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Doctors have hailed a “new era” of medicine after a study showed for the first time that a drug can slow the debilitating symptoms of Alzheimer’s.

Results from the clinical trial also revealed that the drug lecanemab cleared clumps of a protein called amyloid – thought to be a key cause of the most common form of dementia – from patients’ brains.

The data, published at a conference in San Francisco, led to an outpouring of optimism from scientists, many of whom had spent decades trying to understand what leads to the disease and find a treatment.

Rob Howard, professor of old age psychiatry at University College London, said the results were “wonderful and hope-filled” – adding: “At long last we have gained some traction on this most terrible and feared disease and the years of research and investment have finally paid off.

“It feels momentous and historic. This will encourage real optimism that dementia can be beaten and one day even cured.”

The manufacturers of the drug released top-line results in a news release earlier in the autumn, but many doctors held back from celebrating until full results were released at the Clinical Trials on Alzheimer’s Disease conference.

They showed that lecanemab slowed the decline in memory and mental agility by 27% in patients with mild Alzheimer’s.

A new drug has been found to reduce cognitive decline in Alzheimer's patients

‘Doctors are optimistic’

Critically, the drug removed so much of the amyloid protein that the patients wouldn’t have had enough evidence of Alzheimer’s disease on their brain scans to actually qualify for entry to the trial.

The study strongly suggests that the drug only starts to have a clinical effect once amyloid is reduced to low levels in the brain.

Results after 12 months of treatment suggested it was ineffective – but after 18 months, the effect was significant.

Doctors are optimistic that continued treatment will lead to even better results.

Professor Nick Fox, director of the Dementia Research Centre at University College London, said: “It confirms a new era of disease modification for Alzheimer’s disease, an era that comes after more than 20 years of hard work by many, many people, with many disappointments along the way.”

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Lecanemab is not a cure. But even slowing the progression of Alzheimer’s disease would be game changing, delaying the need for specialist care and allowing people to spend more time with their families.

However, the drug has side effects.

One in eight patients given lecanemab suffered brain swelling and other changes, probably as a result of removing the amyloid protein. But most only had evidence of problems on brain scans. Fewer than one in 30 had actual symptoms such as headaches or confusion.

Some patients had bleeding in the brain, though deaths were no higher in those receiving treatment than those given a dummy drug.

Nevertheless, it underlines the need for careful monitoring of those on treatment.

Prof Fox said: “Any risk is clearly important, but I believe that many of my patients would be very willing to take such a risk.

Hospital

‘Massive challenge for the NHS’

Doctors warned that lecanemab will be a massive challenge for the NHS, not just because the drug is given through an intravenous infusion every two weeks.

Most Alzheimer’s patients are currently diagnosed when they have moderate symptoms – too late for treatment with lecanemab. And just 1% have their diagnosis confirmed by a brain scan or lumbar puncture, a biopsy of their spinal fluid.

Susan Kohlhaas, director of research at Alzheimer’s Research UK said: “It’s safe to say that the NHS is not ready for a new era of dementia treatment.

“We estimate that unless there are drastic changes in how people access specialist diagnostic tests for Alzheimer’s disease, only 2% of people eligible for drugs like lecanemab will be able to access them.”

Until now there have only been drugs that treated symptoms rather than the underlying cause. But if lecanemab is licensed for use on the NHS then delays in treatment will result in brain cells dying and the disease progressing.

Prof John Hardy, from the UK Dementia Research Institute in London said the drug had been “a long time coming”.

He added: “I truly believe it represents the beginning of the end.

“The first step is the hardest, and we now know exactly what we need to do to develop effective drugs. It’s exciting to think that future work will build on this, and we will soon have life-changing treatments to tackle this disease.”

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One year on from Donald Trump’s election win, an untold story has emerged

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One year on from Donald Trump's election win, an untold story has emerged

It’s a year since the US put Donald Trump back in the White House and I’ve spent this anniversary week in Florida and in Pennsylvania – two worlds in one country where I found two such contrasting snapshots of Trump’s America.

There are many ways to reflect on the successes and failures of the past year. Different issues matter to different people. But the thing which matters to all Americans is money.

The cost of living was a key factor in Donald Trump’s victory. He promised to make the country more affordable again. So: how’s he done?

On Wednesday, exactly a year since Americans went to the polls, the president was in Miami. He had picked this city and a particular crowd for his anniversary speech.

I was in the audience at the America Business Forum as he told wealthy entrepreneurs and investors how great life is now.

