Research led by the University of Southampton and King’s College London examined the experiences of parents navigating waiting lists for ADHD diagnosis with Child and Adolescent Mental Health Services (CAMHS) in the UK.

NHS data for the end of September 2025 shows that of those children (up to 17 years old) waiting for an assessment with the service, over 63 percent spent more than a year on the list, and a third of these were waiting over two years.

“CAMHS are experiencing  enormous demand to offer timely support to young people. Staff working in these services are under huge pressure, and in-turn, parents and their children, are also suffering – with some concern that long wait times could exacerbate ADHD symptoms,” explains lead author Dr Ellen Hedstrom.

She adds: “Through our study, we wanted to better understand how parents experience the time between their child’s referral, an ADHD assessment, and a diagnostic outcome. Also, what impact this has on them and their child.”

Study findings are published in the journal Health Expectations.

The researchers conducted anonymised interviews with a total of 41 parents of children aged between five and 11 years old. Their wait times ranged between seven months and over two years. Thirty percent of participants fell between an 18 and 24 month wait, and ten percent over two years. About 50 percent of children hadn’t had their initial ADHD assessment at the time of interview.

Strong feedback was given to the research team by parents. Many of felt that:

• Communication about wait time status was either non-existent or unsatisfactory.

• Lengthy wait times negatively impacted the mental health and wellbeing of both themselves and their child.

• Uncertainty led them to feelings of powerlessness, anxiety and being forgotten.

• Finding a crisis care contact was a struggle, or that support they’d accessed was inadequate.

• There’s pressure to get a diagnosis because it can be essential to access support or treatment, for example at school.

Many parents believed there was a disparity between the support they felt they needed and the support they received.

As one parent, Jayne, put it: “It’s hard because there is no support, at the moment, until you get that diagnosis and you’re forever in limbo.”

Another, Jaz, said: “We’ve wasted over 2 years of her education, it is a huge percentage. And in that time, she was just getting further and further behind.”

Others were grappling with whether they should try and find the money to go private, as in the case of Sarah: “We are struggling a bit and it would be nice to know whether we should be trying to save up to get him seen privately, if it’s gonna be years and years, then that’s what we’d do. If it’s gonna be another 6 months, then we’ll wait.”

At the same turn, there was also empathy for health care staff and understanding that clinical services are under enormous strain. Some parents said they wanted to place as few demands as possible on staff, due to this.

Parents’ suggestions for improvement included regular updates of their status on the waiting list, including confirmation of wait times; a digitised system where parents could logon, check any progress, or book appointments; also, the idea of a named key-worker who they could turn to for help and support while waiting. Parents also expressed the need for help with skills and strategies for themselves to manage the behaviour of their children.

Meanwhile, the authors of the study point to a recent successful local authority scheme which piloted a neurodiversity tool – offering early profiling from trained professionals. This gave parents and schools  knowledge for early intervention to help children while they wait for formal diagnosis.

“Many tools and platforms already exist, or could be developed to meet the needs of CAMHS,” concludes Dr Hedstrom. “This would not only give parents more autonomy in the way that they manage their time on a wait list and how they access much-needed information, but also alleviate the burden on mental health services, resulting in a more efficient service.”

1. The paper, ‘Until You Get the Diagnosis You’re Forever in Limbo’—Parents’ Experiences of Waiting for an Attention-Deficit/Hyperactivity Disorder Assessment With Child and Adolescent Mental Health Services, is published in the journal Health Expectations – DOI: 10.1111/hex.70569 and can be read here: https://onlinelibrary.wiley.com/doi/10.1111/hex.70569
2. For interviews contact, Steve Williams, Media Manager, University of Southampton. +44 23 80593 212
3. The University of Southampton drives original thinking, turns knowledge into action and impact, and creates solutions to the world’s challenges. We are among the top 100 institutions globally (QS World University Rankings 2026). Our academics are leaders in their fields, forging links with high-profile international businesses and organisations, and inspiring a 25,000-strong community of exceptional students, from over 135 countries worldwide. Through our high-quality education, the University helps students on a journey of discovery to realise their potential and join our global network of over 300,000 alumni. www.southampton.ac.uk
4. For more about KCL visit: https://www.kcl.ac.uk/

DIY test kits for human papillomavirus (HPV) – a group of viruses responsible for more than 90% cervical cancer cases – will be offered to women across the UK who have delayed or been unable to attend their traditional screenings.

