Day Lila

Mind & Body · Thursday, 24 September 2026

01 Briefing what happened

Alzheimer's drugs clear a protein from the brain, and a review of 17 trials found the difference too small for patients to notice

Mind & Body 43 sources

Two drugs that pull amyloid out of the brain slow decline by about four to six months over a year and a half, while blood tests that find the illness years early are arriving faster than treatments.

6.1 months

sooner that people on a dummy drug reached the decline seen on lecanemab

measured at the end of the 18-month trial [2]

17 trials

pooled by Cochrane, in more than 20,000 people

it called the effect on thinking trivial; only two tested the drugs now in use [1]

20.6%

of people on donanemab had brain swelling on a scan

against 1.8% of people on a dummy drug [2]

2 in 100

Alzheimer's patients are offered the scan or spinal test that confirms it

a finger-prick blood test is now being tried in 1,000 volunteers [5]

The lead story — what happened

  • Alzheimer's disease is the most common cause of dementia. Two proteins, amyloid and tau, can build up in the brain for more than 15 years before memory starts to fail. [5]
  • Lecanemab, made by Eisai, and donanemab, made by Eli Lilly, are antibodies: lab-made immune proteins that latch on to amyloid so the body clears it. [1][2]
  • Lecanemab got full US approval in 2023. [9] Both drugs were approved in the European Union in 2025 after a second review, only for people who do not carry two copies of a gene variant called APOE4. [2]
  • In the lecanemab trial, people on a dummy drug reached the same level of decline 6.1 months sooner than people on the drug, measured at 18 months. [2]
  • In April 2026 Cochrane, an international group that reviews medical evidence, pooled 17 trials in more than 20,000 people. It called the effect on memory and thinking trivial. [1]
  • Alzheimer's Research UK, a research charity, said only two of those 17 trials tested the drugs now in use, and the older, failed drugs shaped the result. [1]
  • NICE, which decides what England's health service pays for, said the drugs slow the illness by four to six months. [1] It refused to pay for them because the cost was too high, and is looking again after the makers appealed. [1]
  • The drugs can make the brain swell. On donanemab, swelling showed up on scans in 20.6% of people, against 1.8% on a dummy drug. On lecanemab it was 8.9% against 1.3%. [2]
  • In the UK, lecanemab is given as a drip every two weeks, with brain scans before the 1st, 5th, 7th and 14th doses to look for that swelling. [3]
  • In a three-year follow-up, donanemab cleared amyloid within about a year and a half in more than three in four people. Those who started early declined 1.2 points less on a dementia scale than untreated people in a separate study. [8]
  • Finding the illness is moving faster than treating it. Two blood tests are now cleared in the US, and one correctly rules out Alzheimer's 97.9% of the time. [4] Today only 2 in 100 patients are offered the scan or spinal test that confirms it. [5]
  • A blood marker called p-tau217 can now estimate when symptoms will start, with a typical error of three to four years. [6] In France about one in five people aged 65 to 85 without dementia already has amyloid in the brain. [7]

4 of 20

About 1 in 5 people on donanemab had brain swelling on a scan

20.6% of people on donanemab, rounded to 4 in 20. On a dummy drug it was 1.8%, fewer than 1 in 20.

Who is involved

  • Eisai and Eli Lilly

    the Japanese and US drug companies that make lecanemab and donanemab

  • Cochrane

    an international group that pools trial results; it called the drugs' effect on thinking trivial

  • European Medicines Agency

    the EU's medicines regulator; it approved both drugs in 2025 after a second look

  • NICE

    the body that decides which drugs England's health service pays for; it said no and is looking again

  • Alzheimer's Research UK

    a UK research charity; it said the review mixed failed drugs with the ones that work

How it unfolded

  1. 2023 Lecanemab gets full approval in the US [9]
  2. 2025 The EU approves lecanemab and donanemab after a second review [2]
  3. Oct 2025 A second Alzheimer's blood test is cleared in the US, the first for family doctors [4]
  4. Apr 2026 Cochrane calls the drugs' effect on thinking trivial [1]
  5. 21 Sep 2026 World Alzheimer's Day [27]

Where this points

Watch what NICE decides on the makers' appeal, because that settles whether England's health service offers either drug. [1]

What is pushing on the whole day

The bar and the word are our reading of how hard each one is pushing today. The arrow is where it is heading. The evidence is in the stories below.

