25Th Alzheimer Europe Conference Dementia: Putting Strategies and Research Into Practice Ljubljana, Slovenia ˝/ 2-4 September 2015
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25th Alzheimer Europe Conference Dementia: putting strategies and research into practice Ljubljana, Slovenia ˝/ 2-4 September 2015 Abstract Book Index Plenary Sessions 1 Special Symposia 7 Parallel Sessions 10 Slovenian Sessions 45 Posters 50 Index of authors 99 The 25th AE Conference in Ljubljana received funding under an operating grant from the European Union’s Health Programme (2014-2020) The content of the 25th Alzheimer Europe conference represents the views of the author only and is his/her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains. Dementia: putting strategies and research into practice / Ljubljana 2015 Abstract Book / Plenary Sessions Plenary Sessions is not easy for the entourage. Many studies show the advantages of an early diagnosis for the patient: relief to understand what is PL1.1. New medicines for Alzheimer’s disease: Lessons from going on, proper care, and appropriate attitude of the close relatives, past failures and perspectives for the future increased empowerment… And now, innovative therapies are tested WINBLAD Bengt in people at risk for developing Alzheimer’s disease because of the presence of lesions associated with this disease in their brain, before In 2010, the number of people affected by dementia worldwide any symptoms. Surveys have shown that most people say they want was estimated to 36 million, with an estimated cost of approx 600 to know if they will develop Alzheimer’s disease, but much less will bUSD. The prevalence of dementia is expected to reach 115 million follow the process when the opportunity arises. A too early diagnosis in 2050, with an equivalent cost increase. The progressive nature may communicate uncertainty. On the other hand, a timely diagnosis of dementia influences the whole life situation for families during refers to the subjective experience of the disease, and meets the several years-decades and so far, no cure or highly significant concerns of the patients and their close relatives. Recommendations symptom relieving treatment is available. Increased understanding guide the diagnosis disclosure process, and help breaking bad news. of the pathophysiology of Alzheimer disease (AD) has given us new The diagnostic process, like the disclosure itself, has a time frame. therapeutic targets, and by using new biomarkers possibilities to It is useful to know what are the patients’ knowledge and thoughts diagnose patients earlier. regarding both their current symptoms and their possible causes. It Many clinical and experimental studies are ongoing, mainly based allows to correct erroneous beliefs and to personalize the disclosure. on anti-amyloid-beta (Aβ) strategies, but the exact role played by Aβ The process should not be too long, nonetheless its duration permits in AD pathogenesis is not yet clear. We need to acknowledge that the patients to progress in their relation with the disease and diminish a single cure for AD is unlikely to be found and that the approach the brutality of the disclosure situation. to drug development for this disorder needs to be reconsidered. Preclinical research is constantly providing us with new information PL1.3. From biomarkers to clinical trials – big data and public- of the complex AD puzzle, and an analysis of this information might private consortia for Alzheimer’s disease prevention reveal patterns of pharmacological interactions instead of single LOVESTONE Simon potential drug targets. Since the last drug entered the market in 2002, many products in Despite increasing knowledge and understanding of the mechanisms different development phases have failed. Why? Wrong molecules, of Alzheimer’s disease and related dementias generated in academia, inappropriate animal models, insufficient proof-of-concept studies, and the considerable efforts of the pharmaceutical industry to develop heterogeneous patient groups, too advanced disease, non-relevant therapies, we are all only too conscious of the repeated failure of outcome measures, intercenter variability in increasingly globalised drug trials at late stage. This is enormously costly to the companies multi-centre trials? who for the most part fund such trials, to the health services and Our hope for the future is that new therapies could potentially even economies of all of our countries but most of all to those slow or even halt the progression of the disease. Increased global with dementia today and who will suffer from dementia tomorrow collaboration between academia, industry and regulatory authorities in the absence of a therapy for disease modification. It is not clear is a vital step for a successful drug development. why the trials are failing. Is it because we have only an incomplete We have good hope that until 2025, ongoing studies directed towards understanding of the condition? Is it that the trials are conducted too beta-amyloid