Announced as part of the NHS 10-Year Health Plan, the kits contain a vaginal swab similar to a long cotton-wool bud. The scheme is due to be rolled out later this year. Traditional screenings, commonly known as ‘smear tests,’ are generally conducted in person at GP clinics.

The new scheme aims to tackle barriers that discourage women from attending in-person screenings, such as discomfort, embarrassment and cultural sensitivities. While there are currently no plans to routinely offer them as an option for physically Disabled women, at-home kits will be offered to women who are under-screened or have never been screened.

Disabled women often face unique barriers to traditional cervical screening, such as challenges in getting to appointments, a lack of accessible clinic facilities, difficulties in getting into the required position for the test, and a lack of understanding from healthcare providers.

The National Institute for Health and Care Research (NIHR)-funded study, which surveyed 1,493 UK-based women and people with a cervix with physical disabilities or impairments, found a broadly positive response to at-home testing:

• 63 per cent said they would be able to perform the test themselves.
• Over half would choose a home-testing kit over an in-person screening if given the choice.

Sue Sherman, a Professor of Psychology from the University of Sheffield, said: “Physically Disabled women face significant barriers when it comes to accessing healthcare, and cervical screening is no different.

“Our study is the first of its kind to explore the attitudes of physically Disabled women and people with a cervix to self-testing as an alternative to clinician-led cervical screening.

“Our research indicates that many physically Disabled women – particularly those who have delayed, missed or never attended a screening – would find this option easier and preferable.

“Ultimately, introducing self-testing will move us closer to ensuring that everyone has access to potentially life-saving screening, regardless of their physical condition.”

Contributor to the study Alycia Hirani, who lives with Osteogenesis Imperfecta (colloquially known as ‘brittle bone disease’), said: “Disabled women deserve choice in healthcare. Expanding testing options and knowledge of alternatives like HPV screening can give so much more access, autonomy and can be life-saving to so many people.”

The study also found that over 70 per cent of the women surveyed had concerns about performing the test correctly. To help address this, researchers recommend

tailored instructions catering to different physical needs and improved training for clinicians to ensure equitable screening access for all.

Read the study in full in the Journal of Medical Screening.

In a paper, published today in the British Journal of Psychiatry, a group of experts led by Professor Samuele Cortese from the University of Southampton say there is no robust evidence that ADHD is over-diagnosed in the UK.

The new paper refutes the view that ‘nowadays everyone has ADHD’ which is gaining traction in public discourse and has been amplified by some leading politicians, as demand rises for NHS assessments and services.

Bringing together academics, clinicians, people with lived experience and carers, the group say this narrative risks misleading the public and policymakers and overshadows a more pressing concern – unmet need.

Professor Cortese said: “Rather than focusing on increases or decreases in diagnostic rates, attention should be directed toward the extent to which those with ADHD are being adequately diagnosed and treated.

“While misdiagnosis and inappropriate diagnosis do occur, the available evidence indicates that under diagnosis and under treatment remain the predominant challenges.”

When standardised diagnostic criteria are applied, the prevalence of ADHD internationally is around 5 per cent in children and 3 per cent in adults.

While prevalence has increased over time, NHS administrative data in England remains substantially below these expected levels, suggesting that many people with ADHD are living without a diagnosis and adequate support.

The group acknowledge that misdiagnosis can occur in some cases, particularly where assessments rely heavily on self-reporting or where alternative conditions are not fully considered.

Professor Tamsin Ford, Head of the Department of Psychiatry at the University of Cambridge, a coauthor on the paper, commented: “While many more people with ADHD are being recognised and treated, we are failing to support many more. Overdiagnosis is not a problem, but misdiagnosis may be as people are driven into the private sector by long waits; and sadly, missed diagnoses remain common.”

The researchers stress that the absence of biological diagnostic markers means that thorough, multidisciplinary clinical assessment is essential. Field trials show that when clinicians are properly trained, an ADHD diagnosis is among the most reliable for a mental health condition.

“Similar to physiological traits, such as blood pressure or weight, ADHD symptoms are distributed along a continuum,” says coauthor Professor Chris Hollis from the University of Nottingham. “But as with hypertension or obesity, there are diagnostic severity thresholds that determine health risks and what interventions should be used. Similarly, in ADHD a risk-stratified stepped-care approach may be useful.”

Professor Cortese and colleagues highlight significant pressure on UK services, with long waiting times and growing demand, especially among adults who were not diagnosed in childhood.

