5th Int'l Conference on Alzheimer's Disease under Way
The Fifth International Conference on Alzheimer's Disease and Related Disorders is being held for six days from July 24th, 1996 at the Royal Hotel, Osaka. This is the first time that the conference is being held in Asia and it promises to be an exciting one, with plenary lectures, symposia, poster sessions, workshops and industry roundtable on the agenda. It is, moreover, the second-large conference on a single disease to be held, next to that of AIDS. More than 80 invited speakers, who are leading experts in their various fields of specialization in neurobiology, treatment and psychosocial aspects of the disease, will be speaking at the various symposia, ensuring high-level discussions. Meanwhile, during the lunch break, a total of 16 industry roundtable discussions are scheduled to take place among industry sponsors and participants such as the latest developments and breakthroughs in pharmaceuticals and others. A public education forum is also slated in form the general public, including family members and other caregivers, on the state of Alzheimer's disease (AD).
With the rapid increase in the number of senior citizens, AD is a subject of increasing concern. In Japan alone, there are about 1.2 million patients. Thus, this conference comes at a most opportune time as is reflected in the participation of 1,300 experts from Japan and abroad. Meanwhile, with the emergence of a shift in focus on AD-related studies and research, this conference should provide the grounds for multidisciplinary exchanges and cooperation. At a press conference, Professor Leon J. That of the Department of Neurosciences, University of California, San Diego, announced the intention of the university to endow a Tsunao Saito Chair of Neurodegeneration in memory of Dr. Saito who was shot to death this May. The chair is to be a permanent one and will be a memorial for Saito and his many achievements. A fund will also be set up in his daughter's name.
The first day of the conference was opened with remarks by Professor Tsuyoshi Nishimura, executive convener. after tracing the program of studies in AD for the past 90 years since it was first reported by Dr. Alzheimer in 1906, Nishimura touched on the major breakthroughs that have been made in the past eight years, saying that 50 percent to 60 percent of Alzheimer cases are explainable by gene analysis. He added, however, that for the remainder the cause remains unexplained. He sets great store on the outcome of the conference and hopes that through exchange of information and knowledge that further progress can be made. Nishimura was followed by Dr. Keiji Tanaka, director of the Division of Mental Health and of the Welfare, Ministry of Health and Welfare, who gave a welcoming address along with the governor of Osaka Prefecture and the deputy mayor of Osaka. Representing the minister of health and welfare, who was unable to attend, Tanaka cited the fact that with the advent of longevity and a rapidly aging society in Japan, where the average lifespan for women is 83 years and for men 76.6 years, AD is one of great concern. as such, many efforts are being made to substantiate health care for the elderly, care centers, short-term centers and others while encouraging research in this debilitating disease. Isamu Yamada, governor of Osaka, brought forth appreciative laughs with his stentorian opener in English, which was followed by "as this is the extent of my English, I would now like to proceed in Japanese, the language I am most expert in." Mixing the heavy with the light, he endorsed the general opinion of everyone present that AD is a pressing issue, especially in Osaka, where currently there are 62,000 AD patients. Estimates indicate that the number will rise to 80,000 by 2,000. On behalf of the mayor of Osaka, Deputy Mayor Junichi Seki welcomed the 1,300 participants from 42 countries, reiterating the concerns of Tanaka and Yamada in regard to the increasing number of people suffering from AD in Japan. The ceremony ended with an Award of Recognition being given to Dr. Henry M. Wisniewski and the first Parke-Davis Award presented to Drs. Allen D. Roses and Judes Poirier.
Brain-Imaging Techniques Bring Revolution in AD Diagnosis
By Professor Tsuyoshi Nishimura, Executive Convener
Ninety years have passed since Dr. Alzheimer reported in 1906 the first case of a particular presenile dementia with early onset, which is at present called Alzheimer's disease. During the first two-thirds of those 90 years, the basic research on Alzheimer's disease was done mainly using classical histopathological methodology. The research progressed rather slowly. In the last 30 years, triggered by the epoch-making studies on the ultrastructure of the brain with Alzheimer's disease by electromicroscopy in the 1960s, the basic research of Alzheimer's disease has shown rapid progress. Also in the clinical field, brain-imaging techniques have brought a revolution in the diagnosis and clinical understanding of Alzheimer's disease. The growing number of patients with Alzheimer's disease in a rapidly aging society like Japan and the recognition of the importance and urgency of measures against the disease further stimulated the demand for the basic and clinical research of Alzheimer's disease and related disorders.
