A neurologist in Colombia, he worked with the world’s largest extended family with Alzheimer’s and helped fuel research to prevent or delay dementia symptoms.Dr. Francisco Lopera, a trailblazing neurologist who identified the world’s largest extended family with Alzheimer’s and spent decades working with them in his native Colombia, died on Tuesday at his home in Medellín. He was 73. The cause was metastatic melanoma.His death was announced on social media by the neuroscience group at the University of Antioquia in Medellín, which Dr. Lopera led until last month, when he retired.Dr. Lopera, a professor at the university for nearly 40 years, made significant discoveries in the field of Alzheimer’s. His work led to identifying the genetic cause of the extended family’s disease, helped pioneer efforts to find drugs to prevent or delay symptoms and spearheaded discoveries of genetic mutations that appear to be able to forestall cognitive decline.He also spent tremendous time and energy providing care and information to patients and their relatives. He identified about 6,000 members of the large clan in Medellín and mountain villages in northwest Colombia. An estimated 1,200 of them were born with a genetic mutation that causes Alzheimer’s, with symptoms starting in their 40s and often causing death in their 60s.“He was very devoted to finding a cure for Alzheimer’s and trying to stop the disease, but he also knew that there were patients that were already facing the disease,” said Yakeel Quiroz, a Colombian neuropsychologist and director of the Multicultural Alzheimer’s Prevention Program at Massachusetts General Hospital who collaborated with Dr. Lopera and was among the many researchers he mentored.Dr. Lopera with a research colleague, Yakeel Quiroz. “He was very devoted to finding a cure for Alzheimer’s and trying to stop the disease,” she said of Dr. Lopera.Massachusetts General Hospital, via Associated PressWe are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

The condition has put significant strain on patients and society — at a global economic cost of about $1 trillion a year, a new report estimates.About 400 million people worldwide have been afflicted with long Covid, according to a new report by scientists and other researchers who have studied the condition. The team estimated that the economic cost — from factors like health care services and patients unable to return to work — is about $1 trillion worldwide each year, or about 1 percent of the global economy.The report, published Friday in the journal Nature Medicine, is an effort to summarize the knowledge about and effects of long Covid across the globe four years after it first emerged.It also aims to “provide a road map for policy and research priorities,” said one author, Dr. Ziyad Al-Aly, the chief of research and development at the V.A. St. Louis Health Care System and a clinical epidemiologist at Washington University in St. Louis. He wrote the paper with several other leading long Covid researchers and three leaders of the Patient-Led Research Collaborative, an organization formed by long Covid patients who are also professional researchers.Among the conclusions:About 6 percent of adults globally have had long Covid.The authors evaluated scores of studies and metrics to estimate that as of the end of 2023, about 6 percent of adults and about 1 percent of children — or about 400 million people — had ever had long Covid since the pandemic began. They said the estimate accounted for the fact that new cases slowed in 2022 and 2023 because of vaccines and the milder Omicron variant.They suggested that the actual number might be higher because their estimate included only people who developed long Covid after they had symptoms during the infectious stage of the virus, and it did not include people who had more than one Covid infection.Many people have not fully recovered.The authors cited studies suggesting that only 7 percent to 10 percent of long Covid patients fully recovered two years after developing long Covid. They added that “some manifestations of long Covid, including heart disease, diabetes, myalgic encephalomyelitis and dysautonomia are chronic conditions that last a lifetime.”The consequences are far-reaching, the authors wrote: “Long Covid drastically affects patients’ well-being and sense of self, as well as their ability to work, socialize, care for others, manage chores and engage in community activities — which also affects patients’ families, caregivers and their communities.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

It was much more accurate than primary care doctors using cognitive tests and CT scans. The findings could speed the quest for an affordable and accessible way to diagnose patients with memory problems.Scientists have made another major stride toward the long-sought goal of diagnosing Alzheimer’s disease with a simple blood test. On Sunday, a team of researchers reported that a blood test was significantly more accurate than doctors’ interpretation of cognitive tests and CT scans in signaling the condition.The study, published Sunday in the journal JAMA, found that about 90 percent of the time the blood test correctly identified whether patients with memory problems had Alzheimer’s. Dementia specialists using standard methods that did not include expensive PET scans or invasive spinal taps were accurate 73 percent of the time, while primary care doctors using those methods got it right only 61 percent of the time.“Not too long ago measuring pathology in the brain of a living human was considered just impossible,” said Dr. Jason Karlawish, a co-director of the Penn Memory Center at the University of Pennsylvania who was not involved in the research. “This study adds to the revolution that has occurred in our ability to measure what’s going on in the brain of living humans.”The results, presented Sunday at the Alzheimer’s Association International Conference in Philadelphia, are the latest milestone in the search for affordable and accessible ways to diagnose Alzheimer’s, a disease that afflicts nearly seven million Americans and over 32 million people worldwide. Medical experts say the findings bring the field closer to a day when people might receive routine blood tests for cognitive impairment as part of primary care checkups, similar to the way they receive cholesterol tests.“Now, we screen people with mammograms and PSA or prostate exams and other things to look for very early signs of cancer,” said Dr. Adam Boxer, a neurologist at the University of California, San Francisco, who was not involved in the study. “And I think we’re going to be doing the same thing for Alzheimer’s disease and hopefully other forms of neurodegeneration.”In recent years, several blood tests have been developed for Alzheimer’s. They are currently used mostly to screen participants in clinical trials and by some specialists like Dr. Boxer to help pinpoint if a patient’s dementia is caused by Alzheimer’s or another condition.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