They point to figures showing that around 27 per cent of children and young people diagnosed with ADHD reported waiting one to two years, while 14 per cent waited two to three years.

Evidence shows that untreated ADHD is associated with serious long-term risks, while effective treatments are available, backed by strong evidence, and generally well tolerated.

“The costs of untreated ADHD are often overlooked,” says Professor Cortese. “They include increased risk of academic failure, suicidal behaviour, substance abuse, criminality, injury and death. The failure to provide treatments which have been shown to reduce these risks represents a major ethical issue that needs to be urgently addressed.”

The authors call for improved funding, workforce training and a more balanced, evidence-based conversation to ensure accurate diagnosis while expanding access to care for those who need it.

The researchers are supported by the National Institute for Health and Care Research (NIHR), UK Research and Innovation (UKRI) and the Office for Life Sciences.

ADHD (over) diagnosis: fiction, fashion, and failure is published in the British Journal of Psychiatry and is available online.

Contact

Steve Williams, Media Manager, University of Southampton, press@soton.ac.uk or 023 8059 3212.

1. In 2018, the administrative prevalence was 2.5% in boys and 0.7% in girls, and 0.7% in men and 0.2% in women, respectively. Current post-pandemic administrative prevalence data are unavailable.
2. Figures on wait list times come from an online survey of 7,340 people, conducted by the House of Commons Petitions Committee between 2021 and 2022.
3. ADHD (over) diagnosis: fiction, fashion, and failure is published in the British Journal of Psychiatry here:ADHD (over) diagnosis: fiction, fashion and failure | The British Journal of Psychiatry | Cambridge Core
4. For interviews, please contact press@soton.ac.uk or 023 8059 3212.

The Simplified Adolescent Factors for Endometriosis (SAFE) score uses a questionnaire to identify at-risk patients and fast track specialist referrals for further investigation.

Professor Gita Mishra AO, Centre Director of UQ’s Australian Women and Girls’ Health Research Centre, said the test could prevent years of waiting for a diagnosis.

“The test uses 6 questions to detect girls or young women at risk of endometriosis and in need of further assessment,” Professor Mishra said.

“Identifying which patients should be referred and treated is challenging and improving how patients are diagnosed is a major priority.

“By detecting endometriosis earlier – ideally in adolescents as soon as they begin their periods – we hope the tool will reduce the average 6-8-year diagnostic delay so we can start treatment as early as possible.’’

Endometriosis is an often-crippling condition where tissue, similar to the inner lining of the uterus, grows outside of it.

The condition has no cure and affects up to 11 per cent of Australian women of reproductive age.

Using the questionnaire, young women are asked if they experience pelvic pain often, if they’ve sought treatment for pelvic pain, taken painkillers for pelvic pain, experienced heavy menstrual bleeding or painful periods, and have a family history of endometriosis.

The SAFE score works on a point‑based system and would help guide referrals in primary care.

The more risk factors identified, the higher a woman’s score and the greater likelihood of the condition.

The tool was designed using data from more than 9000 women from the Australian Longitudinal Study on Women’s Health, with researchers identifying risk factors for endometriosis.

“This simple tool can be used in women of any age, but we have carefully chosen age-appropriate questions to target adolescents,” Professor Mishra said.

“Long delays in diagnosis can be due to unclear symptoms, lack of awareness, misdiagnosis, and normalisation of menstrual pain which impacts quality of life.

“The condition often involves surgery to confirm diagnosis, although experts are working to change this so the condition can be picked up through ultrasound or MRI.

“We need to be able to detect endometriosis early because our research found most women were diagnosed in their late twenties, often when they are trying to fall pregnant.

“Early diagnosis is critical because it can change treatment of fertility issues later on.

“The usual treatment route is ovulation induction, but this is not as effective as IVF for women with endometriosis.’’

Next steps will evaluate the tool in clinical settings, assess its practicality in Brisbane GP, endometriosis and pelvic pain clinics, and explore if an app can be developed.

March is Endometriosis Awareness Month, signified internationally by the colour yellow.

The research is published in eClinicalMedicine.

The findings were published on Feb. 23, 2026 in CANCER, a journal of the American Cancer Society.

“Over the past several years, we’ve had an increasing appreciation for the important relationship between cancer, its treatment, and mental health,” said lead author Julian Hong, MD, MS, of the University of California, San Francisco. “This study reproduces our prior work by leveraging the shared experience across the University of California system, reinforcing a relationship between mental health conditions and mortality for patients with cancer and highlighting the need to prioritize and manage mental health.”