Indeed, much progress in Alzheimer's research was made during the last two years. Now, about 50 percent to 60 percent of Alzheimer's cases are said to be explainable by genetic analysis. However, the cause of the remaining Alzheimer cases remains unsolved. Besides Alzheimer's disease, there are many important problems among the related disorders including prison diseases, cerebrovascular disorders and various degenerative diseases of the brain, which cause dementia.
Furthermore, regarding Alzheimer's diseases and other dementing diseases, there are many important areas other than basic studies, such as specific diagnosis, treatment, prevention, rehabilitation, care, social issue and so on. At this conference, with over 800 presentations, the final program provides a comprehensive overview of our scientific understanding of Alzheimer's diseases and related disorders at this time.
In addition to the strong core of neurobiology, there is an outstanding set of presentations on clinical topics, therapeutics, and caregiving in plenary lectures, symposia, poster sessions, industry roundtable and workshops.
Importance of Osaka Venue Stressed
Dr. Masatoshi Takeda, Deputy Executive Convener
Dr. Masatoshi Takeda, professor and chairman of the Department of Neuropsychiatry of the Osaka University Medical School, in assessing the importance of this meeting mentioned three points related to time and place that, he feels, lend this meeting in Osaka particular resonance. Dr. Takeda, who is also the deputy executive convener of this, the Fifth International Conference on Alzheimer's Disease and Related Disorders, pointed out that "this is the first conference to be held outside of Europe or North America, and this in itself is significant, I believe. Holding it in Japan, where the number of aged people now exceeded 14 percent of the population is aging around the world. And particularly in Japan we are today facing, more urgently than ever, the social problem of dementia in the elderly." As "aged society" is one in which the number of senior citizens exceeds 14 percent of the population. And an "aging society" is one in which that figure stands at 7 percent. Japan turned from an "aging society" to an "aged society" in only 24 years, which is two to four times as fast as most Western societies. So, the problems of the aged are weighing heavily on us now and many specialist are now involved in this field of study."
The last conference was held in Minneapolis two years ago. Since that time great strides have been taken in the field of Alzheimer's disease. According to Dr. Takeda, "The timing of this conference is particularly important because it coincides with significant new findings, particularly in the field of Familial (hereditary) Alzheimer's, which will help us focus in on the causes and the pathological process of AD. In fact, we expect some major findings to be announced at this conference. "My hope for this conference is that we will be able to drive home again the importance of working together as specialists. When we talk about the problem of dementia in the elderly, so many facets must be brought together and considered equally: biology, care systems, social systems." Each is important, and we must integrate the knowledge we can gain from each field including the natural sciences in order to establish a better society for the elderly. I hope this conference will serve to unite us as we pursue our studies of this disease."