In the first two years of the pandemic, the rate of long Covid was starkly lower among people who were vaccinated, researchers reported.A large new study provides some of the strongest evidence yet that vaccines reduce the risk of developing long Covid.Scientists looked at people in the United States infected during the first two years of the pandemic and found that the percentage of vaccinated people who developed long Covid was much lower than the percentage of unvaccinated people who did. Medical experts have previously said that vaccines can lower the risk of long Covid, largely because they help prevent severe illness during the infection period and people with severe infections are more likely to have long-term symptoms.But many individuals with mild infections also develop long Covid, and the study, published Wednesday in The New England Journal of Medicine, found that vaccination did not eliminate all risk of developing the condition, which continues to affect millions in the United States.“There was a residual risk of long Covid among vaccinated persons,” Dr. Clifford Rosen, a senior scientist at the MaineHealth Institute for Research, who was not involved in the study, wrote in an accompanying editorial. Because of that, Dr. Rosen added, new cases of long Covid “may continue unabated.”The study evaluated medical records of millions of patients in the Department of Veterans Affairs health system. It involved nearly 450,000 people who had Covid between March 1, 2020, and Jan. 31, 2022, and about 4.7 million people who were not infected during that time.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

The drug, Kisunla, made by Eli Lilly, is the latest in a new class of treatments that could modestly slow cognitive decline in initial stages of the disease but also carry safety risks.The Food and Drug Administration on Tuesday approved a new drug for Alzheimer’s disease, the latest in a novel class of treatments that has been greeted with hope, disappointment and skepticism.The drug, donanemab, to be sold under the brand name Kisunla, was shown in studies to modestly slow the pace of cognitive decline in early stages of the disease. It also had significant safety risks, including swelling and bleeding in the brain.Kisunla, made by Eli Lilly, is similar to another drug, Leqembi, approved last year. Both are intravenous infusions that attack a protein involved in Alzheimer’s, and both can slow the unfolding of dementia by several months. Both also carry similar safety risks. Leqembi, made by Eisai and Biogen, is given every two weeks; Kisunla is given monthly.Kisunla has a significant difference that may appeal to patients, doctors and insurers: Lilly says patients can stop the drug after it clears the protein, amyloid, which clumps into plaques in the brains of people with Alzheimer’s.“Once you’ve removed the target that you’re going after, you then can stop dosing,” said Anne White, an executive vice president of Lilly and president of its neuroscience division. She said that this could reduce the overall cost and inconvenience of the treatment as well as the risk of side effects.The company said that 17 percent of patients receiving donanemab in the 18-month-long clinical trial were able to discontinue the drug at six months, 47 percent stopped within a year and 69 percent stopped within 18 months. Their cognitive decline continued to slow even after they stopped. The company is evaluating how long that slowing will continue past the duration of the trial, said Dr. John Sims, a medical director at Lilly.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

The National Academies said the condition could involve up to 200 symptoms, make it difficult for people to work and last for months or years.One of the nation’s premier medical advisory organizations has weighed in on long Covid with a 265-page report that recognizes the seriousness and persistence of the condition for millions of Americans.More than four years since the start of the coronavirus pandemic, long Covid continues to damage many people’s ability to function, according to the National Academies of Sciences, Engineering and Medicine, a nongovernmental institution that advises federal agencies on science and medicine.“Long Covid can impact people across the life span, from children to older adults, as well as across sex, gender, racial, ethnic and other demographic groups,” it said, concluding that “long Covid is associated with a wide range of new or worsening health conditions and encompasses more than 200 symptoms involving nearly every organ system.”Here are some of the National Academies’ findings, drafted by a committee of 14 doctors and researchers:How many people have long Covid?The report cited data from 2022 suggesting that nearly 18 million adults and nearly a million children in the United States have had long Covid at some point. At the time of that survey, about 8.9 million adults and 362,000 children had the condition.Surveys showed that the prevalence of long Covid decreased in 2023 but, for unclear reasons, has risen this year. As of January, data showed nearly 7 percent of adults in the United States had long Covid.Diagnosis and consequencesThere is still no standardized way to diagnose the condition and no definitive treatments to cure it. “There is no one-size-fits-all approach to rehabilitation, and each individual will need a program tailored to their complex needs,” the National Academies said, advising that doctors should not require patients to have a positive coronavirus test to be diagnosed with long Covid.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

