The LancetPub Date : 2025-09-22DOI: 10.1016/s0140-6736(25)01294-2
Giovanni B Frisoni, Oskar Hansson, Emma Nichols, Valentina Garibotto, Suzanne E Schindler, Wiesje M van der Flier, Frank Jessen, Nicolas Villain, Eider M Arenaza-Urquijo, Lucia Crivelli, Juan Fortea, Lea T Grinberg, Zahinoor Ismail, Satoshi Minoshima, Rik Ossenkoppele, Henrik Zetterberg, Ronald C Petersen, Bruno Dubois
{"title":"New landscape of the diagnosis of Alzheimer's disease","authors":"Giovanni B Frisoni, Oskar Hansson, Emma Nichols, Valentina Garibotto, Suzanne E Schindler, Wiesje M van der Flier, Frank Jessen, Nicolas Villain, Eider M Arenaza-Urquijo, Lucia Crivelli, Juan Fortea, Lea T Grinberg, Zahinoor Ismail, Satoshi Minoshima, Rik Ossenkoppele, Henrik Zetterberg, Ronald C Petersen, Bruno Dubois","doi":"10.1016/s0140-6736(25)01294-2","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01294-2","url":null,"abstract":"Alzheimer's disease involves a drastic departure from the cognitive, functional, and behavioural trajectory of normal ageing, and is both a dreaded and highly prevalent cause of disability to individuals, and a leading source of health and social care expenditure for society. Before the advent of biomarkers, post-mortem examination was the only method available to establish a definitive diagnosis. In this first paper of the Series, we review state-of-the-art diagnostic practices and the typical patient journey in specialist settings, where clinicians engage in a differential diagnosis to establish whether Alzheimer's pathology (cerebral deposition of β-amyloid and hyperphosphorylated tau) is a contributor to cognitive impairment. Biomarkers indicating dysregulation of β-amyloid and tau homeostasis, measured with PET and cerebrospinal fluid analysis, allow a molecular-level diagnosis—a mandatory step in defining eligibility for the recently approved anti-amyloid treatments. We anticipate that easily accessible blood biomarkers, already available in some countries, will lead to a new diagnostic revolution and bring about major changes in health-care systems worldwide.","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The LancetPub Date : 2025-09-22DOI: 10.1016/s0140-6736(25)01812-4
{"title":"Alzheimer's disease: are health systems ready?","authors":"","doi":"10.1016/s0140-6736(25)01812-4","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01812-4","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The LancetPub Date : 2025-09-22DOI: 10.1016/s0140-6736(25)01389-3
Giovanni B Frisoni, Emil Aho, Carol Brayne, Olga Ciccarelli, Bruno Dubois, Nick C Fox, Kristian S Frederiksen, Cem Gabay, Valentina Garibotto, Thomas Hofmarcher, Clifford R Jack, Miia Kivipelto, Ronald C Petersen, Federica Ribaldi, Christopher C Rowe, Sebastian Walsh, Henrik Zetterberg, Oskar Hansson
{"title":"Alzheimer's disease outlook: controversies and future directions","authors":"Giovanni B Frisoni, Emil Aho, Carol Brayne, Olga Ciccarelli, Bruno Dubois, Nick C Fox, Kristian S Frederiksen, Cem Gabay, Valentina Garibotto, Thomas Hofmarcher, Clifford R Jack, Miia Kivipelto, Ronald C Petersen, Federica Ribaldi, Christopher C Rowe, Sebastian Walsh, Henrik Zetterberg, Oskar Hansson","doi":"10.1016/s0140-6736(25)01389-3","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01389-3","url":null,"abstract":"For the first time, reductions in cerebral β-amyloid pathology load and rate of cognitive and functional decline have been achieved in Alzheimer's disease, through pharmacological intervention in randomised controlled trials. However, the results from phase 3 randomised controlled trials of anti-β amyloid monoclonal antibodies are interpreted in different ways, with some experts supporting a clinically meaningful disease-modifying effect, and others judging insufficient benefit-to-risk ratio and opposing market authorisation. In the final paper of this Series, we discuss these contrasting views, all of which wish to contribute to improvements in the quality of life of people with, or at risk of, Alzheimer's disease. We contrast the efficacy, societal costs, and generalisability of monoclonal antibodies for Alzheimer's disease to biologics for other conditions (eg, cancer, multiple sclerosis, and rheumatoid arthritis) and set this debate in the larger context of modern personalised medicine. We discuss current practice implications, future developments directed to β-amyloid and non-amyloid targets that might have more clinical efficacy and less adverse effects for those with the disease, and large-scale prevention interventions for those at risk.","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The LancetPub Date : 2025-09-22DOI: 10.1016/s0140-6736(25)01329-7
Nick C Fox, Christopher Belder, Clive Ballard, Helen C Kales, Catherine Mummery, Paulo Caramelli, Olga Ciccarelli, Kristian S Frederiksen, Teresa Gomez-Isla, Zahinoor Ismail, Claire Paquet, Ronald C Petersen, Robert Perneczky, Louise Robinson, Ozge Sayin, Giovanni B Frisoni