Changing Pattern in Approach
Dr. Bengt Winblad
Co-convener of the Osaka Conference, Dr. Bengt Winblad of the Department of Clinical Neuroscience and Family Medicine of Stockholm's Karolinska Institute, has helped organize all five international conference. Recognizing that the focus has always been on getting closer to the core of the disease, Dr. Winblad sees a changing pattern in approach. Specifically, participants now know that care and clinical facets are international and that there must be more interaction between laboratory researchers and clinicians. He sees the pattern as one of a combination of genetics, epidemiology and molecular biology. Talking about advances in treatment, he mentioned that "we now have around 20 new drugs that have a potential effect on both mental behavior and loss of memory and international functions. If we look back only two years, it is obvious we have made tremendous progress. Ten years ago we wouldn't have dreamed that there would be 20 potential drugs to deal with AD. In the near future there will be drugs which will be officially recognized as treatment for AD!" Dr. Winblad is especially pleased with the growing interest among the public in this disease. In fact, during this conference there will be a public forum, and 1,000 people are scheduled to attend. "I believe one of the great benefits of these conferences is that they inspire heightened awareness in the public, changing the attitude toward this disease. This in turn encourages researchers to work harder toward a cure"
Goal of Conference Outlined
Dr. Khalid Iqbal
Co-convener and Chairman of the Scientific Program of the Osaka Conference, Dr. Khalid Iqbal, of the New York State institute for Basic Research in Developmental Disabilities, outlined the goals he foresaw for this conference. "The objective is to meet with Alzheimer' disease researchers from around the world and to present and discuss the latest findings on AD, ranging from psychosocial issues to pharmacological treatment to molecular mechanisms in the development of the disease." Pointing out that this conference is the largest on any specific disease other than AIDS, Dr. Iqbal said, "Society is much more aware of this issue and AD is an area of health which is going to continue to increase in importance." since the last conference in Minneapolis, there have been major advances as Dr. Iqbal pointed out: "Now we know there are mutations which cause this disease in certain familial cases. Although sporadic AD is much more common, this will help us learn much more about the disease in general." In praise of the Osaka venue, Dr. Iqbal said, "This is the first time for this conference to be held in Asia, and I believe the significance is that it makes the world more aware of AD. This is a global issue. That's why we're intent on encouraging the next generation of researchers. In fact, we have provided 155 fellowships for young reseachersr from around the world to attend this conference."
Mixing of Disciplines Important
Dr. Henry Wisniewski
Dr. Henry Wisniewski of the New York State Institute for Basic Research, one of the co-conveners of the conference, wears many hats. His main research area, however, is in morphology (the study of the abnormal brain). His work brings him into to close communication with biochemists, as he helps them look for target calls to find the sick element of the tissue. This is because not all neurons are affected by the disease, and those which are need to be studied from a biochemical perspective. This mixing of disciplines is most important since by interacting with experts from other areas, he can locate the missing pieces of the puzzle that is Alzheimer's. He believes without multidisciplinary interaction, the mysteries of the disease cannot be solved, but with more experts working together, the sooner a treatment can be discovered to slow down the process. For, as he says, if we can uncover the cause of polymerization of proteins, we can trace the process and thereby treat it. He looks forward to learning more about new diagnostic methods, therapeutic approaches and experimental models at the conference. This fits in with his desire for increased multidisciplinary interaction, while the latter is from a need for better access to animals and tissue culture. What he would like to see occur at the conference is a networking whereby brain banks can be accessed for fresh tissue, which is most important in the research of cells.
1st Parke-Davis Award Given
The conferring of the first Parke-Davis Award took place on July 24th at the opening ceremony of the Fifth International Conference on Alzheimer's Disease and Related Disorders. The award will be given every second year at the International Conferences to person who have made the most important discovery on AD and not for accumulated work of a whole life. The discovery must also have been verified independently and withstood the test of time. Calls for applications were made through the media and through the conference invitations sent out last year. Members of the Review Panel were composed of Professor Caleb Finch, the United States; Professor Dominick Purpura, the United States, and Professor Dick Swaab, the Netherlands. The recipients this year were Professor Allen Roses from Duke University, U. S. A., and Professor Judes Poirier from McGill University, Canada. The award of a total of 50,000 dollars was made by Professor Bengt Winblad, chairperson of the Parke-Davis Award Review Panel.
Interviews with Prominent Alzheimer's Disease Researchers
The conference, which opened on July 24th, was attended by 1,300 doctors and researchers from Japan and overseas. Numerous symposia marked the opening day. Of the various participants, eminent researchers and doctors as well as those presenting reports on various aspects of Alzheimer's disease.
Dr. John C. S. Breitner
Dr. John C. S. Breitner of Duke University Medical Center is a participant in the roundtable discussions. At the conference, he hopes to learn the latest in Alzheimer's disease as well as exchange views and opinions with his colleagues from around the world. Breitner has been researching the disease for 15 years. He has studied the genetic contributions associated with Alzheimer's disease. Genes have been found to be an important factor in determining the risk of Alzheimer's disease. In the last five years Breitner has researched the factors that may modify the effects of genes on Alzheimer's disease, so that the risks associated with the genes may either be increased or decreased. He has been studying the effects of genes related to Alzheimer's disease in twins because twins share all genes, making it possible to compare effective genes.
