Gemma Illingworth was only 31 when she died from a rare and aggressive type of dementia. A bright, independent artist who painted, traveled the world, and valued life's creative liberties, Gemma's life is not only tragic — it's a valuable lesson in the crucial need to recognize subtle neurological symptoms early on. Diagnosed at 28 with posterior cortical atrophy (PCA), a rare dementia that attacks the brain's visual processing area, Gemma's condition worsened quickly.

Her premature death highlights an increasing public health issue: overlooked early warning signs of cognitive and neurodegenerative impairment. For policymakers, healthcare professionals, and family members, her tale is both a warning and a reminder.

What is Posterior Cortical Atrophy?

Posterior Cortical Atrophy (PCA) is a rare, progressive neurodegenerative illness usually regarded as a subtype of Alzheimer's disease. In contrast to normal Alzheimer's, which first compromises memory, PCA attacks the rear portion of the brain — the occipital and parietal lobes — that are involved in visual and spatial processing. Some of the symptoms are:

• Trouble reading, identifying objects, or estimating distances
• Visual confusion or disorientation
• Hand-eye coordination difficulties
• Trouble with daily visual activities

Because of its atypical presentation, PCA often goes misdiagnosed as depression, anxiety, or even ophthalmological issues. This diagnostic challenge delayed Gemma’s care for years, despite her early struggles with sight, time perception, and coordination — red flags that now, in hindsight, point clearly to the disease’s onset.

The Missed Signs of Early-Onset Alzheimer's

Gemma's family recalls her as "ditsy," a girl who was unusual but self-reliant. From an early age, she had difficulty with her eyesight, telling the time, and coordination. Her difficulties were attributed to her character and not taken as possible signs of a neurological disorder.

It was not until 2020, during the COVID-19 lockdown, that her condition progressed quickly. She was no longer able to process visual information on her computer screen, and she had to cease working. Her symptoms were first blamed on anxiety and depression. It was not until thorough neurological testing in 2021 that PCA was diagnosed. By this time, the disease had progressed significantly.

This delay in diagnosis had a devastating impact — and it serves as a powerful reminder that even subtle neurological symptoms should not be ignored or dismissed.

Once diagnosed, Gemma's ability to live independently quickly declined. She began needing help with basic tasks: dressing, using the stove, managing appointments. She would call her mother up to 20 times a day. Eventually, she returned home, requiring full-time care.

Her sister Jess remembered, "She didn't know what [PCA] really meant, but that was obviously a blessing in disguise." Even with the dire prognosis, Gemma was relieved at first, believing she could now "fix" whatever was amiss.

But there was no cure. Her illness affected her ability to eat, swallow, talk, and walk. Her family took care of her at home until she died in November 2023, surrounded by loved ones. Her sense of humor, they reported, never left her — one of the few things the disease couldn't steal.

In Gemma's memory, her best friend and siblings completed the 2024 London Marathon, raising more than $47,000 for the National Brain Appeal and Rare Dementia Support (RDS).

"RDS couldn't cure Gemma, but they supported us through it the best way possible," her brother Ben explained. Their aim now is not to let other families endure the same suffering.

The funds raised support research, education, and family care for those with rare dementias — a community frequently ignored in popular discussions of memory decline and aging.

Why Early Detection is Important?

Dementia is commonly regarded as an old person's disease. Gemma's experience shatters the stereotype. Although PCA is uncommon, dementias in younger people are increasingly being diagnosed by neurologists globally.

Cognitive decline does not necessarily begin with memory loss. It may begin subtly — in the guise of visual problems, coordination problems, repeated disorientation, or even mood swings. That's why it's important that clinicians, educators, and families realize early symptoms can be disguised as behavioral idiosyncrasies or psychological problems. Early diagnosis can:

Give time for appropriate care planning and lifestyle changes

Halt progression with cognitive therapies or medications (where indicated)

Provide emotional relief and clarity for patients and families

How to Recognize and Prevent Early Memory Decline?