Warnings arriving earlier Building

A forecast now puts a number on extra heat deaths El Nino may cause by February, about 240,000. [10] Since 1979, heatwaves on land have started about three days earlier each decade. [12] A blood marker can estimate when Alzheimer's symptoms will begin, with a typical error of three to four years. [6]

Effects smaller than hoped High

A review of 17 Alzheimer's drug trials called the effect on thinking trivial. [1] Three months after Australia banned social media accounts for under-16s, more than 85% of them were still using the apps. [15] A review of magnetic brain stimulation for Alzheimer's said it is not ready for routine care. [32]

Hotter summers High

August 2026 tied the hottest month ever measured, and western Europe had its warmest summer on record. [11] In European cities, extra city heat and older populations together could add 19% more summer heat deaths by 2030 than the two would cause apart. [14] Heat set off strong public distress in 84.9% of Chinese cities studied. [13]

Families paying for care Building

Dementia costs the US $818 billion in 2026, and families carry more than three times what health systems pay. [26] At list prices, lecanemab is not good value against usual care, a US cost study found. [9] In Pakistan, cigarette taxes have not risen since February 2023, so cigarettes keep getting cheaper. [38]

The rest of the day

29 more stories on this beat.

Each with its own sources. None of these is a link to the story above.

  1. 02

    El Nino heat may kill 450,000 by February

    Scientists at the Climate Impact Lab at the University of Chicago estimate that heat from the current El Nino could cause 240,000 extra deaths between September and February. [10] El Nino is a natural warming of the eastern Pacific that pushes world temperatures up for about a year. [11] Adding the deaths they estimate since it began in June brings the total to about 450,000. [10] They expect more than 30,000 extra deaths in Nigeria, 19,000 in Indonesia, 16,000 in India and 13,000 in Brazil. [10]

    Extra heat deaths forecast from September to February. Nigeria's figure is 'over 30,000'.

    Why it matters — Most of the coming deaths fall in the southern half of the world, where spring and summer are starting, and the oldest people are most at risk, then babies. [10]

  2. 03

    August tied the hottest month on record

    Copernicus, the EU's climate service, said August 2026 tied July 2023 as the hottest month ever measured, at 1.65C above pre-industrial levels. [11] It ended western Europe's warmest summer on record, hotter than the deadly summer of 2003. [11] The UK had its hottest summer since records began in 1884. [11] Copernicus says the El Nino is still growing, so the run of records may go on. [11]

    Why it matters — A heat researcher at Imperial College, a UK university, said the summer strained hospitals and cost tens of thousands of lives across the UK and Europe. [11] At least 35,000 extra deaths in Europe have been linked to this summer's heat. [10]

  3. 04

    Heatwaves now start earlier and end later

    A study in Nature Climate Change looked at heatwaves on land around the world from 1979 to 2023. [12] Heatwaves now begin about 3.3 days earlier each decade and end about 5.4 days later. [12] The heatwave season has grown by about 8.7 days a decade, and got longer on 92% of the world's land. [12] Dry regions shifted most, and heatwaves have recently started arriving faster. [12]

    Why it matters — The authors say heat warnings and heat plans need to plan for when heatwaves arrive, not only how strong they are. [12]

  4. 05

    Heat upset people in more cities than it harmed

    Researchers used social media posts and weather records from Chinese cities between 2010 and 2024 to measure how people felt during heatwaves. [13] They found 84.9% of cities had strong emotional shocks from heat, while 52.1% faced severe physical heat. [13] Poorer regions took longer to recover emotionally. [13] Physical resilience depended mostly on wealth and land cover, while mood depended more on how intense the heat was. [13]

    Why it matters — The authors say heat plans should treat bodily harm and emotional strain separately, because the two do not line up. [13]

  5. 06

    Hot cities and older people add up to more

    A study of more than 2,300 European cities looked at two things that raise heat deaths at the same time: the extra warmth of built-up areas, and populations growing older. [14] In summer, the two together raise heat deaths by 19% in 2030 and 58% in 2100 beyond what each would do alone. [14] In winter the extra city warmth cancels part of the extra cold deaths an older population would bring. [14]