Dr. Ramon Cacabelos
For Dr. Ramon Cacabelos of the Biomedical Research Center of Spain, coming to Osaka was like coming home "I lived here for 10 years and worked at Osaka University Hospital. It is good to be back." Dr. Cacabelos found the conference to be rich in research findings, particularly in the genetics of Alzheimer's disease. Pointing out that molecular genetics could be used for early detection, Dr. Cacabelos said, "With molecular genetics, we can establish preventative programs because we will be able to identity people at risk. By trying to protect the brain, we can delay the most onset of the disease. "We are introducing a new concept of therapy for neuro-immunotrophic activity to protect the brain against the aggression of the immune system." At the conference he cited the genetic-relevant topics that were being discussed and the avenues for developing therapeutic strategies that were being pursed as particularly encouraging.
Dr. Richard Cowburn
As the Osaka Conference entered its second day, several participants expressed satisfaction over the way things were going. Richard Cowburn, associate professor of neurobiology at the Karolinska Institute of Stockholm, among others, expressed his view that much new information was being shared and that many attendees were exciting about offering as well as receiving new information. "I think it is good," he said, "that we meet like this every two years. we get see old colleagues and catch up on what they are doing, while at the same time establishing new contacts and new relationships. It's good to come to a meeting that is focused on Alzheimer's disease rather than attend one where Alzheimer's is simply one of the topics of the conference." Citing the "mad summer of '95," a reference to the time when the Presenilin 1 and 2 genes were identified, he said it was good to come a year later and see what had developed as a result of these important discoveries.
Dr. Ulla Eloniemi
According to Dr. Ulla Eloniemi of the University of Kuopio, Finland, there is a strong possibility of continuing homecare of demented patients through systematic support and counseling. Her three-year study has revealed that methods under study greatly reduce the stress and strain of those providing care while helping cut down on the frequency of long-term care. They consist primarily of short- to 10-day courses in which both the patient and the primary care givers participate. Information and advice on everyday situations are provided as are the services of a research nurse who can be contacted 24 hours a day by mobile phone for advice, support, and counseling in case of emergencies. The nurse is backed by a doctor, who provides advice and medication. The study holds promise of greatly alleviating stress as well as affording patients with a familiar environment in which to face the encroachments of dementia.
Dr. Lindsay a. Farrer
Dr. Lindsay A. Farrer of Boston University School of Medicine, will present the pooled analysis of data compiled from 40 research groups in North America, Europe, Japan and Australia regarding the risk of AD by APOE genotype, age, sex, ethnicity and family history. This is the largest collection of data of AD patients and control groups. according to the preliminary data, it appears that an association does exist and the data may address some of the questions being asked by specialists of AD conference for Lindsay, this one is especially important in regard to networking with colleagues from the 40 research groups who have provided him with data as well as obtaining up-to-date information about the science of AD and what other developments are taking place in the other sciences.
Dr. Dora Games
Dr. Dora Games is associate director of Pharmacology at Athene Neurosciences, a biotechnology company devoted to the study of central nervous system disorders in South San Francisco, Calif. One of Athene Neurosciences' main programs is Alzheimer's disease. Games is involved in the study of a transgenic mouse model that develops many neuropathologies similar to Alzheimer's. The main goal in using the mouse model is to discover and develop new treatments for the disease. The model also will help in understanding some of the mechanisms underlined the neurodegeneration associated with Alzheimer's disease. The model also will help in understanding some of the mechanisms underlined the neurodegeneration associated with Alzheimer's disease. Games is especially looking forward to the opportunity to discuss results and compare research at the conference, as well as hear about the latest treatments being Discussed.
