Independence
Routine cognitive testing could help older adults make safer decisions around driving, finds study

The findings of a new study say routine cognitive testing may help older drivers and their physicians make better decisions about driving to maximise safety while preserving independence as long as possible.
One of the thorniest decisions facing older adults is when to give up their keys and stop driving, but a new study by researchers at Washington University School of Medicine in St. Louis could provide guidance in helping seniors plan ahead.
The researchers found that impaired cognitive function foreshadows the decision for many seniors to stop driving — more so than age or molecular signs of Alzheimer’s disease. Even very slight cognitive changes are a sign that retirement from driving is imminent. Further, women are more likely to stop driving than men, the study showed.
The findings suggest that routine cognitive testing — in particular, the kind of screening designed to pick up the earliest, most subtle decline — could help older adults and their physicians make decisions about driving to maximise safety while preserving independence as long as possible.
“Many older drivers are aware of changes occurring as they age, including subjective cognitive decline,” said corresponding author Ganesh M. Babulal, PhD, OTD, an associate professor of neurology.
“Doctors should discuss such changes with their older patients. If risk is identified early, there is more time to support the remaining capacity and skills, extending the time they can drive safely, and to plan for a transition to alternative transportation options to maintain their independence when the time comes to stop driving.”
Adults over age 65 are the most careful drivers on the road. They are less likely than drivers in any other age group to speed or to drive in bad weather, at night or under the influence of substances.
Despite these precautions, age-related changes such as slower reaction time, impaired vision and cognitive decline still put older drivers at risk of crashes, and when such crashes happen, older drivers are more likely to be killed or seriously injured than younger drivers are. At the same time, giving up driving is not without its own risks. People who stop driving are more likely to develop depression and become isolated.
The American Academy of Neurology concluded in 2010 that cognitive impairment, as measured by a score greater than zero on the Clinical Dementia Rating (CDR) scale, was the best predictor of stopping driving.
The CDR scale goes from zero, indicating normal cognitive function, to three, indicating severe dementia. But the CDR, which was developed at Washington University in 1982, is designed to detect impairments significant enough to affect daily life. Studies have shown that a person’s cognitive skills can deteriorate for years before a CDR score indicates trouble.
Babulal and colleagues set out to determine the role of other factors, including subtle cognitive changes, in the decision to step away from the wheel. They studied 283 people with an average age of 72 who drove at least once a week and who had no cognitive impairments at the start of the study. The researchers were primarily interested in determining when and why each participant stopped driving.
The participants underwent cognitive tests at the start and then every year for an average of 5.6 years. The cognitive testing included the CDR and a preclinical Alzheimer’s cognitive composite (PACC) score, which is designed to detect subtle cognitive changes in people who score as unimpaired on the CDR. The participants also underwent brain scans and donated cerebrospinal fluid at the start of the study and then every two to three years, so the researchers could look for molecular signs of Alzheimer’s disease. At baseline, about one-third of the people met the criteria for preclinical Alzheimer’s disease based on levels of biomarkers for the disease — amyloid plaques and tau tangles — in the brain and cerebrospinal fluid.
During the study, 24 people stopped driving, 15 people died, and 46 people developed cognitive impairment as measured by a CDR score greater than zero.
Analysis showed that three factors predicted who would stop driving during the study: cognitive impairment, worsening PACC scores, and being a woman. People who met the criteria for cognitive impairment by scoring 0.5 or greater on the CDR were 3.5 times more likely to stop driving than were those who remained at zero, and people with lower scores on the PACC were 30 per cent more likely to stop driving than were those with higher scores. Age and the presence of biomarkers of Alzheimer’s disease were not tied to the decision to stop driving.
The biggest effect was seen regarding gender, with women four times more likely to stop driving during the course of the study than men were.
“We know from past studies that there isn’t a difference in driving ability between men and women,” Babulal said.
“What we have shown in prior work is that women are often more aware of their abilities, are more willing to admit that they are no longer able to safely drive, and plan more in advance to transition out of driving compared to their male counterparts. It is highly recommended that older male drivers talk with their providers about driving and consider stopping driving earlier.”
Doctors do not routinely counsel older patients on driving cessation, a fact that Babulal sees as a missed opportunity to promote healthy ageing.
“There are things we can do to help people adapt to age-related changes,” Babulal said. “Driver rehabilitation programs, often led by occupational therapists, can provide specialised training and strategies for older drivers to adjust to physical and cognitive changes to maintain driving capacity.
“Community support programs provide a forum for older adults to share experiences and learn from each other about safe driving practices and alternative transportation options. Ultimately, most people will need to stop driving, but by starting the conversation early, we can better support older adults’ independence and quality of life.”
News
Forus gains AI backing with 21 per cent stake

Eye-screening firm Forus Health has received a 21 per cent investment to scale its AI diagnostics across India and abroad.