    Why it matters — Plans that count city heat and ageing one at a time will undercount summer deaths, the authors say. [14]

  6. 07

    Most Australian under-16s still on social media

    Australia banned under-16s from holding accounts on ten platforms, including TikTok, Instagram and YouTube, in December 2025. [17][16] A study in The BMJ followed 408 teenagers from just before the ban to about three months after. [15] More than 85% of under-16s were still using the banned platforms, mostly on their own accounts, and some used fake accounts or private browsers. [15] Daily use fell only among 14- and 15-year-olds, from 78% to 69%. [15]

    Share of Australian 14- and 15-year-olds using social media every day.

    Why it matters — The authors found little sign of an early drop in use and say the full effect may take a decade to show. [15] Platforms face fines of up to A$49.5m for serious breaches, while children and parents are not punished. [17]

  7. 08

    The UK plans an under-16 ban next spring

    The UK government plans to ban under-16s from some social media platforms, including TikTok and YouTube, with the ban expected by spring 2027. [18] Another minister told Parliament that under-16s will face some age or feature limits even if a full ban is not chosen, and curfews are being considered. [19] The European Union has chosen a different line, banning under-13s and personal accounts for under-15s. [16]

    Why it matters — Researchers writing in STAT say the bans are a chance to measure what really changes for teenagers, such as sleep, friendships and study, not just screen time. [16] In the US, Meta, which owns Facebook and Instagram, agreed to pay up to $18 billion to settle claims that its apps harmed children. [16]

  8. 09

    No home-grown chikungunya in the US this year

    Chikungunya is a virus spread by mosquito bites that causes fever and joint pain. [20] The US Centers for Disease Control and Prevention counted 116 cases in US states in 2026 by 15 September, all linked to travel, and none caught locally. [20] In 2025, locally caught cases were reported in Florida and New York. [20] One vaccine, Vimkunya by Bavarian Nordic, is licensed in the US and recommended for travellers going to places with outbreaks. [21]

    Why it matters — Local spread needs the right mosquitoes, and a study this year expects the Asian tiger mosquito, which carries the virus, to thrive further north as the climate warms. [23]

  9. 10

    Chikungunya came back across the Americas

    The Pan American Health Organization reported 313,132 chikungunya cases in 18 countries and one territory of the Americas in 2025, with 170 deaths. [22] Worldwide, 41 countries reported more than 500,000 cases that year. [22] The virus kept spreading into 2026 in parts of Brazil and southern Bolivia, and returned to the Guiana Shield in the north of South America. [22] By late January the region had counted 7,150 more cases. [22]

    Why it matters — PAHO asked countries to keep testing and reporting cases, because the virus is turning up in places that had not seen it for years. [22]

  10. 11

    Chikungunya could reach Europe and North America by 2100

    A study in Frontiers in Cellular and Infection Microbiology found about 21% of the world's land, across 139 countries, is now suitable for the mosquitoes that spread chikungunya. [23] Under likely warming, northeastern North America, central Europe and East Asia could become hotspots by 2100. [23] The Asian tiger mosquito, which copes better with cooler weather, is expected to spread most. [23] Europe's disease agency counted about 33,000 cases worldwide by late May 2026, including nine deaths. [23]

    Why it matters — Today, cases in Europe and North America are almost all in travellers coming home, which is why the US count has no local cases this year. [23][20]

  11. 12

    Narcolepsy scientists win a Lasker Award

    Emmanuel Mignot and Masashi Yanagisawa won one of this year's Lasker Awards, prestigious prizes for medical research. [24] Working separately from the late 1990s, both found that orexin, a brain chemical, is central to narcolepsy, an illness of uncontrollable sleepiness. [24] Their work laid the ground for new wakefulness drugs that companies are racing to bring to market. [24] Other awards went to Japanese scientists for a haemophilia A treatment and to the actor Michael J. Fox for his Parkinson's work. [24]

    Why it matters — Lasker Awards often come before a Nobel Prize, and the orexin drugs are chasing a market that STAT puts at $5 billion. [24]

  12. 13

    Three risk factors, 13 fewer years without dementia

    A study led by Josef Coresh at New York University followed 12,409 Americans from age 55 in the early 1990s to 2022. [25] It looked at three risks to blood vessels: diabetes, high blood pressure and smoking. [25] People with none lived about 30 years past 55 without dementia, and people with all three about 17 years. [25] Women lived 1.5 to three years longer without dementia than men with the same risks. [25]

    Years lived past age 55 without dementia, by how many of diabetes, high blood pressure and smoking a person had.