“One year ago we were a dead country, now we’re considered the hottest country in the world.” he told them to cheers. “Record high, record high, record high…”

The vibe was glitzy and wealthy. These days, these are his voters; his crowd.

“After just one year since that glorious election, I’m thrilled to say that America is back, America is back bigger, better, stronger than ever.” he said.

“We’ve done really well. I think it’s the best nine months, they say, of any president. And I really believe that if we can have a few more nine months like this, you’d be very happy. You’d be very satisfied.”

There was little question here that people are happy.

Liz Ciborowski says Trump has been good for the economy
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Liz Ciborowski says Trump has been good for the economy

“Trump’s been a good thing?” I asked one attendee, Liz Ciborowski.

“Yes. He has really pushed for a lot of issues that are really important for our economy,” she said.

“I’m an investor,” said another, Andrea.

“I’m a happy girl. I’m doing good,” she said with a laugh.

Andrea says she's happy with how the economy is faring
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Andrea says she’s happy with how the economy is faring

A year on from his historic victory, the president was, notably, not with the grassroots folk in the places that propelled him back to the White House.

He had chosen to be among business leaders in Miami. Safe crowd, safe state, safe space.

But there was just one hint in his speech which seemed to acknowledge the reality that should be a concern for him.

“We have the greatest economy right now,” he said, adding: “A lot of people don’t see that.”

That is the crux of it: many people beyond the fortunate here don’t feel the “greatest economy” he talks about. And many of those people are in the places that delivered Trump his victory.

That’s the untold story of the past year.

A thousand miles to the north of Miami is another America – another world.

Steelton, Pennsylvania sits in one of Donald Trump’s heartlands. But it is not feeling the beat of his greatest economy. Not at all.

At the local steel union, I was invited to attend a meeting of a group of steel workers. It was an intimate glimpse into a hard, life-changing moment for the men.

The steel plant is shutting down and they were listening to their union representative explaining what happens next.

David Myers used to be employed at the steelworks
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David Myers used to be employed at the steelworks

The conversation was punctuated with all the words no one wants to hear: laid off, severance, redundancy.

“For over 100 years, my family has been here working. And I was planning on possibly one day having my son join me, but I don’t know if that’s a possibility now,” former employee David Myers tells me.

“And…” he pauses. “Sorry I’m getting a little emotional about it. We’ve been supplying America with railroad tracks for over a century and a half, and it feels weird for it to be coming to an end.”

Cleveland Cliffs Steelton plant is closing because of weakening demand, according to its owners. Their stock price has since surged. Good news for the Miami crowd, probably. It is the irony between the two Americas.

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Steelton in Pennsylvania
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Steelton in Pennsylvania

Down at the shuttered plant, it’s empty, eerie and depressing. It is certainly not the image or the vision that Donald Trump imagined for his America.

Pennsylvania, remember, was key to propelling Trump back to the White House. In this swing state, they swung to his promises – factories reopened and life more affordable.

Up the road, conversations outside the town’s government-subsidised homes frame the challenges here so starkly.

“How much help does the community need?” I asked a man running the local food bank.

Elder Melvin Watts is a community organiser
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Elder Melvin Watts is a community organiser

“As much as they can get. I mean, help is a four-letter word but it has a big meaning. So help!” community organiser Elder Melvin Watts said.

I asked if he thought things were worse than a year ago.

“Yes sir. I believe they needed it then and they need it that much more now. You know it’s not hard to figure that out. The cost of living is high.”

Nearby, I met a woman called Sandra.

Sandra says it's getting harder to make ends meet
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Sandra says it’s getting harder to make ends meet

“It’s been harder, and I’m a hard-working woman.” she told me. “I don’t get no food stamps, I don’t get none of that. You’ve got to take care of them bills, eat a little bit or don’t have the lights on. Then you have people like Mr Melvin, he’s been out here for years, serving the community.”

Inside Mr Melvin’s food bank, a moment then unfolded that cut to the heart of the need here.

A woman called Geraldine Santiago arrived, distressed, emotional and then overwhelmed by the boxes of food available to her.

“We’ll help you…” Mr Melvin said as she sobbed.

Geraldine's welfare has been affected by the shutdown
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Geraldine’s welfare has been affected by the shutdown

Geraldine is one of 40 million Americans now not receiving the full nutritional assistance programme, known as SNAP, and usually provided by the federal government.

SNAP benefits have stopped because the government remains shut down amid political deadlock.

I watched Geraldine’s rollercoaster emotions spilling out – from desperation to gratitude at this moment of respite. She left with a car boot full of food.