and/or tau metabolism have proven effective and are on late in the disease process? Or is it simply that the drugs don’t work the market. Recently positive reports have been presented regarding well enough? Clearly no one truly knows the answer to this but what passive immunotherapy and inhibition of beta-amyloid production. is overwhelmingly clear is that this is a very hard problem and hard problems tend to require new solutions. It isn’t enough to continue PL1.2. Improving the timely diagnosis and providing adequate to do the same thing. support to people with early memory complaints One potential, and partial, solution to the hard problem of Alzheimer’s PASQUIER Florence disease is the innovative use of data and another is public private partnerships. Neither are truly novel but arguably neither have Memory disorders are one of the most distressing symptoms been used to quite the same degree as is being implemented by with ageing. Alzheimer’s disease is famous and feared. However two Innovative Medicine Initiatives (IMI) – the European Medical people are not all alike. Some worry quickly and want to know and Information Framework (EMIF) and the European Prevention of understand what happens to them. Others reassure themselves, Alzheimer’s Disease studies (EPAD). These large, pre-competitive attribute their problem to inconvenience of age, or do not want public private consortia bring together university and other public to know, and temporize. Then will come the time when memory and third sector organizations together with many large pharma problems are so severe than the persons will forget that they forget and small biotech and other companies. EMIF is focused on the and deny their troubles up to refuse assistance and support. This re-utilisation and aggregation of data and cohorts for dementia 1 25th Alzheimer Europe Conference Abstract Book / Plenary Sessions research including especially the identification of novel biomarkers PL2.1. A New European Joint Action for early, preclinical and prodromal detection. EPAD is establishing HUGGINS Geoff a registry, a trials ready cohort and an innovative clinical trial that is dependent on the use of such biomarkers. Together with the The session will describe the objectives and structure of the new joint Alzheimer’s Research UK Drug Discovery Alliance and the Dementias action on dementia and how it builds on the previous work taken Platform UK and other national initiatives, the research community in forward under Alcove. The focus of the joint action is diagnosis and Europe has established a tremendously exciting platform that looks support, care co-ordination, the quality of residential care for those set to make a contribution to the generation of novel therapeutics for living with dementia and the development of dementia friendly early, preclinical disease modification; in effect leading the search to communities. In terms of approach the joint action will have a clear establish a preventative therapy for Alzheimer’s. focus on implementation as well as evidence of best practice and will work to accelerate the uptake of best practice. PL1.4. Prevention of Alzheimer’s disease – Myths, wishes and reality PL2.2. A positive impact of collaboration in the Joint PIRTOŠEK Zvezdan Programme on Neurodegenerative Diseases Research (JPND) on the National Research Policy Because Alzheimer’s disease (AD) is such a devastating disease, VOLASKO Peter many unproven and unscientific prevention strategies are advised and patients may be tempted by untried, unproven, and unscientific JPND is relatively well-known and appreciated among the following treatments. stakeholders in Slovenia: ND field researchers as well as some Risk factors can be divided into two groups: those that can not be clinicians and diagnosticians, policy makers at the Ministry of controlled and those which can be influenced by certain health, Education, Science and Sport and the Ministry for Health, “Young lifestyle and environmental factors. Research Leaders” who are promoting the campaign against 1. Risk factors for AD that are beyond our control include age and Dementia, Slovenian Members of the European Parliament, some genetics. The risk of developing the disease doubles every 5 years over civil society organisations dealing with this phenomenon (e.g. age 65 and it is estimated that up to half the people older than 85 have “Spominčica”) and other interested public. AD. Genetic link to two frorms of AD has been found: (i) early onset Slovenian researchers are actively performing in JPND projects AD (before the age of 65) is associated with changes in certain genes and initiatives. So far they have participated only in the first call – on three chromosomes; (ii) risk of late onset AD (after the age of 65 harmonisation of biomarkers. Two Slovenian research groups were y) is increased with the APOE ε4 form of the APOE gene, while the successful in this call which is an excellent result for a small country APOE ε2 form of this gene may provide some protection.