The researchers used The University of California Data Discovery Platform, in which data on all patients at University of California–affiliated hospitals are recorded.

They identified adult patients with a cancer diagnosis and no documented mental health disorder prior to cancer diagnosis between 2013 and 2023.

Among 371,189 patients, 39,687 (10.6%) developed a mental health disorder within the first year after cancer diagnosis.

After adjusting the data for factors which might affect the primary outcome, the researchers reported that a mental health disorder diagnosis was linked to a 51% higher risk of all-cause death in the initial 1–3 years after cancer diagnosis. This elevated risk decreased to a 17% higher risk after 3–5 years. Then it disappeared.

The authors concluded, “Patients with cancer who experience a mental health condition are at an increased risk of all-cause mortality. This reinforces and emphasizes existing recommendations for prompt screening and management of distress and mental health following a cancer diagnosis.

The study, published in Radiation Measurements, demonstrates a practical solution for personal preparedness in mass-casualty events. The system combines a small piece of Gafchromic EBT4 film with a foldable, battery-powered portable scanner and a smartphone camera.

“To protect people in the event of a severe radiological or nuclear accident, voluntary on-site dose assessments and prompt decisions regarding medical actions must be performed immediately,” says study corresponding author Hiroshi Yasuda, a professor at Hiroshima University’s Research Institute for Radiation Biology and Medicine. “Simplicity, universality, and cost-effectiveness are critical factors for these emergency measures.”

The EBT4 film is designed to change color instantly when exposed to radiation, a change that can be detected by the naked eye. By placing the film in a portable scanner and capturing an image with a smartphone, users can quantify relatively high radiation doses—up to 10 Gray—using mobile image-processing applications. To put this into perspective, a 10 Gray dose to the skin is high enough to cause permanent hair loss.

The research team tested the system using various smartphone models, including Samsung and iPhone devices. Their analysis showed that the cyan color channel in digital images provided the most consistent and reliable dose-response data. While professional desktop scanners offer higher precision, this smartphone-based approach provides an adequate solution that is highly portable and costs less than USD$70.

“Our goal was to design a system that works even under the worst-case accident scenarios, such as after a natural disaster where infrastructure might be damaged,” Yasuda adds. The team is now working to standardize the protocols and ensure the system remains reliable under diverse environmental conditions.

###

The study was co-authored by doctoral student Hassna Bantan and Professor Hiroshi Yasuda, both at Hiroshima University’s Research Institute for Radiation Biology and Medicine.

The open access publication costs for this paper were supported by Hiroshima University.

Image: Setup of the portable scanning system: a smartphone positioned above an LED-lit chamber for consistent film image capture. 

View more Credit: Bantan et al., 2026, Radiation Measurements, CC BY-NC-ND 4.0

Depression is the most severely impacted, with almost a third fewer diagnoses than expected compared with pre-pandemic trends.

The King’s College London study is the first to evaluate whether diagnosis rates have recovered after emerging from the pandemic. Published today in the British Medical Journal (BMJ), it uses anonymised data from over 29 million people in England.

The pandemic had an unprecedented impact on healthcare systems around the world, leading to abrupt decreases in diagnosis rates for a wide range of diseases.

Of the 19 major conditions analysed, diagnoses of depression were 27.7% lower than expected compared with pre-pandemic trends. Diagnoses were also lower than expected for asthma (16.4%), chronic obstructive pulmonary disease (COPD, 15.8%) and osteoporosis (11.5%).

The study also identified differences in how diagnosis rates recovered across ethnic and socioeconomic groups. While dementia diagnoses recovered to pre-pandemic levels for individuals of white ethnicity and those living in less deprived areas, they remained lower than expected among other ethnic groups and in more deprived communities.

Co-author Professor Sam Norton, Professor of Medical Statistics at King’s College London, said: “The deficits in depression diagnoses were particularly striking and somewhat puzzling. After an initial decrease during the early pandemic, diagnosis rates partially recovered by late 2021, but have declined markedly since 2022. This pattern was most evident among younger adults aged 20 to 39 years, and among individuals of white or mixed ethnicity.

“This is difficult to reconcile with other indicators of mental health need. Disability benefit claims for mental health conditions have increased substantially over the same period, suggesting these declining diagnosis rates may not reflect improving mental health.”

