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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While thalassemia is known widely as a blood disorder, its impact can extend far beyond anemia and transfusions, said experts on World Thalassemia Day today.
World Thalassemia Day is observed every year on May 8 to raise awareness about the inherited blood disorder caused by faulty genes.
The disorder, which often requires blood transfusions every fortnight, affects approximately 1.3 million people living with severe forms of thalassemia worldwide. About 1.5 percent of the global population is carriers, and the disease claims nearly 11,000 lives annually.
Speaking to HealthandMe, health experts raised concerns about the growing mental health and neurological challenges faced by patients, especially children and young adults living with the condition.
Dr. Praveen Gupta, Chairman – Marengo Asia International Institute of Neuro & Spine (MAIINS), Gurugram, shared that repeated blood transfusions are important and save the lives of thalassemia patients, but long-term transfusion therapy can potentially lead to neurological complications if not properly monitored.
“Chronic transfusions can cause iron overload, which is the accumulation of iron in critical organs such as the brain, and may impact cognitive and psychological function, as well as mood,” Dr. Gupta explained.
He added that "changes in oxygen supply and related complications may make patients more vulnerable to headaches, lethargy, or even undetected brain injury".
However, experts stress that most neurological complications can be prevented through multidisciplinary care, iron chelation therapy, and regular monitoring.
The expert stated that thalassemia may also indirectly affect brain development in children, particularly when severe anemia continues for long periods and limits oxygen supply to the growing brain.
Dr. Gupta noted that poor oxygenation, nutritional deficiencies, iron overload from repeated transfusions, and metabolic complications may affect:
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Dr. Vipin Khandelwal, Sr. Consultant Paediatric Haemato Oncology & BMT at Apollo Hospitals Navi Mumbai, told HealthandMe that thalassemia affects the blood’s ability to carry oxygen, and prolonged disruption can impact growth, immunity, bone health, and learning abilities.
“The early signs of thalassemia are often subtle, which is why many families miss them until anemia becomes severe,” he said.
Parents should watch for persistent symptoms such as:
He stressed that while thalassemia is inherited, many serious complications can be prevented with early diagnosis, regular check-ups, timely transfusions, and proper iron monitoring.
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Further, the experts also highlighted risk of anxiety, stress, low self-esteem, and depression among people with thalassemia who face lifelong blood transfusions, frequent hospital visits, leading to physical fatigue, and fear of complications. Over time, these challenges may increase, many often go unnoticed or untreated.
Dr. Roshan Dikshit, Senior Consultant, Haematology & Bone Marrow Transplant at Aakash Healthcare, told HealthandMe that thalassemia is not only a physical health condition, but also an emotional and psychological challenge. He stressed the need to provide mental support to thalassemic patients.
“Frequent hospital visits, lifelong blood transfusions, fear of complications, and social limitations can increase the risk of anxiety, stress, and depression, especially among teenagers and young adults,” said Dr. Roshan Dikshit, Senior Consultant, Haematology & Bone Marrow Transplant at Aakash Healthcare.
According to Dr. Dikshit, many patients struggle with:
Importantly, these emotional challenges often go unnoticed.
“Mental health support should be considered an essential part of thalassemia care. Counseling, family support, social acceptance, and open communication can significantly improve a patient’s emotional well-being and quality of life,” he said.
He also emphasized that early psychological intervention can help patients cope better with the disease and reduce the long-term mental health burden associated with chronic illness.
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Many women experience bloating, acidity, stomach discomfort, or constipation from time to time. These symptoms are usually linked to diet, stress, or minor digestive issues. However, these are often overlooked.
On World Ovarian Cancer Day, doctors are urging women to pay closer attention to such recurring symptoms and seek timely medical advice.
World Ovarian Cancer Day is observed every year on May 8 to raise awareness about ovarian cancer and promote early detection. This year’s theme is “No Woman Left Behind.”
According to global estimates, nearly 250,000 women are diagnosed with ovarian cancer each year, and about 140,000 die from the disease.
Ovarian cancer is one of the deadliest gynecological cancers and is often referred to as the “silent killer” because its early symptoms are vague and easily mistaken for common digestive or urinary issues.
It develops when abnormal cells in the ovaries grow uncontrollably and may spread to other parts of the body. Survival rates are significantly higher when detected early—around 93 per cent of women diagnosed at stage one survive at least five years, compared to just 13 per cent at stage four, according to the American Cancer Society.
