A fading sense of smell may do more than hint at aging—it could be one of the earliest warning signs of Alzheimer’s disease. New research from DZNE and Ludwig-Maximilians-Universität München reveals that immune cells in the brain mistakenly target and destroy nerve fibers critical for odor perception, offering fresh clues into how the disease begins and how it might be diagnosed sooner.

Patients and families may notice that scents seem muted or distorted, sometimes years before other symptoms. Until now, the exact cause behind this early warning sign remained elusive.

A new study led by researchers at the German Center for Neurodegenerative Diseases (DZNE) and Ludwig-Maximilians-Universität München (LMU) sheds fresh light on the mystery. The findings, published in Nature Communications, suggest that the brain’s own immune system mistakenly destroys nerve fibers vital for processing odors. This breakthrough could open the door to earlier diagnosis—and possibly earlier treatment—of Alzheimer’s.

How the Brain Processes Smell?

Smell perception begins in the olfactory bulb, a small but complex structure in the forebrain that receives input from sensory receptors in the nose. But the olfactory bulb doesn’t work alone. It relies on nerve fibers extending from the locus coeruleus, a brainstem region that helps regulate attention, blood flow, and sensory processing.

The new study shows that in early Alzheimer’s disease, this communication line is disrupted. Microglia—immune cells that normally act as the brain’s cleanup crew—start dismantling the nerve fibers linking the locus coeruleus and olfactory bulb. This immune-driven attack deprives the brain of crucial odor-processing pathways, leading to smell loss.

“Our study suggests that in early Alzheimer’s disease, changes occur in the nerve fibers linking the locus coeruleus to the olfactory bulb. These alterations signal to the microglia that affected fibers are defective or superfluous. Consequently, the microglia break them down,” explained Dr. Lars Paeger of DZNE and LMU.

What Is The “Eat-Me” Signal That Triggers Alzheimer’s?

At the heart of this immune misfire lies an unusual molecular change. Researchers observed that phosphatidylserine, a fatty acid normally tucked inside the protective membrane of neurons, shifts to the cell’s outer surface in affected nerve fibers.

When this happens, microglia interpret it as an “eat-me” signal. Under normal conditions, this signal supports a healthy process called synaptic pruning, where unnecessary or damaged connections are cleared away. But in Alzheimer’s, this mechanism seems to go awry.

Paeger explained that hyperactive neurons—cells firing abnormally due to early disease changes—appear to trigger this membrane shift. Once flagged as dysfunctional, these otherwise critical smell-related fibers are targeted and destroyed.

PET imaging scans in living patients, which confirmed damage to smell-related nerve circuits in people with Alzheimer’s or mild cognitive impairment.

“Smell issues in Alzheimer’s disease and damage to the associated nerves have been discussed for some time. However, the causes were unclear until now. Our findings point to an immunological mechanism as cause for such dysfunctions – and, in particular, that such events already arise in the early stages of Alzheimer’s disease,” said Prof. Joachim Herms, senior researcher on the study.

Why Smell Loss Is Important in Diagnosis of Alzheimer’s?

More than 6 million Americans currently live with Alzheimer’s disease, a number projected to rise sharply as populations age. Yet diagnosis often comes late, when memory loss and cognitive decline are already advanced.

Smell loss offers an earlier red flag. If the biological mechanisms behind it can be mapped and measured, doctors could potentially screen for Alzheimer’s years before symptoms interfere with daily life. This could be especially critical as new treatments, such as amyloid-beta antibodies, are designed to work best in the earliest phases of disease progression.

“Our findings could pave the way for the early identification of patients at risk of developing Alzheimer’s, enabling them to undergo comprehensive testing to confirm the diagnosis before cognitive problems arise,” Herms noted. “This would allow earlier intervention with amyloid-beta antibodies, increasing the probability of a positive response.”

The study also highlights the often-overlooked locus coeruleus, a small cluster of neurons deep in the brainstem. Beyond smell, this structure regulates blood flow, sleep-wake cycles, and stress responses through widespread connections.

Damage to the locus coeruleus is one of the earliest detectable signs of Alzheimer’s, even before amyloid plaques and tau tangles spread widely. The new findings underscore that its breakdown may not only affect memory and attention but also disrupt sensory pathways, making smell loss one of the first noticeable symptoms.

Can Sense of Smell Be Preserved?

While the research answers critical questions, it also raises new ones. If immune cells misidentify smell-related fibers as expendable, can this process be slowed or stopped? Could therapies aimed at stabilizing neuron membranes prevent the fatal “eat-me” signal from being displayed in the first place?

Future studies will likely explore whether drugs that regulate microglial activity—or protect the integrity of phosphatidylserine positioning—could preserve nerve connections in early Alzheimer’s.