Although prevention of dementia is not always possible, early identification can dramatically enhance quality of life. Following are the preventive steps anyone can take:

1. Be Alert to Atypical Symptoms

Observe sudden or progressive change in visual-spatial awareness, particularly in young adults. Difficulty judging distances, recognizing objects, or maneuvering in familiar spaces may require neurological assessment.

2. Prioritize Complete Health Evaluations

When symptoms occur, push for full testing. This should involve neuroimaging (MRI or CT), cognitive screening, and — if necessary — spinal fluid analysis.

3. Get Early Intervention

Work with experts like neuropsychologists, neurologists, and occupational therapists early on. They can offer tools and coping strategies to deal with daily activities.

4. Emphasize Brain Health

A diet high in antioxidants (berries, greens), exercise, mental stimulation, and adequate sleep all help improve brain function and lower the risk of cognitive impairment.

5. Know Your Family History

Certain dementias are linked to genetics. If family history exists, don't wait on neurological evaluation if symptoms develop.

Earphones have slipped into almost every part of daily life. They power music, calls, podcasts, workouts, and long online meetings. What often goes unnoticed, however, is the steady rise of a silent and irreversible condition linked to their misuse: noise-induced hearing loss.

According to the World Health Organisation, more than one billion young people worldwide are at risk of hearing damage due to unsafe listening habits involving earphones and similar devices. Health experts say this is no longer a distant concern but a growing reality, with similar listening patterns being seen across India as well.

What Is Noise-Induced Hearing Loss?

Noise-induced hearing loss, or NIHL, occurs when loud sounds damage the delicate hair cells inside the inner ear. These hair cells play a critical role in transmitting sound signals to the brain. Once damaged, they do not recover or regenerate.

Dr Vinayak Kurle, Consultant ENT at Aster RV Hospital, Bangalore, explains that prolonged exposure to loud audio is one of the most common causes. “The inner ear has a limited number of hair cells. When they are exposed to excessive noise, especially over long periods, the damage can be permanent,” he says.

The generally accepted safe listening level is 85 decibels. Exposure to sound above this level for extended durations significantly increases the risk of hearing loss. Many personal audio devices can easily cross this threshold, especially at higher volume settings.

Early Warning Signs You Should Not Ignore

Hearing damage often develops gradually, which makes it easy to overlook early symptoms. Some of the first signs include:

• Ringing or buzzing in the ears
• A blocked, muffled, or distorted sense of hearing
• Difficulty understanding speech, particularly in noisy environments
• Ear discomfort after long listening sessions
• Increased sensitivity to everyday sounds

Dr Kurle notes that many people dismiss these signs as temporary fatigue. “Ignoring early symptoms delays diagnosis and allows the damage to progress,” he says.

Why Delayed Action Can Be Harmful

Untreated hearing loss affects far more than just hearing. Over time, it can contribute to social withdrawal, low mood, reduced concentration, and a decline in work performance. Studies have also linked hearing impairment to cognitive decline when left unaddressed.

What makes NIHL especially concerning is that the damage builds slowly. By the time people realise something is wrong, hearing loss is often already permanent.

How To Protect Your Hearing?

The good news is that noise-induced hearing loss is largely preventable with simple, consistent habits. Avoiding exposure to loud noise remains the most effective step. When loud environments cannot be avoided, protective options such as earplugs, earmuffs, or noise-filtering devices can reduce risk.

Noise-cancelling earphones can also help, as they reduce the need to raise volume in noisy surroundings. Following the WHO’s 60–60 rule is another practical safeguard. This means listening at no more than 60 percent volume for no longer than 60 minutes at a time.

Experts also advise limiting total daily earphone use, keeping volume below 80 decibels, taking regular listening breaks, and scheduling periodic hearing tests. At the first sign of symptoms such as ringing or muffled hearing, consulting an ENT specialist is crucial.

“Hearing loss does not happen overnight,” Dr Kurle says. “It develops quietly over time. Healthy listening habits today are the only way to protect hearing in the long run.”

Preserving hearing requires awareness, restraint, and timely action. In a world filled with constant sound, listening safely may be one of the most important health choices we make.