Diagnosis rates may be influenced by increasing pressures on the NHS, meaning it is taking longer for people to be formally diagnosed. It is also possible that more people are accessing mental health support without receiving a formal diagnosis of depression. Following a national drive to expand access to psychological therapies, referrals to NHS Talking Therapies services increased by nearly two-thirds between 2013 and 2024, with self-referrals accounting for almost 70% of all referrals.

The team also suggest that pandemic-related disruption could be behind the fall in diagnoses for asthma, COPD and osteoporosis. Backlogs in diagnostic testing for these conditions during the pandemic is likely to be a key factor, and the NHS has identified this as a priority area for improvement.

Further analysis revealed that chronic kidney disease (CKD) diagnoses have increased by 34.8% compared to expected levels.

Lead author Dr Mark Russell, consultant rheumatologist and epidemiologist at King’s College London, said: “The rise in CKD diagnoses may reflect increased testing and greater awareness following guideline changes and the introduction of new treatments.

“It is also possible that the pandemic itself has contributed to an increase in CKD, either through the direct effects of Covid-19 infection or through delays in diagnosing related conditions such as diabetes.”

The research team used OpenSAFELY, a highly secure and anonymised NHS data platform, to analyse disease trends for 29 million people between April 2016 and November 2024.

Dr Russell added: “This study highlights the incredible health data resources available within the NHS and demonstrates how real-time, anonymised data could be used safely and securely, without any individual patient data ever leaving the NHS system, to transform disease monitoring, enabling earlier identification of inequities and informing how care is delivered.”

Notes to Editors

The OpenSAFELY platform is principally funded by grants from NHS England, the Wellcome Trust, and the Medical Research Council.

Researchers found that elevated gut inflammation detected by stool tests – even when people felt well – strongly predicted future disease flares.

The study also found that higher meat consumption was linked to an increased risk of relapse in people with ulcerative colitis, though not in Crohn’s disease.

Experts say embedding this approach to treatment of IBD could potentially allow earlier intervention and help personalise care to those most at risk.

Inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis, affects nearly one per cent of the UK population. People often experience long periods of remission, followed by sudden and debilitating flares of symptoms such as pain, diarrhoea and fatigue.

Many patients ask whether everyday diet plays a role in triggering flares, but robust evidence has been limited, experts say.

To address this, University of Edinburgh researchers led the PREdiCCt study, which followed 2,629 people with IBD who reported being in remission at the start of the study. Participants were recruited from 47 NHS centres between 2016 and 2020.

At enrolment, participants completed a food-frequency questionnaire and provided clinical information, including blood tests and a stool test measuring faecal calprotectin – a marker of gut inflammation. They then completed monthly symptom questionnaires and were followed for a median of four years.

Researchers recorded both symptom-based flares and ‘objective’ flares, where inflammation was confirmed by tests and treatment needed to be escalated.

They found that faecal calprotectin was a strong early warning signal, even when people felt well. Higher levels at baseline were linked to a much greater risk of future flares.

In ulcerative colitis, the chance of an objective flare within two years increased from around 11 per cent in people with low calprotectin levels to 34 per cent in those with high levels.

They also found that diet was linked to flare risk in ulcerative colitis. People who consumed the most meat had around double the risk of an objective flare compared with those who ate the least. This pattern was not seen in Crohn’s disease, and there were no consistent links between flares and fibre intake, ultra-processed foods, polyunsaturated fats or alcohol.

Experts say that because PREdiCCt is an observational study, it cannot prove that eating meat causes flares. However, they believe the findings support future clinical trials to test whether reducing meat intake, alongside routine inflammation monitoring, could help prevent relapses in ulcerative colitis.

Charlie Lees, Professor of Gastroenterology at the University of Edinburgh: “This major study is the first of its kind to properly track the relationship between habitual diet and disease flares in such a large, prospective way. It has been a massive team effort over the past decade to recruit and follow more than 2,600 people living with IBD across the UK. Our results provide a new framework for management: using objective biomarkers to catch subclinical inflammation early and identifying specific dietary factors that may help prevent debilitating relapses. This is exactly the kind of personalised evidence-base we need to improve the lives of people living with Crohn’s and colitis.”

The study, which is published in the journal Gut: https://doi.org/10.1136/gutjnl-2025-337846 [URL will become active after embargo lifts], also involved nutrition researchers from the University of Aberdeen. It was funded by UK Research and Innovation (UKRI), the Scottish Government’s Chief Scientist Office and Cure Crohn’s Colitis.