Meanwhile, incorporating smell testing into routine checkups for older adults may become a more practical step. Inexpensive scratch-and-sniff exams already exist and could serve as a noninvasive screening tool to identify people who may need further evaluation.

For families watching loved ones struggle with subtle changes—whether misplaced keys, unusual forgetfulness, or an inability to smell morning coffee—the findings offer clarity. Smell loss is not just an odd, isolated symptom but a biological signal that Alzheimer’s is affecting the brain long before dementia sets in.

Recognizing this signal early could give patients and clinicians a window of opportunity: time to prepare, time to plan, and perhaps in the future, time to intervene with treatments that slow or alter the course of disease.

Alzheimer’s remains one of the greatest public health challenges of our time. While there is still no cure, understanding its earliest signals brings us closer to meaningful change. By uncovering how immune cells mistakenly dismantle smell pathways, this study not only solves a long-standing puzzle but also lays the foundation for earlier, more effective care strategies.

The sense of smell may be more than just a window to the world—it may be a window into the earliest changes of Alzheimer’s disease.

The World Health Organization (WHO) has, for the first time, added GLP-1 receptor agonists, popularly known as the active ingredients behind weight loss drugs like Ozempic and Wegovy to its Essential Medicines List (EML). The move, announced Friday, marks a turning point in the global conversation about diabetes, obesity, and equitable access to life-saving treatments.

The Essential Medicines List is one of WHO’s most influential public health tools. Updated every two years, the list identifies medicines that should be available in every functioning health system, regardless of a country’s income level. It now includes 523 medicines for adults and 374 for children. Adoption is widespread: over 150 countries use the EML as a reference point for drug procurement, health insurance coverage, and treatment guidelines.

By including GLP-1 receptor agonists such as semaglutide (Ozempic, Wegovy), liraglutide, and tirzepatide (Mounjaro), WHO has formally acknowledged their role not just in diabetes management but also in broader health outcomes, particularly cardiovascular and kidney health.

Also Read: World Physiotherapy Day 2025: Themes, Significance And History

Why the Addition of GLP-1 Drugs is Revolutionary?

GLP-1 receptor agonists mimic a natural hormone that regulates blood sugar and appetite. They stimulate the pancreas to release insulin, slow digestion, reduce liver glucose production, and act on the brain to suppress hunger. This dual benefit—controlling diabetes and supporting weight loss—has propelled them into mainstream awareness.

Scientific evidence reviewed by WHO’s Expert Committee confirmed their ability to lower blood sugar, reduce risks of heart and kidney complications, support weight management, and even extend life expectancy in people with type 2 diabetes and related conditions. For patients with cardiovascular disease, kidney disease, or obesity, these drugs are emerging as game-changers.

The Limits of the Decision

It’s important to note that while GLP-1s are popularly associated with weight loss, WHO stopped short of endorsing them for obesity alone. The drugs were added specifically for adults with type 2 diabetes mellitus who also have established cardiovascular disease, chronic kidney disease, or obesity.

This distinction matters. While obesity affects over one billion people worldwide, WHO’s cautious stance reflects the still-limited long-term data on safety, sustainability of weight loss, and cost-effectiveness in populations without diabetes.

Barriers to Access

Affordability remains the biggest hurdle. Médecins Sans Frontières (MSF) called the decision a “critical milestone” but highlighted that in low-resource settings, GLP-1s are practically out of reach.

A recent MSF study found GLP-1 agonists can cost up to 400 times more than their estimated manufacturing price, while rapid-acting insulin analogues also newly included on the list—are priced 75 times higher than what they could be profitably produced for.

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“Rapid-acting insulins and GLP-1s are unaffordable and often unavailable in low-resource and humanitarian settings,” said Elizabeth Jarman of MSF’s Access Campaign. “Countries must act quickly to update national EMLs, plan procurement, and push pharmaceutical corporations to make them affordable.”

WHO echoed this call, urging governments to prioritize patients who would benefit most, support generic competition to drive prices down, and ensure distribution at the primary care level, especially in underserved areas.

Expanding the Scope Cancer Treatment

The 2025 update of the EML goes far beyond GLP-1s. Twenty new medicines were added for adults, alongside 15 for children. Notable inclusions are:

Cancer Immunotherapies: Pembrolizumab (Keytruda) and alternatives atezolizumab and cemiplimab for metastatic cervical, colorectal, and non-small cell lung cancers. These immune checkpoint inhibitors have been shown to prolong survival by four to six months in advanced cancers.

Cystic Fibrosis Therapy: Trikafta (a triple-combination drug by Vertex Pharmaceuticals) was hailed as a “historic breakthrough” by patient advocacy groups, marking the first time a cystic fibrosis-specific therapy made the EML.

Insulin Expansion: Short-acting insulin analogues were added, complementing the long-acting formulas already listed since 2021. This creates a complete set of recommended insulin therapies, critical for tailoring diabetes treatment.