    Why it matters — Black participants lived about three fewer dementia-free years than White participants. [25] The study shows a link, and the researchers say more work is needed on what changing these risks does. [25]

  13. 14

    Dementia costs the US $818 billion this year

    A study in the journal Alzheimer's and Dementia estimated that 5.7 million US adults aged 51 and over are living with dementia in 2026, helped by 5.2 million care partners. [26] It put the total cost at $818 billion. [26] The biggest part, $320 billion, is lost quality of life for people with dementia. [26] Unpaid care by family and friends adds $237 billion, and families carry more than three times the cost that health systems do. [26]

    Why it matters — The authors say new treatments may raise medical bills while easing the load on carers. [26] A US cost study found lecanemab is not good value for money at the price its maker charges. [9]

  14. 15

    India could prevent up to 70% of dementia

    Writing for World Alzheimer's Day on 21 September, doctors in the Indian Journal of Medical Research set out how India could prevent dementia. [27] A national survey estimated about 8.8 million Indians over 60, or 7.4%, have dementia, more of them in villages and among people with little schooling. [27] The 2024 Lancet Commission, a panel of dementia experts, estimated nearly 45% of dementia worldwide could be prevented or delayed by tackling 14 risks. [27] For India the estimate is up to 70%. [27]

    Why it matters — The biggest risks in India are little schooling, poor eyesight, lack of exercise and isolation. [27] With no affordable cure, the authors say prevention is the realistic plan, as numbers head for about 11 million by 2050. [27]

  15. 16

    Speaking a second language well linked to sharper thinking

    Researchers tested 492 older adults in India on memory, language and planning, and asked about the languages they speak. [28] Most learned a second language, usually Hindi, as children. [28] Speaking the second language well was linked to better planning and decision-making, both in people with schooling and in people without. [28] Learning it early was linked to better language skills among people who never went to school. [28]

    Why it matters — The study measured people once, so it shows a link rather than proof that languages protect the brain. [28]

  16. 17

    A diabetes drug missed its main goal in Alzheimer's

    The ELAD trial gave 204 people with mild to moderate Alzheimer's and no diabetes daily injections of liraglutide, a diabetes and weight-loss drug, or a dummy drug for a year. [29] Its main goal was a change in how much sugar the brain burns, seen on a scan, and it found no change between the groups. [29] One secondary score, on planning and thinking, came out better on the drug. [29]

    Why it matters — Liraglutide acts like a natural hormone called GLP-1, and in mice bred to get an Alzheimer's-like disease it improved memory, which is why it was tried. [29]

  17. 18

    An inflammation drug failed overall, with signs in a smaller group

    XPro1595 blocks one harmful form of TNF, an immune signal that drives inflammation. It was tested in 207 people with early Alzheimer's for 24 weeks. [30] Across the 200 with results, it made no difference to its main thinking score. [30] In a group of 100 chosen in advance because they had amyloid and high inflammation, results leaned towards the drug on thinking and on agitation. [30] No brain swelling was seen. [30]

    Why it matters — Unlike the amyloid drugs, it caused none of the brain swelling that needs repeat scans. [30][2] Because the smaller group was named before the trial began, the authors say the drug is worth testing in people with high inflammation. [30]

  18. 19

    Health records flag 20 everyday drugs

    Researchers searched health records from four US hospital networks for 122,972 people aged 50 and over with mild memory problems. [31] They checked whether starting any of 181 common drugs was linked to a slower slide into dementia. [31] Twenty were, including the painkiller celecoxib and the stomach drug famotidine, and the pattern held in a second set of records. [31] The authors call them candidates for trials, not proven treatments. [31]

    Why it matters — Using drugs that are already approved is a faster and cheaper route than building new ones, the authors say. [31]