Dr. Changiz Geula
Dr. Changiz Geula of the Harvard Medical School's Laboratory for Neurodegenerative and Aging Research, was particularly enthusiastic about attending the Osaka Conference. "This," he said, " is THE conference on Alzheimer's disease (AD). I brings all of the researchers together and is an extremely important venue in many ways." Dr. Geula mentioned three issues of particular interest to him: (1) How to diagnose AD while patients are still alive; (2) How to diagnose it before clinical symptoms appear; and (3) The pathology of AD in the brain. "The connection between diagnosing early and therapy is very important. Our aim is to diagnose early in order to successfully initiate therapy that can bring the disease under control at an early stage."
Dr. Kouzin Kamino
Dr. Kouzin Kamino is typical of the young generation of scientists that the conveners of the Osaka Conference are particularly keen in encouraging. His specialty is genetic epidemiology and he is a researcher in the Geriatric Department at Osaka University Medical School. "I hope," he said, "to get the opportunity to work together with many people from abroad in his important field. I am interested to see what others in this field are introducing here. I am presenting a poster showing several kinds of mutations of Presenilin 1, which are causative genes of the early onset of familial Alzheimer's disease."
Dr. Lon S. Schneider
Dr. Lon S. Schneider of the University of Southern California is one of the leading authorities on experimental drugs for Alzheimer's disease in the United States. He is especially interested in the effects related to drugs combined with estrogen replacement therapy. He has been involved in the development of various drugs related to Alzheimer's disease treatment. Cognex (Tacrine) is one drug that is on the market in many countries. It has been observed that when women taking hormone replacement therapy were given Cognex, drug effectiveness response was greatly enhanced. Schneider's general observation is that Alzheimer's disease is heterogeneous and that genetic has a bearing on how the disease is expressed in the individual and how they respond to medication. The research on Alzheimer's disease is continuing to make advances and improved treatments for the disease.
Dr. Takehiko Yanagihara
Dr. Takehiko Yanagihara of the Department of Neurology of Osaka University Medical School characterized the Osaka Conference as "very successful." Referring to the timeless of the meeting. Dr. Yanagihara pointed out that in the last few years there has been a quantum leap in the research of Alzheimer's disease thanks to the new technology of genetic tools. The conference underscored the outstanding progress in research in genetics. But, he says that now is the time to go back to the study of protein chemistries in order to help develop drugs that can actually prevent the disease. Dr. Yanagihara delivered a lecture on July 24, entitled Demographic Differences in Senile Dementia. Through this speech he showed how the number of AD cases has increased in Japan along with its modernization. "I believe that, contrary to Europe and North America, the majority of those suffering senile dementia are suffering from vascular dementia (that is caused by strokes, etc.,) rather than AD in less developed countries, and this is a point we must carefully study."
Next Conference to be Held in Amsterdam in 1998
Plans have already been set for the Sixth Conference on Alzheimer's Disease and Related Disorders, scheduled for six days from July 1998 in Amsterdam, the Netherlands. Dick F. Swaab of the Netherlands Institute for Brain Research and convener of the conference, estimated that the number of participants for the Amsterdam conference would continue to grow (attendance has zoomed since the first conference 10 years ago) reaching at least 2,000. "I think," he said, "that these conferences are important because people can meet many others and talk things over, comparing notes and progress. Conferences are not really where one comes to learn the latest developments, much of which are already known by the time the conference is held. What is important is to stimulate the young researchers in this field, giving them an overview on these topics so that they will be encouraged to continue research throughout their lives. This is the reason we have given and will continue to give so many fellowships to young people. By attending these conferences, they have the opportunity to present their findings on posters. This is extremely stimulating for them, I believe." Dr. Swaab underscored the notion that there will continue to be great advancements in this field by the time the Amsterdam Conference begins. He pointed out that more genetic and environmental factors will come to be understood as causes of AD. "I predict that more and more of those factors which are preventable will become apparent. I also feel that there will be advances in diagnosis and the importance of post modern diagnosis will be further highlighted." He also mentioned the growing need for brain banks. "One of the major advantages of these conferences is that they have encouraged the growth of brain banks. I believe the Amsterdam Conference will continue the traditions of inspiring our young researchers and encouraging worldwide cooperation."
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