Vaccines and Pediatric Medicines: The children’s list now includes drugs for haemophilia, cystic fibrosis, and newly approved vaccines for malaria and mpox.

Tensions Over Excluded Drugs

Not all proposals made it onto the list. Knowledge Ecology International criticized WHO for excluding risdiplam, a treatment for spinal muscular atrophy (SMA). The drug, they argued, is effective, relatively inexpensive to manufacture, and could transform outcomes for children with SMA.

WHO’s Expert Committee deferred inclusion due to incomplete trial data, though subsequent studies published later in the year showed highly promising results.

How Does The Updated Essential Medicine List Affect Global Health?

The stakes of WHO’s decision are high. Diabetes and obesity are among the most pressing health challenges worldwide. More than 800 million people are living with diabetes, half without treatment, while obesity affects over a billion. These conditions are not confined to wealthy nations; their fastest growth is occurring in low- and middle-income countries.

Including GLP-1s in the Essential Medicines List sends a strong signal to governments, insurers, and pharmaceutical companies: these drugs are not luxury treatments for the wealthy but part of the global standard of care.

Yet the path from inclusion to access is not straightforward. Countries must adopt the drugs into their national lists, negotiate prices, and strengthen health systems to deliver them effectively. As David Reddy, director-general of the International Federation of Pharmaceutical Manufacturers, pointed out, inclusion on the list must be accompanied by infrastructure, diagnostics, and trained professionals.

Cancer treatments remain one of the most tightly scrutinized areas of the EML. Cancer kills nearly 10 million people each year, accounting for one in three premature deaths from non-communicable diseases. Despite the flood of new cancer drug approvals in recent years, WHO only recommends therapies that demonstrate clear survival benefits of at least four to six months.

The inclusion of pembrolizumab and its alternatives reflects both clinical evidence and a deliberate effort to reduce global inequities in cancer care. Still, the high cost of immunotherapies poses a major barrier. Without mechanisms like tiered pricing and voluntary licensing, poorer countries may struggle to make these life-extending drugs widely available.

The 2025 Essential Medicines List reflects both optimism and realism. On one hand, it celebrates remarkable advances in science—from GLP-1s reshaping diabetes care to breakthrough therapies for cystic fibrosis and cancer. On the other, it acknowledges the sobering reality of cost and access.

Every year on September 8, World Physiotherapy Day, a global healthcare event is observed. The practice started in 1996, commemorating the date of the World Physiotherapy foundation in 1951. After major surgeries, patients are recommended physiotherapy to help them with movements, this is why a separate day is designated for a therapy that gets the patients back on their feet, doing things like they did before.

The aim of physiotherapy is to achieve a symptom-free movement at basic to complex physical activities.

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World Physiotherapy Day 2025 Theme

This year in 2025, the theme for World Physiotherapy Day is 'Healthy Ageing', with a special focus on preventing frailty and falls. The theme emphasizes the significance of exercise and physical therapy for encouraging healthy aging. It also focuses on lowering frailty and preventing falls in older person, which comes with a good posture and balance, possible through regular exercises.

As the world's population ages, maintaining mobility, independence, and high standard of living becomes a public health concern. However, regular exercise could help the elderly with mobility, and thus physiotherapy interventions become a necessity.

In 2024, the theme was Low back pain or LBP and the role of physiotherapy in its management and prevention.

The Significance of World Physiotherapy Day

Everyone values the ability to live as independently as possible in their daily lives. When injuries, illnesses, or health conditions affect movement, many people, from patients to fitness enthusiasts, turn to physical therapy. The goal is simple: to regain the ability to perform the activities that matter most to them.

Among the many approaches used in healthcare, therapeutic exercise stands out as a core component. It plays a central role in programs designed to restore function, enhance performance, and even prevent future problems.

Physical function is multidimensional, involving several interconnected areas. A well-designed therapeutic exercise plan may focus on:

• Improving balance
• Building cardiopulmonary endurance
• Developing coordination
• Increasing flexibility
• Enhancing mobility
• Strengthening muscle performance
• Boosting neuromuscular control
• Supporting postural control and stability
• Maintaining overall equilibrium

Together, these elements work to help individuals move better, feel stronger, and live more confidently.

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Here Is The History Of World Physiotherapy Day

World Physiotherapy Day is observed every year on September 8, a date chosen in 1996 by the global organization World Physiotherapy. The organization itself was founded on September 8, 1951, in the United Kingdom and today represents over 600,000 physiotherapists worldwide, bringing together 127 member organizations.

ALSO READ: Debunking Common Myths About Physiotherapy

World Physiotherapy works to promote safe working conditions for physiotherapists and advocates for evidence-based practices that make quality physiotherapy care accessible and affordable for all.