  19. 20

    Magnetic brain stimulation not ready for Alzheimer's care

    Repetitive transcranial magnetic stimulation, or rTMS, stimulates the brain with magnetic pulses from outside the head. [32] A review of 14 trials in mild to moderate Alzheimer's found most reported better thinking scores after 4 to 12 weeks of sessions. [32] Side effects were mild, such as headaches and scalp discomfort. [32] But the trials were small, short and used very different settings. [32]

    Why it matters — The authors conclude rTMS is not ready for routine care and call for larger trials that compare it with fake stimulation. [32]

  20. 21

    Alzheimer's patches were stopped far sooner than pills

    Researchers in Tochigi, Japan, used insurance records for 8,117 people aged 65 and over with severe Alzheimer's who started an older type of Alzheimer's drug. [33] People on pills stayed on it for 1.5 years on average, against 0.6 years on skin patches. [33] Patch users were 11 times more likely to stop. [33] Hospital stays and deaths were lower in the pill group. [33]

    Why it matters — The authors note there is little evidence these drugs help in severe Alzheimer's, so long use of the pills raises its own questions. [33]

  21. 22

    Alzheimer's changes how DNA folds in brain cells

    A team led by Hansruedi Mathys, Zhijun Duan and Jian Ma studied brain tissue from 20 people aged 75 or older, half of whom had Alzheimer's. [34] They looked at how DNA folds up inside cells from the front of the brain. [34] In Alzheimer's, distant parts of the DNA sat together more often and neighbouring parts less often. [34] Tightly packed, switched-off DNA mixed more than usual with the loose, active kind. [34]

    Why it matters — How DNA folds decides which genes a cell can use, so the change may help explain the altered gene activity seen in Alzheimer's and in ageing. [34]

  22. 23

    A finger-prick test for Alzheimer's moves to a bigger trial

    In a Nature Medicine study of 337 people at seven centres, a few drops of blood from a finger prick, dried on a card, were tested for p-tau217, a marker of Alzheimer's. [35] The levels matched normal blood samples closely and picked out people with Alzheimer's changes in their spinal fluid with good accuracy. [35] A larger trial, Bio-Hermes-002, is now testing a finger-prick test in 1,000 volunteers over 60 in the UK, US and Canada. [5]

    Why it matters — Waits to see a specialist in the US can run for months or more than a year, so a test a family doctor can use matters. [43] The Nature Medicine authors say the card method still needs work before clinics use it. [35]

  23. 24

    A pattern of RNA in blood spots Alzheimer's

    Researchers read genetic material called RNA in the blood of 816 people without memory problems and 405 with Alzheimer's. [36] They found 34 circular RNAs, stable loops that can cross from the brain into the blood, linked to the disease. [36] A model built on those 34 did about as well as p-tau217, the best-studied blood marker. [36]

    Why it matters — Catching the illness before symptoms is what the new treatments need, the authors say, and this adds a second kind of blood test to the protein tests now reaching clinics. [36]

  24. 25

    Smoking drove most of the gap in US deaths by schooling

    A Nature Health study looked at 33 million deaths among white US adults aged 30 to 79 from 1992 to 2024. [37] For men with little schooling, the risk of dying between 30 and 79 rose from 65% to 79%. For men with the most schooling it fell from 44% to 34%. [37] Smoking caused 63% of the 3.2 million extra early deaths among people with less schooling. [37]

    Chance a white US man dies between 30 and 79, by schooling.

    Why it matters — Among people under 65, opioids caused 3% of those extra deaths, rising to 8% in 2010 to 2019. [37] The authors call smoking the leading reason survival among white US adults has stalled. [37]

  25. 26

    Tobacco kills 164,000 a year in Pakistan

    The World Health Organization says tobacco kills an estimated 164,000 people a year in Pakistan and costs about $6.6 billion. [38] That damage is seven times what the tobacco industry pays in tax there. [38] Pakistan has not raised its duty on cigarettes since February 2023, so they have become more affordable. [38] Worldwide, at least 40 million children aged 13 to 15 use tobacco. [38]

    Why it matters — WHO says higher tobacco taxes cut smoking and raise money for health at the same time, and Pakistan's are below the 75% of the price it recommends. [38]