Due to rising obesity levels, sedentary lifestyles, and a rapidly aging population, type 2 diabetes has become far more common than it was a few decades ago. While high-income countries saw a decline in diabetes-related deaths between 2000 and 2010, this trend reversed from 2010 to 2016. As a result, there has been an overall 5 percent rise in premature deaths linked to diabetes since 2000.

What is especially concerning is that type 2 diabetes is now increasingly diagnosed in children, largely driven by poor diet, excess weight, and lack of physical activity. Beyond its well-known effects on the heart, kidneys, eyes, and nerves, diabetes is also associated with long-term conditions affecting the brain, including dementia.

This raises an important question: how exactly are diabetes and dementia connected? To understand this better, we spoke to Dr Prabhojit Mohanty, Psychiatrist, Sexologist, and De-addiction Specialist, who shared insights on the link.

What Is Diabetes?

Diabetes is a long-term metabolic disorder in which blood sugar levels remain consistently high. This happens either because the pancreas does not produce enough insulin or because the body is unable to use insulin properly. Insulin plays a crucial role in helping glucose enter cells to be used as energy. When this process is disrupted, sugar builds up in the bloodstream, gradually causing damage to vital organs such as the heart, eyes, kidneys, and nerves.

The two main forms are Type 1 diabetes, an autoimmune condition that requires lifelong insulin therapy, and Type 2 diabetes, which is linked to insulin resistance and influenced by lifestyle and genetic factors, according to the Cleveland Clinic.

What Is Dementia?

Dementia refers to a group of symptoms marked by a significant decline in cognitive abilities that interferes with everyday functioning. It affects memory, thinking, reasoning, and decision-making. Dementia is not a single disease but an umbrella term for conditions caused by different underlying disorders, the most common being Alzheimer’s disease.

As dementia progresses, symptoms become more severe, affecting mood, behavior, and the ability to carry out routine activities, often leading to increased dependence on others. Early diagnosis can help slow progression and improve quality of life, as noted by the Alzheimer’s Association.

Diabetes And Dementia: What Is The Link?

An expanding body of research points to a clear association between diabetes and dementia. Large-scale studies and meta-analyses indicate that individuals with diabetes face nearly a 59 percent higher risk of developing dementia compared to those without the condition. This increased risk applies to both Alzheimer’s disease and vascular dementia and tends to rise the longer a person lives with diabetes. From a clinical perspective, several mechanisms are involved. Persistently high blood sugar levels and insulin resistance cause damage to both small and large blood vessels. Over time, this harms the brain’s microvasculature, reducing blood supply and raising the likelihood of strokes and vascular dementia.

Dr Prabhojit Mohanty explained, “When diabetes occurs alongside hypertension, the danger becomes even greater. Both conditions speed up damage to blood vessels in the brain. High blood pressure weakens vessel walls and contributes to plaque formation, which further limits blood flow to the brain. From a biological standpoint, insulin has roles beyond regulating sugar. When the brain becomes resistant to insulin, it affects neuron health, communication between brain cells, and how the brain uses glucose, increasing vulnerability to neurodegenerative conditions such as Alzheimer’s disease.”

Scientists have also introduced the idea of “type 3 diabetes” to describe Alzheimer’s disease as a condition driven by insulin resistance within the brain itself. According to this theory, impaired insulin signalling in neural tissue plays a role in the buildup of amyloid plaques and tau tangles, which are defining features of Alzheimer’s disease. People with diabetes often also struggle with high blood pressure and abnormal cholesterol levels. Together, these factors further raise the risk of dementia and significantly affect the quality of life of both patients and their caregivers. Detecting diabetes early, maintaining good control of blood sugar and blood pressure, and adopting healthier lifestyle habits can go a long way in protecting cognitive function with age.

In simple terms, there is strong clinical and biological evidence showing a clear and well-established connection between diabetes and dementia.