Forus Health develops ophthalmic diagnostics — tools that detect eye disease — and “oculomics”, which uses eye images to flag wider risks such as diabetes or hypertension. Its devices have screened over 22 million people in more than 75 countries, and its AI-integrated platform has delivered comprehensive eye assessments to over five million patients.
The deal is a secondary transaction intended to support the scale-up of Forus Health’s AI eye-screening platforms and international deployment.
Inviga Healthcare Fund has acquired the 21 per cent stake, its second major investment after Mynvax in 2024, signalling support for India-built AI diagnostics in global markets.
Dr B. S. Ajaikumar, founder of Inviga Healthcare Fund and chair of HCG, said: “Forus Health embodies the Inviga ethos: clinically strong, technologically deep, socially impactful, growth oriented, profitable. This investment is a testament to our confidence in India’s ability to produce world-class healthcare innovations for domestic and international markets. We are delighted to partner with visionary founders like Chandrasekhar (KC) who combine deep insight with execution to make preventive, equitable healthcare a reality.”
K. Chandrasekhar, founder and chief executive of Forus Health, said: “We are thrilled to welcome Inviga as we enter the next phase of our growth. Their expertise in healthcare, operational experience, and insights from a clinician’s perspective are incredibly valuable. Together, we aim to enhance our AI and platform capabilities, utilise our proven ability to innovate in medical devices, and expand our reach both in India and globally. Our mission remains focused on eradicating preventable blindness.”
Rakshith Rangarajan, fund manager at Inviga Healthcare Fund, said: “Our collaboration with Forus is a strategic step intended to facilitate the expansion of a reputed med-tech franchise that is serving a significant market demand through a sustainable and economically sound business model. It reflects our commitment to advancing accessible solutions that address large, unsolved health challenges. The Make in India, Make for India and Make for the World ethos of Forus resonates deeply with our Fund. We’re confident this partnership will drive sustained growth and long-term value creation.”
The burden underscores the need for scalable tools: an estimated 270 million people in India live with visual impairment, much of it preventable; globally, 2.2bn people live with vision impairment or blindness, with over 1bn cases considered preventable or treatable. Forus Health’s 3nethra screening devices and wearable 3nethra specto — a smartphone-operated digital refractor for remote and tele-optometry — target earlier detection and easier access to care.
News
Snoring, silence, and the menopause taboo: The hidden health crisis affecting millions

By Professor Ama Johal, clinical lead and dental sleep expert at Aerox Health
During menopause, it’s very common for women to notice significant changes to their sleep patterns and experience things like restless nights, loud snoring, or simply waking up feeling exhausted.
What most don’t realise, however, is that these symptoms can signal something far more serious – obstructive sleep apnoea (OSA), one of the most impactful and consequential sleep-related breathing disorders.
Women across the world are unknowingly fighting an uphill battle. Around 90 per cent of females with moderate to severe sleep apnoea remain undiagnosed.
This collective lack of awareness is due to a plethora of factors including archaic taboos around the subject and lack of education or omission of menopause in sexual education.
Ultimately, this combination leaves women underprepared and vulnerable to the biological, social and medical realities associated with the menopause.
Now more than ever, we must confront this silence head-on and recognise the hidden sleep crisis affecting so many women globally and the opportunity to address it.
The hidden sleep crisis
Snoring that develops or worsens during menopause can progress into OSA due to a decline in estrogen and progesterone which reduces muscle tone in the throat and in turn makes the obstruction or collapse of the airways more likely during sleep.
Yet this link between menopause and sleep disorders remains largely overlooked, leaving millions of women undiagnosed, untreated, and unaware that their sleep struggles are more than just “part of getting older”.
In my practice, I see the consequences of this misunderstanding far too often.
I hear from many female patients who have been suffering in silence, without the knowledge that they could seek help. In fact, I often encounter the common misconception that snoring is a man’s issue.
This preconceived notion perpetuates a persistent gender bias in sleep-related health research.
As ENT consultant and sleep surgeon at University College London hospitals, Ryan Chin Taw Cheong recently highlighted, the development of snoring is reason enough to consult your doctor. It’s time for this pervasive issue to emerge from the dark.
So why don’t women seek help?
When considering why many women do not seek help for their symptoms, there are two overarching reasons.
Firstly, the information and knowledge is not widely available for sufferers to realise that snoring can be a medical issue which can be assessed and subsequently readily treated.
Secondly, there is a potent stigma surrounding both the menopause and snoring which is an inhibiting factor amongst sufferers, discouraging open discussion.
Perhaps unsurprisingly, menopause is not included in traditional sex education in schools. Being unaware of what is ‘normal’ and what could require medical attention is widespread amongst my patients with sleep disorders, yet this information is not freely disseminated outside of clinics.