  26. 27

    Early deaths from heart attacks linked to drugs fell after 2021

    A study of US death records counted 176,641 deaths under age 65 from 1999 to 2023 involving both a heart attack and substances such as alcohol, opioids or stimulants. [39] The death rate rose from 1.4 to 4.16 per 100,000. [39] It climbed fast until 2005, kept rising until 2021, then fell about 9% a year to 2023. [39] Adults aged 45 to 65 had a far higher rate than younger adults. [39]

    Why it matters — The authors forecast only a small further fall, to 3.8 per 100,000 by 2035, with rural areas and South Dakota, Kentucky and Arkansas hardest hit. [39]

  27. 28

    Smoking linked to overdose deaths in veterans on painkillers

    A US study followed veterans prescribed opioid painkillers, first seen at veterans' clinics between 2014 and 2019, for nearly seven years. [40] In that time 2.2% attempted suicide, 0.4% died by suicide and 0.5% died of an overdose. [40] Smoking at the start was linked to a 67% higher rate of overdose death and 19% higher rate of suicide death, after allowing for other risks. [40] Cannabis use was linked to 11% more suicide attempts. [40]

    Why it matters — The authors say doctors should keep a closer eye on patients in this group who smoke or use cannabis. [40] Suicidal thoughts are a matter for a doctor or a crisis line.

  28. 29

    Pregnant patients are left out of almost all drug trials

    Researchers at Brown University checked 44,160 drug trials open to women aged 18 to 45 on ClinicalTrials.gov, the US register of medical studies. [41] Only 0.8% clearly allowed pregnant participants, and 75% excluded them. [41] In earlier work, one of them found fewer than 1% of drug trials enrol pregnant patients, a figure unchanged over 15 years. [41] They want the register to add one field showing whether a trial takes pregnant or breastfeeding people. [41]

    Why it matters — The gap leaves little evidence on drug safety in pregnancy, which US officials have pointed to in arguments over antidepressants and paracetamol. [41]

  29. 30

    Black patients still under 4% of cancer drug trials

    A study of 23,539 people in the trials behind US-approved cancer drugs from 2013 to 2024 looked at who took part. [42] White participants fell from 83.2% to 68.9% over that time. [42] Asian participants, and trials run in Asia, rose to about a fifth. [42] Black participants stayed under 4% throughout. [42]

    Why it matters — A mixed trial population is what lets doctors see whether a drug works or harms differently across groups, the authors say. [42]

02 Lesson why it matters

When a trial misses its main goal, the good news often moves to a smaller group

Check enough groups and scores and one will look good by luck, so a win found after the main test failed needs a trial of its own.

The twist

After a main test fails, every extra group or score that gets checked is one more chance for luck to look like a win.

The picture

1 of 20

Check 20 groups where a drug does nothing, and about one looks like a win

Made-up numbers. Trials usually accept a 1-in-20 chance that a result is luck, so twenty checks on a drug that does nothing give about one false win.

How it works

  1. A trial names one main question before it starts
  2. The main answer comes back no, or too small to notice
  3. Researchers then look at smaller groups and other scores
  4. With many looks, one can come out well by luck alone
  5. So that finding is a lead to test again, not an answer

The same force, elsewhere today

Where this chain is also running, in today's other stories.

  • The inflammation drug XPro1595

    It missed its main score in 200 people, then leaned its way in 100 people with high inflammation; that group was named before the trial, which makes it a fairer lead.

  • Liraglutide in Alzheimer's

    The brain-scan goal showed no change, and one secondary thinking score came out better. A new trial would have to test that score on its own.

  • Health records flag 20 everyday drugs

    181 drugs were checked at once and 20 came out linked to slower decline; with that many checks, some links are expected by chance, which is why they are called candidates.

  • Australia's social media ban

    Across all ages the study found no clear drop in use, and the one fall it did find came in a single age group, 14- and 15-year-olds.

Where you've seen this

Sport statistics

split a player's record enough ways and one split, such as away games in the rain, will look like a gift

School teaching methods

a method that failed across the school gets reported as working for one class

Adverts

a company tries twenty versions and praises the one that did best that week

The catch

Sometimes the smaller group really is different: a drug that calms inflammation should work best in people with a lot of it, and a group named before a trial starts is a fair test.