High blood pressure (hypertension) is a significant risk factor for cardiovascular disease, stroke, dementia, and chronic kidney disease, yet it often causes no symptoms and can go undetected for years. This 12-year longitudinal study, involving over 8,000 participants, provides a detailed national picture of how high blood pressure is being managed in Ireland and examines adherence to the latest European Society of Cardiology (ESC) guidelines, including the 2024 recommendations.

Drawing on more than a decade of TILDA data, the researchers show that unmet need in hypertension care is not a new problem, but one that has persisted over time. At the most recent data collection, 62% (approximately 445,000 people aged 50 and over) with high blood pressure were not appropriately managed: they had undiagnosed hypertension, were diagnosed but not receiving treatment, or were on treatment but had blood pressure above recommended targets.

When the lower blood pressure target of <130/80 mmHg, as advised by the 2024 ESC guidelines, is applied, this figure rises to 77% — meaning more than three out of every four older adults with hypertension in Ireland are not optimally managed.

Key findings from the study: 

• Hypertension prevalence remained consistently high, increasing from 63% to 71% over 12 years.
• Only 56% of those with hypertension are aware they have it, highlighting substantial ongoing under-diagnosis.
• 71% of those with hypertension were taking a medication, treatment intensity was often suboptimal: only 14% were prescribed a guideline-recommended dual therapy and only 57% guideline-recommended monotherapy.
• Among those receiving treatment, just 33% achieved the guideline-recommended blood pressure target of <130/80 mmHg, while 54% were controlled to <140/90 mmHg.
• Overall, 62% (445,000 people) with hypertension in Ireland were not appropriately managed according to the 2018 ESC guidelines, consistent with previous TILDA evidence showing poor long-term control of modifiable cardiovascular risk factors.
• Forty per cent of the population had elevated blood pressure (SBP value of 120–139mmHg or a DBP value of 70-89mmHg) and 71% of this group had evidence of high cardiovascular risk.
• People aged 85 years and older and those with moderate to severe frailty were less likely to have undiagnosed hypertension and were more likely to be taking guideline-recommended medications similar rates of blood pressure control when compared to the wider population.
• People with chronic kidney disease (CKD) were more likely to receive guideline-recommended treatment and achieve blood pressure control to a target of <140/90mmHg, suggesting targeted care can be effective in high-risk groups.

Dr Caoimhe McGarvey, Research Fellow at TILDA and Specialist Registrar in Geriatric Medicine at St James’s Hospital Dublin and lead author on the new study, commented:

“High blood pressure is a common and treatable condition. However, when left untreated it can cause heart disease, kidney disease, stroke and dementia. This study highlights a significant unmet need in the management of high blood pressure in Ireland. Systematically addressing this need has the potential to dramatically reduce avoidable complications and improve the health outcomes for older adults across the country.”

Professor Donal Sexton, Consultant Nephrologist and Associate Professor at Trinity College Dublin,  said:

“This study exemplifies the unique ability of the TILDA study to assess how well we are performing as a nation in the treatment of modifiable risk factors for cardiovascular disease, chronic kidney disease and premature death. It emphasises the unmet need in the management of high blood pressure in Ireland and the urgent requirement to improve its recognition and treatment.”

Regius Professor Rose Anne Kenny, Principal Investigator of TILDA and Professor of Medical Gerontology at Trinity College Dublin, added:

“The message for the public is simple: if you are 40 years or over get your blood pressure checked. It’s quick, painless, and can make a life-changing difference.

TILDA has been highlighting gaps in the detection and control of high blood pressure for over a decade. What makes this study particularly powerful is the maturity of the TILDA dataset, following the same people over more than 12 years gives Ireland a unique national asset for understanding how health changes as we age and how well our health system is responding.”

This long-term evidence shows that, despite clear guidelines and effective treatments, too many older adults are still living with poorly controlled hypertension. High blood pressure is one of the most modifiable risk factors for stroke, heart disease and dementia, and improving its management represents one of the most effective opportunities we must support healthier ageing in Ireland.

This research aligns closely with current Health Service Executive (HSE) and Department of Health priorities, which emphasise the early detection and effective management of chronic conditions to support healthy ageing and reduce avoidable illness. High blood pressure is easy to check and can often be managed effectively once identified. Adults are encouraged to have their blood pressure checked regularly with their GP or local pharmacist, particularly as they get older or if they have other health conditions. Early detection and appropriate treatment can significantly reduce the risk of heart disease, stroke, kidney disease and dementia.