Unfortunately, many cases are diagnosed at advanced stages, when treatment options are limited, and outcomes are poorer.
“Ovarian cancer is commonly called a ‘silent disease’ because its early signs are vague and often resemble routine gastric issues,” Dr. Tejinder Kataria, Chairperson – Radiation Oncology, Medanta Hospital, Gurugram, told HealthandMe.
Common symptoms include:
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One should not ignore these symptoms if they persist for more than two to three weeks.
“Many women delay seeking medical attention because these symptoms feel too common to be serious. Early evaluation through clinical examination, imaging, and blood tests can help detect the disease earlier,” Dr Kaur noted.
“The growing tumor can press on nearby organs such as the intestines or bladder, leading to digestive changes and abdominal discomfort,” she explained.
The experts also highlighted several risk factors that are often overlooked, including:
Being aware of subtle and persistent symptoms can significantly improve outcomes. Ovarian cancer survival rates are much higher when diagnosed early, making timely medical consultation crucial.
Anaemia associated with thalassemia itself may increase fatigue and reduce oxygen supply to both mother and baby if not carefully monitored. (Photo credit: iStock)
Thalassemia, particularly thalassemia major and thalassemia intermediate, can affect fertility and pregnancy due to iron overload caused by repeated blood transfusions. In these patients, excess iron gets deposited in various endocrine and vital organs, leading to hormonal disturbances and fertility-related complications.
Patients with thalassemia major usually require regular blood transfusions for survival, sometimes every one to three months. Thalassemia intermediate patients may require fewer transfusions, but they too remain at risk of iron overload. Over time, excess iron can accumulate in organs such as the pituitary gland, thyroid, ovaries, kidneys, liver, and suprarenal glands. This iron deposition can impair hormonal function and contribute to infertility. Experts note that many patients with thalassemia major may face fertility issues because of this reason.
Dr. Sunil Bichile, Hematologist, Saifee Hospital, Mumbai, said, "Although thalassemia management has improved significantly over the years, pregnancy in such patients is still considered high-risk. " Even when iron levels are properly managed, risks to both the mother and fetus may still exist. However, these complications are mainly seen in thalassemia major and thalassemia intermediate patients. Individuals with thalassemia minor generally do not face these fertility or pregnancy-related issues and can have normal pregnancies."
"Doctors also emphasise the importance of carrier screening and prenatal diagnosis. If both partners are thalassemia carriers, prenatal testing around 12 weeks of pregnancy can help determine whether the fetus has thalassemia major. Early diagnosis allows families and doctors to make informed medical decisions and helps reduce severe thalassemia cases," Dr Bichile added.
Women with thalassemia are now increasingly able to experience healthy pregnancies due to advances in medical care. However, one of the most important concerns during pregnancy in thalassemia patients is iron overload—a condition caused by repeated blood transfusions over many years. Excess iron gets deposited in vital organs such as the heart, liver, and endocrine glands, potentially leading to serious complications if not managed properly before conception and during pregnancy.
"Iron overload can significantly increase pregnancy-related risks. When excess iron affects the heart, it may lead to cardiac complications such as arrhythmias or heart failure, which can worsen during pregnancy because of the increased workload on the cardiovascular system. Iron deposition in endocrine glands may also cause hormonal imbalances, affecting fertility and increasing the risk of gestational diabetes, thyroid disorders, or difficulties in maintaining a healthy pregnancy," Dr Liza Bulsara, Pediatric Hematologist and Oncologist, Ruby Hall Clinic, Pune, explained.
Women with poorly controlled iron overload may face a higher chance of miscarriage, fetal growth restriction, preterm delivery, or complications during childbirth. In some cases, liver dysfunction caused by iron accumulation can further complicate pregnancy management. Additionally, anaemia associated with thalassemia itself may increase fatigue and reduce oxygen supply to both mother and baby if not carefully monitored.
Dr Bulsara emphasised that pre-pregnancy counselling is essential for women with thalassemia. A detailed assessment of iron levels through serum ferritin tests and MRI evaluation of the heart and liver helps doctors determine whether the body is prepared for pregnancy. Proper iron chelation therapy before conception plays a crucial role in reducing excess iron stores and improving maternal outcomes. During pregnancy, transfusion schedules, haemoglobin levels, cardiac health, and fetal growth require close multidisciplinary monitoring.
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