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.

A few months ago, a successful 36-year-old corporate executive sat across from me and said, “Doctor, I thought I had time. Nobody told me fertility could decline this fast.” A week later, I met a 27-year-old woman with severe PCOS who assumed she would face infertility in the future, when in reality, early intervention could significantly improve her chances of natural conception.

These conversations have become increasingly common in my practice and reflect an important reality: women today are more educated, financially independent, and health-conscious than ever before, yet fertility awareness remains surprisingly low. Fertility challenges in India are hard on the couple, especially on the woman, sadly, because of family expectations, interference, unconscious and conscious biases, and social stigma.

Infertility: A Growing Concern

Globally, infertility affects nearly one in six people during their reproductive years. In India alone, an estimated 15–20 million couples struggle with infertility. Studies suggest that infertility prevalence in India ranges between 4% and 17%, with urban areas showing a steady rise. Delayed marriages, late pregnancies, stress, obesity, sedentary lifestyles, environmental pollution, and hormonal disorders such as PCOS are major contributors.

One of the biggest misconceptions women have is that fertility remains stable until menopause. Biologically, this is simply not true. Female fertility peaks during the 20s. A healthy woman in her twenties has roughly a 25–30% chance of conceiving each month naturally.

By the early thirties, this falls to around 20%, and after the age of 35, fertility declines more rapidly because both the number and quality of eggs decrease significantly. By the age of 40, the monthly chance of natural conception may drop below 10%.

Understanding Ovarian Reserve

Unlike men, women are born with all the eggs they will ever have. As age advances, ovarian reserve naturally diminishes. This decline cannot be reversed by fitness, good looks, supplements, or expensive wellness treatments. While healthy living certainly improves reproductive health, it cannot stop the biological aging of the ovaries.

In modern India, many women are delaying pregnancy due to career aspirations, financial planning, late marriages, or simply the desire to achieve personal goals first. While these are valid choices, fertility awareness must become part of those decisions. Assisted reproductive technologies such as IVF have created a perception that pregnancy can be achieved at any age. However, even IVF success rates decline significantly with advancing maternal age because egg quality remains the most critical factor.

How Lifestyle Choices Affect Fertility

Lifestyle has emerged as a major fertility influencer. Smoking, vaping, obesity, excessive alcohol intake, poor sleep, chronic stress, and lack of physical activity negatively affect reproductive health. Environmental toxins deserve special attention. Exposure to plastics, pesticides, industrial pollutants, and endocrine-disrupting chemicals is increasingly being linked to declining fertility in both men and women. Fertility specialists across India are also reporting

worsening sperm quality, highlighting that infertility is not solely a female issue. Male factors contribute to nearly 40–50% of infertility cases.

The encouraging news is that timely lifestyle changes can make a meaningful difference. Maintaining a healthy weight, exercising regularly, consuming a balanced diet, reducing processed foods, improving sleep quality, and managing stress through yoga or mindfulness can support fertility and overall reproductive health.

Why Early Fertility Testing Matters

Women should also become proactive about fertility assessment. Simple investigations such as Anti-Müllerian Hormone (AMH) testing, pelvic ultrasound for ovarian reserve, thyroid evaluation, vitamin D levels, and screening for PCOS can provide valuable information. A semen analysis for the male partner remains an essential component of infertility evaluation.

So when should a woman seek medical help? Women below 35 should consult a fertility specialist if pregnancy has not occurred after one year of regular unprotected intercourse. For women above 35, evaluation should begin after six months. Immediate consultation is advisable for women with irregular periods, endometriosis, PCOS, recurrent miscarriages, pelvic infections, or a family history of early menopause. There is a possibility of preserving eggs or embryos for women and couples who do not want to get pregnant before the age of 34 years. But that also needs to be done in a timely manner.

Pregnancy After 35: Understanding the Risks

Pregnancy after 35 is increasingly common and often successful, but it carries higher risks. These include miscarriage, gestational diabetes, hypertension, chromosomal abnormalities such as Down syndrome, preterm birth, and a greater likelihood of cesarean delivery. Fortunately, with early prenatal care and appropriate monitoring, most women can still achieve healthy pregnancy outcomes.

The most important message I would like every young woman to understand is this: fertility is not just about becoming pregnant—it is about understanding your reproductive timeline before biology begins making decisions on your behalf. Women today plan their education, careers, finances, and investments meticulously. Fertility deserves the same foresight.

Awareness in your twenties may protect your choices in your thirties. In reproductive health, knowledge is not just for power but also for exploring possibilities and making the right decisions.

When a woman who maintains a healthy lifestyle, exercises regularly, follows a balanced diet, and never skips her annual health screenings, but is still diagnosed with breast cancer, it sends shockwaves far beyond her personal circle.

Each such case, particularly when it involves a celebrity or influencer, often sparks anxiety and a flood of questions for oncologists, with one concern standing out above all: if someone so health-conscious can develop breast cancer, is anyone truly safe?

The fear is natural. Yet, doctors consistently emphasize that regular screening, timely medical attention, and early detection remain the strongest tools in successfully treating breast cancer and helping patients lead healthy, cancer-free lives.

Can a Healthy Lifestyle Guarantee Protection?

Science does not have a precise answer for who is immune to breast cancer and who is not. What we do know is that a healthy lifestyle and consistent monitoring lower risk and improve outcomes compared to those who discover the condition at Stage 2 or beyond.

Women deal with a myriad of hormone-related issues. When combined with BRCA1 and BRCA2 gene mutations, inherited genetic changes that significantly raise the risk of breast and ovarian cancers, and external environmental factors, the likelihood of breast cancer incidence increases.