READ: You can read the published paper: ‘Adherence to the European Society of Cardiology hypertension guidelines over 12 years of follow-up in the Irish’ at the following link: https://openheart.bmj.com/content/12/2/e003744

Indeed, a research letter by Rutgers and Columbia University researchers in JAMA Psychiatry shows those prescriptions are becoming more common in the United States, even though antipsychotic drugs do little for dementia and carry a black-box warning on their labels stating they increase the risk of death in senior patients.

Using a national prescription-claims database that captures more than 90% of retail pharmacy fills, researchers tracked antipsychotic use among adults 65 and older from 2015 through 2024 and found that the annual rate of any antipsychotic use increased nearly 52% to 4.05 per 100 from 2015 to 2024. Long-term use, defined as at least 120 days a year, rose 65% to 2.45 per 100 older adults. Rates were highest among people 75 and older, rising from 3.42 to 5.12 per 100.

The trend is striking because antipsychotics have limited proven effectiveness in people 65 and older and serious risks, including falls, fractures, cardiovascular and cerebrovascular events, pulmonary embolism and death.  Antipsychotics may be used as a last resort to manage severe behavioral and psychological symptoms of dementia, such as aggression, agitation, hallucinations, or delusions, especially when these symptoms pose a risk to the safety of the individual or others.  However, such use carries substantial risk and should be avoided in most cases and limited to short-term use whenever possible.

“The evidence is pretty solid on the risks,” said Stephen Crystal, the letter’s co-author and director of the Center for Health Services Research at the Rutgers Institute for Health, Health Care Policy and Aging Research.

The claims data don’t include diagnoses, so the researchers couldn’t determine why each prescription was written or whether it was appropriate. Antipsychotics remain essential for some people, including those with schizophrenia, bipolar disorder with psychosis or other severe psychiatric illnesses.

However, Crystal noted those conditions aren’t common enough in older populations to explain the surging number of antipsychotic prescriptions.

“We think that conditions like schizophrenia that have FDA-approved indications for antipsychotic treatment are unlikely to account for the majority of the rates of use that we observed,” he said.

The biggest concern for the researchers is using antipsychotics for the behavioral and psychological symptoms that can accompany dementia: agitation, wandering, acting out behavior and shouting. In many cases, the medications are used to “damp down” behaviors that are distressing to caregivers and disruptive to facilities, said Crystal, who also holds endowed professorships at the Institute for Health and Rutgers School of Social Work.

Because the drugs can be highly sedating, they reduce the tendency to roam and act out, but that sedation comes with a steep tradeoff for frail patients, increasing fall risk and reducing physical activity.

The study also reveals a shift in who manages cases. Among patients who took an antipsychotic in a given year, the share with at least one prescription from a psychiatrist fell from 30% in 2015 to 20% in 2024. Over the same period, the share who filled an antipsychotic from a pharmacy in a long-term care facility rose from 14% to 21%.

Crystal said the decline in psychiatrist involvement matters because optimal care for behavioral symptoms in dementia often starts with careful evaluation rather than a quick prescription. Clinicians may need to confirm the diagnosis and look for treatable causes that can mimic or worsen confusion, including medication interactions, infections, depression and unmanaged pain. Even when dementia is the main driver, nondrug approaches can work, but they require training, staffing and time.

“This can look like managing symptoms,” Crystal said. “Which is common because it’s so much easier to write a prescription than do the work of addressing the underlying condition, particularly at nursing home and assisted living facilities that are dangerously short-staffed.”

There was one potentially encouraging sign in the data: the use of first-generation antipsychotics, which are associated with higher mortality risk in older patients than second-generation medications, declined from 22% to 14%.

Still, the overall rise in use and the growth in long-term prescribing suggest a system leaning more heavily on medication to solve problems that are often social, environmental and staffing-related. The authors have called for renewed efforts to evaluate and spread nonpharmacological interventions that can reduce reliance on antipsychotics in older adults.

For families contending with a new prescription, the study’s lead author, Mark Olfson of the Columbia University Department of Psychiatry, said that it is reasonable to ask what problem the drug is meant to address and what other steps have been tried. Just as important is what happens next: whether the clinician has a plan to reassess, taper and stop the medication once a crisis has passed.

“These are high-stakes decisions,” he said.

The findings were made by a research team led by scientists at the University of Oxford and including the University of East London, and published in Nature’s Scientific Reports.