{"title":"Treatment for Alzheimer's disease","authors":"Nick C Fox, Christopher Belder, Clive Ballard, Helen C Kales, Catherine Mummery, Paulo Caramelli, Olga Ciccarelli, Kristian S Frederiksen, Teresa Gomez-Isla, Zahinoor Ismail, Claire Paquet, Ronald C Petersen, Robert Perneczky, Louise Robinson, Ozge Sayin, Giovanni B Frisoni","doi":"10.1016/s0140-6736(25)01329-7","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01329-7","url":null,"abstract":"Over the last three decades, the evidence on how to best treat the cognitive and non-cognitive symptoms of patients with Alzheimer's disease has increased. Although these pharmacological and non-pharmacological strategies have significantly improved health outcomes for patients with Alzheimer's disease, many lack stringent evidence of efficacy. In this second paper of the Series, we provide practical and realistic advice on how to prioritise pharmacological and non-pharmacological strategies to ameliorate cognitive impairment and behavioural and psychological symptoms of dementia. In this clinical environment, dementia specialists are faced with the challenge of holistically integrating the much anticipated and, in some respects, controversial anti-β amyloid monoclonal antibodies. Here, we present the current approval scenario of monoclonal antibodies, our view on how they might further contribute to improve patients' quality of life, and how they could be seamlessly integrated with existing best care options.","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The LancetPub Date : 2025-09-19DOI: 10.1016/s0140-6736(25)01806-9
Abbas M Hassan, Jennifer F Waljee
{"title":"Harms of the US travel ban to the physician workforce","authors":"Abbas M Hassan, Jennifer F Waljee","doi":"10.1016/s0140-6736(25)01806-9","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01806-9","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145089066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The LancetPub Date : 2025-09-19DOI: 10.1016/s0140-6736(25)01908-7
Elvira Isganaitis, Lori M Laffel
{"title":"Dual incretin agonist for paediatric type 2 diabetes: an eagerly awaited opportunity","authors":"Elvira Isganaitis, Lori M Laffel","doi":"10.1016/s0140-6736(25)01908-7","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01908-7","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145089065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The LancetPub Date : 2025-09-19DOI: 10.1016/s0140-6736(25)01438-2
Anette-Gabriele Ziegler, Eda Cengiz, Thomas W H Kay
{"title":"The future of type 1 diabetes therapy","authors":"Anette-Gabriele Ziegler, Eda Cengiz, Thomas W H Kay","doi":"10.1016/s0140-6736(25)01438-2","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01438-2","url":null,"abstract":"The treatment of type 1 diabetes is entering a transformative era. Teplizumab, the first immunotherapy treatment to delay the onset of clinical type 1 diabetes, has been approved by the US Food and Drug Administration. Other immune-based therapies show promise in preserving β-cell function. Public health screening using islet autoantibodies is expanding, enabling earlier diagnosis, reducing diabetic ketoacidosis, and allowing timely introduction of disease-modifying treatments before the need for insulin therapy. β-cell replacement is shifting from traditional transplantation of organ donor islets and the pancreas to stem cell-derived β cells. Bioengineering methods, such as encapsulation, and gene editing to create hypoimmune cells could reduce the need for immunosuppression that has hampered β-cell replacement, and patient-derived stem cells open doors to personalised therapies. Although these innovations have been made available to a small number of patients, scaling them to widespread use remains a challenge. Meanwhile, glucose regulation is improving through the use of automated insulin delivery systems that combine glucose monitoring with insulin pumps. New-generation insulins (those that are ultrarapid, ultralong, and glucose-responsive) improve outcomes by minimising blood sugar fluctuations. Together, these breakthroughs offer renewed hope for improving long-term management and quality of life for people living with type 1 diabetes.","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145089064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The LancetPub Date : 2025-09-18DOI: 10.1016/s0140-6736(25)01906-3
{"title":"Childhood obesity: a global health crisis","authors":"","doi":"10.1016/s0140-6736(25)01906-3","DOIUrl":"https://doi.org/10.1016/s0140-6736(25)01906-3","url":null,"abstract":"No Abstract","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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