And the whole of it

Everyone in these trials is doing honest work: the scientist looking for who was helped, the company hoping its drug works, the family hoping for any good news. From inside one trial, none of them can tell whether a good result in a smaller group is real or luck. Only the next trial can show which.

03 Truth what's really going on

What is really going on

Two Alzheimer's drugs, lecanemab and donanemab, pull amyloid out of the brain and slow decline by about four to six months over a year and a half, and one in five people on donanemab get brain swelling on a scan. [1][2] Blood tests that can find the illness years before symptoms are arriving faster than any treatment that stops it. [4][6]

Why it works on us — Calling a drug a gamechanger turns a result that passed a statistics test into a change a family expects to see at home. [1]

Who gains

  • Eisai and Eli Lilly — EU approval in 2025 opened a new market for drugs given by drip every few weeks for months. [2][1]
  • Makers of Alzheimer's blood tests, such as Roche and Fujirebio — Treatment needs proof of amyloid, and scans and spinal taps are costly, so blood tests are becoming the way in. [3][4][5]
  • Social media companies in Australia — More than 85% of under-16s were still using their apps three months into the ban. [15]
  • The tobacco industry in Pakistan — Cigarette duty has not risen since February 2023, so cigarettes have become cheaper to buy. [38]

Who pays

  • Families of people with dementia in the US — They carry more than three times the cost that health systems pay, including $237 billion of unpaid care this year. [26]
  • People taking donanemab — About one in five get brain swelling on a scan, against 1.8% on a dummy drug, and all need repeat scans. [2][3]
  • Older people and babies in the southern hemisphere — They are the groups most at risk from the extra heat deaths forecast up to February. [10]
  • White US men with little schooling — Their risk of dying between 30 and 79 rose to 79%, and smoking caused 63% of the extra early deaths. [37]
  • Pregnant patients — Three in four drug trials open to women exclude them, so drug safety in pregnancy stays unknown. [41]

What nobody knows yet

Open questions from across today’s stories — ours included.

  • 01

    Whether the drugs slow Alzheimer's by an amount patients and families can notice.

    Cochrane called the effect trivial across 17 trials, while Alzheimer's Research UK says only two of those trials tested the drugs now in use. [1] The European Medicines Agency says it is uncertain what size of change counts as meaningful. [2]

  • 02

    How long any benefit lasts beyond 18 months.

    The makers' estimates of benefit beyond 18 months rest on untested assumptions, the European Medicines Agency says, and the three-year donanemab results compare against people from a separate study. [2][8]

  • 03

    Whether Australia's ban will change teenagers' mental health at all.

    Three months in, most under-16s were still online, and the study measured use, not wellbeing. [15]

  • 04

    How many people El Nino heat will actually kill by February.

    The 240,000 figure depends on the seasonal forecast being right, and it counts only heat, not the fires, floods and disease El Nino also brings. [10]

  • 05

    Whether chikungunya will start spreading locally in Europe and North America.

    The 2100 hotspots come from climate scenarios, and today nearly all cases there are in travellers. [23][20]

  • 06

    Whether any of the 20 drugs flagged in health records protects the brain.

    The links come from records of who took what, and none has yet been tested in a trial for dementia. [31]

  • 07

    Whether XPro1595 helps people with high inflammation.

    The signal came from 100 people, only 28 of them on the dummy drug, after the trial missed its main goal. [30]

  • 08

    Whether NICE will now pay for the drugs in England.

    It is looking at its rejection again after an appeal by the makers. [1]

04 Hope carry this

A blood test cleared in the US in October 2025 correctly rules out Alzheimer's in 97.9% of people tested, and a separate finger-prick test is now being tried in 1,000 volunteers.

Also true today

  • In a study that followed 12,409 Americans for three decades, people with no diabetes, high blood pressure or smoking at 55 lived about 30 more years without dementia.
  • US states have recorded no locally caught chikungunya this year, after local cases in Florida and New York in 2025.
  • Early deaths in the US from heart attacks linked to alcohol and drug use fell by about 9% a year from 2021 to 2023.
  • Two scientists who found that the brain chemical orexin is central to narcolepsy won a Lasker Award, and drugs built on their work are now being developed.

Across the beats