People using injectable weight loss drugs may need long-term medical and lifestyle support, researchers have warned, after a large study found that weight is regained far more quickly than with traditional diet and exercise plans. Scientists at the University of Oxford found that people taking medications such as semaglutide (Wegovy) and tirzepatide (Mounjaro) lose weight while on treatment, but typically regain it within around 20 months after stopping the injections.

The study also showed that improvements in blood sugar control, cholesterol levels, and blood pressure fade once the drugs are discontinued, leaving patients back at their original health markers. By comparison, people who lose weight through structured diet and exercise programmes tend to maintain the loss for longer, close to four years on average, although most eventually regain weight as well.

Health Gains Reverse After Treatment Ends

The findings come alongside separate research from University College London and the University of Cambridge, which suggests that people prescribed newer weight loss drugs could face risks such as nutrient deficiencies and loss of muscle mass. Under current NHS rules, Wegovy can only be prescribed for up to two years, while Mounjaro has no set time limit.

Most people using these medications pay for them privately, due to strict NHS eligibility criteria. Research indicates that around half stop treatment, often because of cost, side effects, or because they feel they have reached their target weight.

The Oxford analysis, published in the British Medical Journal, reviewed 37 studies involving more than 9,000 participants. On average, people stayed on medication for 10 months and were followed up for eight months after treatment ended.

Across all weight loss drugs, participants lost an average of 8.3 kg during treatment, but regained 4.8 kg within a year, returning to their starting weight within about 1.7 years. Those taking Wegovy or Mounjaro lost nearly 15 kg, but regained around 10 kg in the first year after stopping. Based on projections from one year of data, full weight regain occurred within roughly 1.5 years. Measures linked to heart and metabolic health, including blood glucose and cholesterol, also returned to baseline within about 1.4 years.

Experts Say Obesity Requires Ongoing Care

Professor Susan Jebb, professor of diet and population health at the University of Oxford and an adviser to ministers and the NHS on obesity, said the findings were clear. “What we’ve shown is that weight regain after medication is common and happens quickly. The benefits for blood sugar and cholesterol closely track weight changes, so when weight comes back, those benefits disappear too.”

She noted that weight regained after medication happens almost four times faster than after behaviour-based programmes, regardless of how much weight was initially lost. Professor Jebb said long-term solutions may be necessary, whether through ongoing medication, behavioural support, or a combination of both.

“Obesity is a chronic, relapsing condition,” she said. “It’s reasonable to expect that treatment may need to continue for life, much like medicines for high blood pressure. We should think of this as long-term treatment for a long-term condition.”

She added that combining diet and exercise programmes with drug treatment helps people lose more weight initially. However, once medication stops and appetite returns, those strategies alone often fail to prevent regain. In contrast, people in behavioural programmes without drugs may practice these habits more consistently, which could explain why weight regain is slower.

Professor Jebb said it is clear that some form of ongoing intervention is needed if the benefits of weight loss drugs are to last. Some patients try tapering doses or using medication intermittently, while others rely on lifestyle support alone, but she said evidence on what works best remains limited.

Sam West, a postdoctoral researcher at the University of Oxford and co-author of the study, said: “People on medication lose more weight than those in behavioural programmes, but they regain it about four times faster.”

The researchers also questioned whether long-term drug treatment is cost-effective for the NHS. They concluded that since obesity is a long-term, relapsing condition, extended use of weight management medications may be needed to maintain health benefits.

Concerns Over Nutrition and Muscle Loss

Separate findings published in Obesity Reviews highlighted gaps in nutritional guidance for people taking semaglutide and tirzepatide. Dr Marie Spreckley from the University of Cambridge said many patients receive little structured advice on diet quality, protein intake, or micronutrient needs, despite significant appetite suppression.

“If nutritional care isn’t built into treatment,” she said, “there’s a real risk of trading one health problem for another, through avoidable nutrient deficiencies and unnecessary muscle loss.”

An NHS spokesperson said that while these drugs are a valuable addition to weight loss treatment, they are not a quick fix. “They must be combined with lifestyle and behavioural support, including advice on healthy eating and physical activity, to help people maintain weight loss over time,” the spokesperson said.