A year on from his victory, Donald Trump continues to frame himself as the “America First” president and now with an economy transformed. But parts of America feel far, far away.

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Nancy Pelosi, the first woman in Speaker’s office, to stand down after 40 years in US Congress

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Nancy Pelosi, the first woman in Speaker's office, to stand down after 40 years in US Congress

Nancy Pelosi, the first woman in the Speaker’s office, has announced her retirement from American politics after a nearly 40-year career.

The 85-year-old, who has represented San Francisco since 1987, revealed her decision two days after Californian voters overwhelmingly approved “Proposition 50”, a state redistricting effort aimed at flipping five House seats to Democrats in the midterm elections next year.

“I will not be seeking re-election to Congress,” Pelosi said in a video address to voters.

“With a grateful heart, I look forward to my final year of service as your proud representative.

“My message to the city I love is this: San Francisco, know your power,” she said. “We have made history. We have made progress. We have always led the way.”

“And now we must continue to do so by remaining full participants in our democracy and fighting for the American ideals we hold dear.”

Nancy Pelosi at the Democratic National Convention in 2024.  Pic: Reuters
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Nancy Pelosi at the Democratic National Convention in 2024. Pic: Reuters

Mrs Pelosi served as the 52nd Speaker of the House of Representatives from 2007 to 2011, and again from 2019 to 2023, and was the first woman elected to the role.

She was also the first woman to lead a major political party in either chamber of Congress, heading the House Democrats from 2003 to 2023.

During her second tenure as Speaker, the House twice impeached Donald Trump – in December 2019, and January 2021 – though the Senate acquitted him both times.

And in February 2020, during President Trump’s State of the Union address, she famously tore up her official copy of it, arguing “it was such a dirty speech”.

An architect of the Affordable Care Act, Mrs Pelosi has also been credited with quietly persuading Joe Biden to withdraw from the 2024 presidential race.

End of an era

Nancy Pelosi was a central figure during two of the most turbulent political periods – the Trump presidency and President Biden’s departure from the 2024 election.

During the Trump era, she emerged as the Democratic Party’s most visible counterweight to the administration.

She led the House through two impeachments and became was prime target for those who stormed the Capitol Building on January 6th 2021.

In 2024, her behind-the-scenes influence was decisive as Democrats confronted Joe Biden’s declining political position.

While careful in her public statements, her subtle signalling to leaders and donors accelerated his departure from the race.

From a wider perspective, her retirement marks the end of one of the most influential congressional careers in modern US politics.

As the first woman Speaker of the House, she shaped legislative priorities for two decades and her departure signals a generational shift within the Democratic Party.

Now her political contemporaries have paid tribute.

Former President Joe Biden said America “will always be grateful” to her.

He posted on X: “I often said Nancy Pelosi was the best Speaker of the House in American history – it’s why I awarded her the Presidential Medal of Freedom.

“When I was President, we worked together to grow our economy, create millions of jobs, and make historic investments in our nation’s future.”

California’s Democrat Governor Gavin Newsom, said she “inspired generations” and “set the standard for what public service should be”.

While party colleague, Senator Adam Schiff, who also represents California, called her “the greatest Speaker in American history” and highlighted her “tenacity, intellect, strategic acumen and fierce advocacy”.

And Representative Don Beyer of Virginia, another Democrat, said she was “a major figure in American history”, a “barrier breaker”, and “one of our most brilliant and accomplished leaders”.

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“Why did you refuse the National Guard on January 6?”

First elected in 1987, she came into politics later in life, and has long resisted calls to step aside, turning questions about her future into spirited rebuttals.

But she’s faced new challenges in recent years and her decision to step down is not fully unexpected.

Read more:
JD Vance’s telling reaction to a big 24 hours in US politics
What Zohran Mamdani’s win means for Trump

Last year she fractured her hip when she fell during a European trip, and was rushed to a military hospital for surgery.

And in 2022, her husband Paul Pelosi was gravely injured by a home intruder who beat him over the head with a hammer and demanded to know “Where is Nancy?”

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Nonetheless, she’s maintained a rigorous political schedule of public events and party fundraisers.

Now eyes will turn to the question of her successor, both at home in San Francisco, and in the US Congress where she plays a behind-the-scenes leadership role.

She’s already faced a potential primary challenge from Saikat Chakrabarti, a left-wing newcomer who played a part in the rise of Alexandria Ocasio-Cortez – another rising star in the progressive firmament.

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JD Vance may have had the most telling reaction to a big 24 hours for US politics

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JD Vance may have had the most telling reaction to a big 24 hours for US politics

Don’t be led by what appears to be obvious.