People with two copies of the gene variant APOE4 are almost certain to get Alzheimer’s, say researchers, who proposed a framework under which such patients could be diagnosed years before symptoms.Scientists are proposing a new way of understanding the genetics of Alzheimer’s that would mean that up to a fifth of patients would be considered to have a genetically caused form of the disease.Currently, the vast majority of Alzheimer’s cases do not have a clearly identified cause. The new designation, proposed in a study published Monday, could broaden the scope of efforts to develop treatments, including gene therapy, and affect the design of clinical trials.It could also mean that hundreds of thousands of people in the United States alone could, if they chose, receive a diagnosis of Alzheimer’s before developing any symptoms of cognitive decline, although there currently are no treatments for people at that stage.The new classification would make this type of Alzheimer’s one of the most common genetic disorders in the world, medical experts said.“This reconceptualization that we’re proposing affects not a small minority of people,” said Dr. Juan Fortea, an author of the study and the director of the Sant Pau Memory Unit in Barcelona, Spain. “Sometimes we say that we don’t know the cause of Alzheimer’s disease,” but, he said, this would mean that about 15 to 20 percent of cases “can be tracked back to a cause, and the cause is in the genes.”The idea involves a gene variant called APOE4. Scientists have long known that inheriting one copy of the variant increases the risk of developing Alzheimer’s, and that people with two copies, inherited from each parent, have vastly increased risk.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

The abortion case before the Supreme Court on Wednesday featured vigorous questioning and comments, particularly by the three liberal justices. At issue is whether Idaho’s near-total ban on abortion is so strict that it violates a federal law requiring emergency care for any patient, including providing abortions for pregnant women in dire situations.A ruling could reverberate beyond Idaho, to at least half a dozen other states that have similarly restrictive bans.The implications of the case could also extend beyond abortion, including whether states can legally restrict other types of emergency medical care and whether the federal law opens the door for claims of fetal personhood.Here are some takeaways:The case centers on whether Idaho’s abortion ban violates federal law.Idaho’s ban allows abortion to save the life of a pregnant woman, but not to prevent her health from deteriorating. The federal government says it therefore violates the Emergency Medical Treatment and Labor Act, or EMTALA, which was enacted nearly 40 years ago.EMTALA says that when a patient goes to an emergency room with an urgent medical issue, hospitals must either provide treatment to stabilize the patient or transfer the patient to a medical facility that can, regardless of the patient’s ability to pay. It says that if a state law conflicts with the federal law, the federal law takes precedence.A lawyer representing Idaho, Joshua Turner, told the Supreme Court that the state does not believe its abortion ban conflicts with the federal law. He said the ban allows emergency departments to provide abortions if a pregnant woman has a medical problem that is likely to lead to her death, not just if she is facing imminent death.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

The abortion case before the Supreme Court on Wednesday featured vigorous questioning and comments, particularly by the three liberal justices. At issue is whether Idaho’s near-total ban on abortion is so strict that it violates a federal law requiring emergency care for any patient, including providing abortions for pregnant women in dire situations.A ruling could reverberate beyond Idaho, to at least half a dozen other states that have similarly restrictive bans.The implications of the case could also extend beyond abortion, including whether states can legally restrict other types of emergency medical care and whether the federal law opens the door for claims of fetal personhood.Here are some takeaways:The case centers on whether Idaho’s abortion ban violates federal law.Idaho’s ban allows abortion to save the life of a pregnant woman, but not to prevent her health from deteriorating. The federal government says it therefore violates the Emergency Medical Treatment and Labor Act, or EMTALA, which was enacted nearly 40 years ago.EMTALA says that when a patient goes to an emergency room with an urgent medical issue, hospitals must either provide treatment to stabilize the patient or transfer the patient to a medical facility that can, regardless of the patient’s ability to pay. It says that if a state law conflicts with the federal law, the federal law takes precedence.A lawyer representing Idaho, Joshua Turner, told the Supreme Court that the state does not believe its abortion ban conflicts with the federal law. He said the ban allows emergency departments to provide abortions if a pregnant woman has a medical problem that is likely to lead to her death, not just if she is facing imminent death.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

The state’s Supreme Court ruled that the 1864 law is enforceable today. Here is what led to its enactment.The 160-year-old Arizona abortion ban that was upheld on Tuesday by the state’s highest court was among a wave of anti-abortion laws propelled by some historical twists and turns that might seem surprising.For decades after the United States became a nation, abortion was legal until fetal movement could be felt, usually well into the second trimester. Movement, known as quickening, was the threshold because, in a time before pregnancy tests or ultrasounds, it was the clearest sign that a woman was pregnant.Before that point, “women could try to obtain an abortion without having to fear that it was illegal,” said Johanna Schoen, a professor of history at Rutgers University. After quickening, abortion providers could be charged with a misdemeanor.“I don’t think it was particularly stigmatized,” Dr. Schoen said. “I think what was stigmatized was maybe this idea that you were having sex outside of marriage, but of course, married women also ended their pregnancies.”Women would terminate pregnancies in several different ways, such as ingesting herbs or medicinal potions that were thought to induce a miscarriage, Dr. Schoen said. The herbs commonly used included pennyroyal and tansy. Another method involved inserting an object in the cervix to try to interrupt a pregnancy or terminate it by causing an infection, Dr. Schoen said.Since tools to determine early pregnancy did not yet exist, many women could honestly say that they were not sure if they were pregnant and were simply taking herbs to restore their menstrual period.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.