India has been part of this global community since 1967, with various Indian physiotherapy associations and professionals actively represented in World Physiotherapy.

The American Heart Association (AHA) and the American College of Cardiology (ACC) have just released their first major update to blood pressure management guidelines since 2017. These new recommendations go beyond simply telling you what numbers to aim for, they focus on prevention, early intervention, and more personalized care across your entire lifespan.

High blood pressure (hypertension) is one of the biggest risk factors for heart disease, the world’s leading cause of death, as well as kidney disease, stroke, type 2 diabetes, and even dementia. With nearly half of all U.S. adults having higher-than-normal blood pressure, these new guidelines are significant for millions of people.

Blood Pressure Targets Remain the Same

One thing that hasn’t changed in 8 years, is how high blood pressure is defined. The cutoff points are still the same as they were in 2017:

• Normal: Less than 120/80 mm Hg
• Elevated: 120–129 mm Hg systolic and under 80 mm Hg diastolic
• Stage 1 Hypertension: 130–139 mm Hg systolic or 80–89 mm Hg diastolic
• Stage 2 Hypertension: 140 mm Hg or higher systolic, or 90 mm Hg or higher diastolic

Your blood pressure reading has two numbers:

The top number (systolic) measures the pressure when your heart pumps, while the bottom number (diastolic) measures it when your heart is at rest.

More Aggressive Early Intervention

While the numbers haven’t changed, how doctors treat them has. The new guidelines recommend starting with healthy lifestyle changes, like eating better, exercising, and reducing salt, for anyone with readings in the 130–139 range. If those changes don’t work after three to six months, medication may be prescribed earlier than before.

This shift is meant to prevent complications before they start. “We’re aiming to help more people get their blood pressure under control earlier to prevent heart disease, strokes, kidney problems, and even dementia,” said Dr. Daniel W. Jones, chair of the writing committee for the new guidelines.

ALSO READ: The 'Three S' That Are Worsening Your Blood Pressure Levels

A Bigger Focus on Weight Loss and GLP-1 Medications

One of the most notable updates involves the use of GLP-1 receptor agonists, such as Ozempic and Mounjaro, which have become popular for weight loss. The guidelines now say that patients who have high blood pressure and are overweight should discuss these medications with their healthcare provider, as losing weight can dramatically improve blood pressure control.

For people with severe obesity, surgery may even be recommended if lifestyle changes and medications are not enough.

New Pregnancy and Postpartum Recommendations

High blood pressure during pregnancy can be dangerous, leading to complications such as preeclampsia, which can threaten both the parent and baby. The new guidelines recommend that pregnant and postpartum individuals with stage 2 hypertension start on certain medications to lower the risk of complications. This is an important shift, as research shows pregnancy-related hypertension can have lasting effects on cardiovascular health.

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The Brain Connection: Dementia Risk

Another significant addition to the 2025 guidelines is the acknowledgment of the link between high blood pressure and cognitive decline. New research shows that hypertension can reduce blood flow to the brain, leading to memory issues and an increased risk of dementia. By controlling blood pressure early, the hope is to preserve cognitive function later in life.

The PREVENT Risk Calculator

Doctors are now encouraged to use a new tool, called PREVENT, to estimate a patient’s risk of developing heart disease over the next 10 and 30 years. This calculator considers multiple factors: age, sex, cholesterol levels, blood pressure, and more, to create a personalized risk profile and guide treatment decisions.

Alcohol Guidance Tightened

In a change that may surprise many, the updated guidelines now recommend avoiding alcohol entirely if possible. Previous advice allowed for one drink per day for women and two for men, but growing evidence shows even moderate alcohol intake can raise blood pressure. For those who still choose to drink, the AHA now advises staying under those older limits.

Lifestyle Changes Are Still the Foundation

Despite all the new tools and treatments, the cornerstone of blood pressure management remains the same: a healthy lifestyle. The updated recommendations reinforce:

• Following a heart-healthy diet like the DASH plan, rich in fruits, vegetables, whole grains, lean proteins, beans, and nuts
• Reducing sodium intake to less than 2,300 mg per day, ideally aiming for 1,500 mg
• Exercising regularly, with at least 150 minutes of moderate activity weekly plus resistance training
• Managing stress through mindfulness, yoga, or relaxation techniques
• Maintaining a healthy weight, losing at least 5% of body weight if overweight

Why This Matters

High blood pressure is often called the “silent killer” because it has no symptoms but can do significant damage over time. By encouraging earlier treatment, recognizing new links to conditions like dementia, and providing tools like the PREVENT calculator, the 2025 guidelines aim to help people live longer, healthier lives.

“The reality is that the first line of treatment, lifestyle changes, really does work if you commit to it,” Dr. Jones said. “It can be hard in today’s food environment, but the payoff is worth it.”