The team has demonstrated, for the first time, that simple, ultra-low-cost tests already used for alcohol detection can be repurposed to identify lethal toxic contaminants in medicinal syrups and their raw materials.

The findings open a realistic new way to prevent contaminated medicines from reaching children, particularly in low- and middle-income countries.

The breakthrough addresses a long-standing and deadly problem. Ethylene glycol (EG) and diethylene glycol (DEG) – industrial chemicals used in antifreeze and brake fluid – have repeatedly entered pharmaceutical supply chains, often through mislabelled or substituted raw ingredients.

In 2022 alone, contaminated syrups caused the deaths of more than 300 children across Indonesia, The Gambia, Uzbekistan and Cameroon. More recently, at least 24 further child deaths were reported in India.

Until now, detecting EG and DEG has depended on formal laboratory techniques that are expensive, time consuming, require highly qualified and trained personnel, and are often unavailable where the risk is greatest.

The research team has shown that this barrier can be overcome by repurposing everyday tools:

• Alcohol test strips, commonly used to detect alcohol in saliva or breast milk, can identify ethylene glycol contamination in under two minutes.
• Disposable breathalysers can distinguish ethylene glycol and diethylene glycol in raw materials in as little as ten seconds.

Both methods cost less than £1 per test, require minimal training, use no hazardous solvents, and can be deployed outside laboratory environments – representing a step-change in what is possible for medicine safety screening across supply chain.

Project leader, Professor Paul Newton of the Centre for Tropical Medicine and Global Health at the University of Oxford said, “Urgent interventions are needed to be implemented to prevent these recurring tragedies of childhood deaths and screening devices for detecting the toxins offer great promise in enabling this.”

Dr Merchant, from the University of East London’s Department of Bioscience, is a co-author on the study.

He said, “More than 80 years have passed since the sulfanilamide disaster, when diethylene glycol was mistakenly used in a liquid medicine – later infamously termed the ‘elixir of death’. That tragedy led to the introduction of the most stringent pre-market safety regulations for medicines in the United States and subsequently across Europe.

“Yet, it is deeply concerning that lives continue to be lost today due to illicit contamination with ethylene glycol (EG) and diethylene glycol (DEG), compounded by inadequate regulatory oversight in parts of the developing world.

“Global regulators must act decisively and collaboratively to ensure that no one ever dies from such preventable failures again. By lowering the barrier to detection, this work has the potential to stop contaminated medicines at source and prevent avoidable child deaths.”

The paper, ‘Rapid screening of ethylene glycol and diethylene glycol in raw materials and medicinal syrups using low-cost field deployable assays’, is published in Nature’s Scientific Reports

Bladder cancer remains a major clinical challenge as it is one of the most common and deadliest urological cancers with a high recurrence rate. Yet its diagnosis still relies heavily on invasive and costly procedures like cystoscopy (inserting a thin, tube-like instrument through the urethra) or cytology, a noninvasive test that can identify tumor cells shed in urine but has limited sensitivity.

Investigators of the current study were motivated to find a simpler, more comfortable way to detect and monitor bladder cancer. They analyzed urine samples from 156 patients with bladder cancer and 79 matched controls and using real-time PCR, measured the concentration and integrity (long-short size distribution) of cfDNA fragments from five genes (ACTB, AR, MYC, BCAS1, and STOX1).

“Our most significant finding was that the small fragment of the MYC gene may represent a valuable tool to diagnose bladder cancer, as it exhibited excellent specificity (97%) and predictive value (88%) for identifying muscle-invasive bladder cancer,“ explains lead investigator Pilar Medina, PhD, Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain.

MYC produces a transcription factor crucial for regulating cell growth, proliferation, and metabolism.

Additionally, researchers found that the ratio of large to small fragments of the housekeeping gene ACTB and the small fragment of the AR gene increased with disease severity, suggesting these could be reliable staging biomarkers. The integrity of these genes may be useful to identify bladder cancer relapse.

Lead author Raquel Herranz, MS, Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain, notes, “With growing interest in liquid biopsies and personalized medicine, our study offers a timely and practical alternative to invasive diagnostics. This study is one of the first to comprehensively evaluate urine cfDNA fragmentation and integrity across most bladder cancer stages, bringing us closer to a future in which bladder cancer can be diagnosed and monitored through a simple urine test, improving patient comfort and care.”

Dr. Medina concludes, “Our findings show that urine can tell us much more than we thought; it holds the potential to transform how we detect and manage bladder cancer.”