplementary measure rather than a replacement for addressing symptoms.
The home and work environment can assist through being sympathetic to women receiving treatment without embarrassment. Involving menopause in the field of healthcare translates to valuing the quality of life as a significant health concern. It should never come to a point whereby a natural occurrence becomes a barrier for the accessibility of information.
By Dr. Priya Gupta, Senior Consultant, Obstetrics & Gynaecology, Cocoon Hospital Jaipur
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