Unfortunately, cognitive fog and irritability – symptoms of snoring and obstructive sleep apnoea – are too often written off as stress, anxiety or ‘just the menopause’.
Avoiding sharing symptoms with medical providers, combined with online misinformation, often results in individuals suffering in silence or worse, turning to unregulated miracle menopause cures that exacerbate the risks of undiagnosed OSA.
These so-called ‘cures’ reinforce the harmful notion that the menopause is a defect which needs to be fixed rather than a natural life stage.
The health costs of ignoring snoring
A breadth of research links untreated OSA to cardiovascular disease, hypertension and cognitive decline.
However, aside from the medical risks, snoring and sleep apnoea can have profound social and emotional consequences.
For women, the shame in snoring, a symptom often mischaracterised as a ‘male issue’, can significantly affect self esteem and mental health.
Partners may also suffer if the snoring is disruptive to their sleep, in some instances causing rifts in relationships and a phenomena known as ‘sleep divorces’ (sleeping in separate beds or rooms).
In fact, according to a recent study commissioned by 32Co, 47% of recently divorced Brits cite interrupted sleep linked to snoring or sleep disorders as contributing to their relationship breakdowns, with 85 per cent believing ‘sleep divorces’ contributed to ultimate separation.
Sleep specialists seek to manage and monitor the symptoms of sleep disorders and OSA to minimise disruption to an individual’s personal and public life.
Screening menopausal women for OSA is a preventative measure which leads to informed patients. It is not simply about getting better sleep but about the long-term health outcomes.
Breaking the silence: what needs to change
Drawing on the stories of those I meet in my clinic, I would like to outline five steps that we can take to address this silent epidemic.
First, the menopause and associated symptoms should be included in a comprehensive sex and health education.
This could be provided both in schools’ curricula and made readily available at health services catering to adults.
Second, throughout the course of history women’s issues have been chronically underserved.
More resources can be funnelled into conducting research to help us better understand the impact of the menopause on women’s physical and mental health.
Future research would also help to neutralise the gender bias of previous studies.
Third, launching public health campaigns and workplace initiatives to encourage employers to recognise sleep disorders as a significant element of menopause will help build awareness and reduce the impact of stigmas.
Fourth, myth-busting, shattering taboos, and normalising discussion about the menopause will be key.
We must view snoring as a gender neutral issue rather than a male stereotype and denounce harmful rhetoric and jokes that perpetuate stigma.
Fifth, we must better equip more localised healthcare providers up and down the country to both diagnose and treat OSA effectively.
Sleep disorders are not niche issues but a major public health concern with potentially severe consequences.
Quality of life amongst my patients is inextricably linked with sleep quality.
Recognising the relationship between snoring and OSA and the menopause is not simply about pathologising a natural stage of life, but providing women with the information, respect and medical care they deserve.
Only through more transparency and collaboration amongst researchers, educators and clinicians can we hope to close the gender gap in sleep medicine and bring this hidden crisis to light.
News
Diabetes expert launches ‘world-first’ music-based health learning platform

A platform that uses music to help people better understand diabetes and other healthcare concepts has been launched ahead of World Diabetes Day.
Developed by Dr Stephen Lawrence, associate clinical professor in diabetes at the University of Warwick, Prescribed Notes is the world’s first platform to use music as an immersive, memorable tool for learning complex health concepts.
Combining face-to-face and online lessons, each session is tailored, interactive and brought to life through live music and storytelling.
The platform combines live piano music with evidence-based diabetes and healthcare education to engage, inspire and empower diverse audiences.
As a practising physician, academic and accomplished improvising pianist, Dr Lawrence noticed that traditional medical education often struggles to make a lasting impact on healthcare professionals.
In response, he created Prescribed Notes, drawing on research and his own experience showing that medical information is more easily understood and retained when delivered through music and rhythmic patterns.
Dr Lawrence said: “Music has an incredible ability to make complex ideas stick in the mind.
“With Prescribed Notes, we are creating a space where medical knowledge and melody come together, helping people understand and remember healthcare concepts in a way that is both engaging and inspiring.”
“By combining storytelling, live performance and evidence-based education, we aim to transform the way people experience learning about diabetes and other health conditions, making it memorable, meaningful and, above all, enjoyable.”
Dr Lawrence brings extensive expertise to this platform, having previously served as the diabetes lead for the Royal College of General Practitioner (RCGP) and as the primary care lead for Diabetes UK.
His experience in these roles has given him insights into the challenges faced by both people living with diabetes and healthcare providers.
World Diabetes Day is an annual global awareness campaign held on 14 November to highlight the importance of diabetes awareness and management.
It marks the birthday of Sir Frederick Banting – co-discoverer of insulin.
The day serves as a platform to raise awareness about diabetes and to promote the importance of coordinated action to confront the disease as a critical global health issue.
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