There is a caveat. The proactiveness of health-conscious individuals helps keep many hormonal issues in check. Which means, when cancer does develop, it is more likely to be detected early, enabling better treatment and improved clinical outcomes.

When Did You Last Examine Yourself?

This is for every woman over 20; if you spend 10 minutes once a month for self-examination, it can go a long way in catching a major risk early.

Examine your breasts a few days after your period, feeling for any lump or thickness in the breast or underarm area. Use a mirror to check for changes in size, shape, contour, skin redness, or dimpling. Persistent pain beyond your period, nipple inversion, soreness, or discharge are signs to take the next step: a mammogram and specialist consultation.

Mammogram Is A Non-Negotiable

Mammograms use X-rays to detect even the tiniest growths, and the frequency of the test depends on age and risk factors.

The first segment is those between the ages of 40 - 49: In most cases, women up to the age of 50 are recommended annual tests, but it is critical for those with dense breast tissue or a family history of breast cancer. Discuss with your doctor if you require a bi-annual mammogram.

The second category is between the ages of 50 - 75, and annual mammograms are a nonnegotiable. Given the higher incidence, Bi-annual tests are increasingly being advised by specialists.

The third segment is the High-risk category with detected BRCA mutation, family history, and prior breast biopsies. Screening for this segment begins around 30 and may include MRI alongside mammography and a personalized screening plan considering the criticality.

Hidden Threats in Everyday Life

Urban living brings a certain level of carcinogenic exposure through smoking, chemicals in food and cosmetics, air pollution, and industrial toxins, all of which elevate the risk. Chronic stress, an output of corporate and city life, compounds the burden further. This is precisely where being healthy and fit matters most. Conscious lifestyle choices help women respond to the condition better than those without them.

Bringing in a change, however, requires a domino effect; one woman who gets screened encourages another, and slowly a larger community begins to speak openly about cancer, ask questions, and seek answers without fear of judgment.

The discomfort of a mammogram lasts only seconds. The consequences of a late-stage diagnosis last far longer.

High blood pressure is often called the “silent killer.” Unlike fever, pain, or breathlessness, elevated blood pressure may not produce any warning signs for years. Many individuals continue their daily routines feeling completely normal, while hidden damage slowly affects the heart, brain, kidneys, and blood vessels.

The Myth: “I Feel Fine, So My Blood Pressure Must Be Normal”

A person may have blood pressure readings of 160/100 mmHg or higher and still feel perfectly healthy. Unfortunately, by the time symptoms appear, complications may already have developed. Some patients discover hypertension only after a heart attack, stroke, kidney disease, or vision disturbance. This is why regular blood pressure monitoring is crucial.

Why Hypertension Is Increasing in Modern India

India is witnessing a major lifestyle transition. Urbanization, technology-driven work culture, and changing dietary patterns have significantly increased cardiovascular risk factors.

1. Sedentary Lifestyle

Many people spend 8–10 hours sitting in offices, working on computers, attending virtual meetings, or commuting in traffic. Physical activity has drastically reduced, especially in urban populations. Lack of exercise contributes to obesity, diabetes, stress, and elevated blood pressure.

Even younger adults in their 30s and 40s are now being diagnosed with hypertension, which was once considered a disease of older age.

2. Fast Food and High Salt Intake

Processed foods, packaged snacks, restaurant meals, and fast foods are often high in salt, unhealthy fats, and preservatives. The World Health Organization (WHO) recommends that adults consume less than 5 g of salt per day. However, studies and national public health campaigns such as Eat Right India report that the average Indian adult consumes nearly 10–12 g of salt daily.

Additionally, a recent survey among patients with Stage 2 hypertension indicated that nearly half (49.3%) did not follow a salt-restricted diet, while 55.5% were obese. These findings highlight poor adherence to lifestyle modifications even in patients with dangerously high blood pressure.

3. Stress and Mental Fatigue

Modern lifestyles come with constant deadlines, financial pressures, social expectations, and digital overload. Poor sleep, anxiety, and lack of work-life balance also play a significant role in cardiovascular health.

The Growing Concern Among Working Women

Today’s women frequently manage dual responsibilities, professional commitments, along with household and family duties. Long work hours, irregular meals, stress, lack of sleep, and limited time for self-care can silently affect their health.

Many women ignore routine health check-ups because they prioritize family needs over their own well-being. Additionally, conditions such as pregnancy-related hypertension, menopause, obesity, thyroid disorders, and diabetes can further increase cardiovascular risk in women.

Why Early Monitoring Matters More Than Ever

Hypertension detected early can often be controlled effectively through lifestyle modifications and timely treatment.

• Early monitoring helps:
• Detect silent hypertension before complications develop
• Prevent heart attacks and strokes
• Reduce the risk of kidney disease and heart failure

A simple blood pressure check takes only a few minutes but can prevent life-threatening complications in the future.

Who Should Monitor Blood Pressure Regularly?

Every adult above 18 years should know their blood pressure status. However, regular monitoring becomes especially important for:

• Individuals above 30 years
• People with diabetes or obesity
• Smokers or tobacco users
• Individuals with a family history of hypertension or heart disease
• People with stressful jobs or sedentary lifestyles
• Women with a history of pregnancy-related hypertension

Home Monitoring: A Useful Habit

Regular home monitoring can help detect blood pressure fluctuations early and improve treatment adherence. However, patients should use validated devices and follow correct measurement techniques. Importantly, patients should not self-medicate or stop medicines without consulting their doctor.

Hypertension is no longer a disease limited to older adults. It is increasingly affecting young professionals, homemakers, entrepreneurs, and working women living under constant stress and sedentary routines. The absence of symptoms does not mean the absence of disease. Your blood pressure may be silently affecting your body long before you notice any warning signs. Early monitoring provides an opportunity to act before complications can occur.