The Mamdani victory is historic for him, a dreamy American journey for an immigrant rising to the top, and, along with the governor victories in New Jersey and Virginia, it undoubtedly represents a gear shift for the Democrats who have been lost in a Trumpian vortex since Joe Biden’s disastrous presidential debate 18 months ago.

All of this is true. And in that sense, it was of course a very good night for the Democratic Party. Winning is clearly better than losing.

But what if Mamdani is actually a poison chalice for the Democrats? They are drinking this socialist’s champagne now because they finally have some momentum.

But he isn’t a champagne socialist. He is a purist socialist; proudly one.

Explainer: Who is Zohran Mamdani?

Pic: AP
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Pic: AP

With his skilful communication skills and his apparent authenticity, he has energised New York City. And no wonder. The alternative was the flawed, compromised Andrew Cuomo. Mamdani offered hope for a deeply liberal city that’s lost in Trump World.

Trump endorsed Cuomo not because he agrees with Mamdani’s own tagline: “I am Trump’s worst nightmare…”

Trump endorsed Cuomo because he knew that it would probably increase Mamdani’s share of the vote – and it did.

Why would Trump do this? Maybe because he thinks Mamdani is the perfect foil for him.

Trump's endorsement of Andrew Cuomo wasn't all it seemed on the surface. Pic: AP
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Trump’s endorsement of Andrew Cuomo wasn’t all it seemed on the surface. Pic: AP

What Trump can get out of apparent defeat

Mamdani’s victory gives Trump and his allies two things.

First, they can sit back and watch the Democrats squabble about whether Mamdani’s leftward Democratic socialism is the future of their party. And be in no doubt, they will.

Second, they can warn centrists and right-leaning folk: ‘Look, the Democrats really are socialists…’. The president continues to frame him as a “communist”.

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And so it begins, the Trump/Mamdani rivalry…

The Democrats may choose the Mamdani lane and stick with it, especially if he is successful in New York. But the Big Apple is not remotely representative of America.

Beyond New York City, Mamdani is, history would suggest, off the spectrum when it comes to electable Democratic Party candidates – America remains a conservative society; political spectrums here naturally tack right.

Team Trump knows all this, so they’ll relish the prospect of the Democratic Party machine (which has form in picking the wrong candidate) being lured by Mamdani-mania.

Cost of living a key issue

Beyond that, there is a vital takeaway for Trump from this mini and not wholly representative referendum on his presidency so far.

Many ordinary Americans are still hurting economically, big time.

The Democrats won in New York, New Jersey and Virginia because their candidates all focused on kitchen table issues.

The president clearly recognises this, to an extent. “Day by day, we’re going to make America affordable again,” he said after the Mamdani victory.

But he was speaking not to the people who are feeling the squeeze. Instead, he chose to mark a year since he was elected with a speech to a wealthy business crowd in Miami. Safe crowd, safe state, safe space.

Trump perhaps realises he's failing on one key promise. Pic: AP
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Trump perhaps realises he’s failing on one key promise. Pic: AP

JD Vance’s telling reaction

Maybe the most telling thing to come out of the past 24 hours in American politics was from the vice president.

In a social media post, JD Vance first warned followers not to overreact to the results.

He then went on to offer his own notable interpretation of the Democratic Party victories.

“We need to focus on the home front.” he wrote. “The president has done a lot that has already paid off in lower interest rates and lower inflation, but we inherited a disaster from Joe Biden and Rome wasn’t built in a day.

“We’re going to keep on working to make a decent life affordable in this country, and that’s the metric by which we’ll ultimately be judged in 2026 and beyond.”

Read more: Mamdani can’t expect easy wins

Vice President JD Vance
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Vice President JD Vance

My interpretation of his interpretation?

Two points: first, that Vance thinks that Trump needs to get back to his base. Ten months of presidential jet-setting and global-conflict-solving may have been necessary, but it won’t spell victory in the midterms next year or beyond.

The second point – Vance is so clearly in it for the long game. The “beyond” he talks about has him at its centre.

I’m not sure Vance would have chosen a Miami arena full of business leaders to mark a year since the election. The business and investment community is happy and wealthy.

I think Vance would have been with the other America, where people are feeling the squeeze still.

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Trump continues to talk about the economy being “Biden’s economy”. Vance seems to be hinting at the inevitable – that at some point they need to own it and to fix it. They need to make people feel better off.

Vance wants to run and to win in 2028, and that fight begins now.

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