Finding the big picture for Alzheimer’s

The $4m Oskar Fischer Prize hopes to catalyse a breakthrough in Alzheimer’s research by encouraging a ‘big picture’ approach to the disease. We spoke to founders Dr. James Truchard and Dr. George Perry to find out more.

What led you both to set up the Oskar Fischer Prize?

Truchard: My background is in engineering. I retired in 2017 and picked Alzheimer's as a project to work on. I've been trying to learn as much as I can, given my background, in the last two and a half years, and I've funded about a dozen different activities, including two startups. Through personal research I came across Oskar Fischer’s story and learned that he was a pioneer in neuroscience who studied dementia at the same time as Alois Alzheimer.

I was inspired to make the donation to UTSA to take a new systems approach to the research on Alzheimer’s, building on the work started more than a century ago.

Perry: I'm a professor at the University of Texas at San Antonio, and chief scientist at the Brain Health Consortium. I've been in the Alzheimer's field for nearly 40 years and am editor in chief of the Journal of Alzheimer's Disease.

What are you hoping to achieve with the Prize?

Truchard: The idea of the Oskar Fischer Prize is to give researchers the opportunity to step back and share their thoughts on the big picture of Alzheimer’s disease.

Alzheimer’s research has so far been fairly narrowly-targeted, with most of it focused on amyloid beta. This has really constrained people's ability to think about other possibilities. A lot of research, unless you have the term Amyloid Beta in your proposal, won’t get funded. The idea here is to expand the thinking around the disease.

Perry: This is a very complex disease involving multiple factors. If you focus on just a single component, you're only looking at a small portion of the disease. We are hoping to bring together those single ideas into a coherent vision. That vision can offer new routes to therapies, and hopefully end the drought of new drug approvals.

Truchard: Over a century ago Einstein brought together a lot of the fundamental physics observations into a general theory. We hope to do something similar – find that genius who can do the same thing for Alzheimer’s.

Perry: I don't think we have any preconceptions about what people are going to propose. We hope they'll propose something that's beyond our conception.

Truchard: We are not excluding possibilities. We have no rules. We're leaving it wide open to make certain that we're not excluding the real answer.

There are some folks who see this as a sequence of events that take place that ultimately lead to Alzheimer's disease. That’s a different approach to what traditional researchers have used up to now. There have been very few people who try to get a multi-step, multi-part explanation into place. If we don't do that it's unlikely that we’ll make good headway. The human body is immensely complex and there are many different closed loops that are very hard to analyse. Unless you step back and look at the whole, it's very difficult to really close on a good answer.

We hope that the prize will give researchers permission to take that step back and put forward a hypothesis that then can be critiqued.

That’s quite a good message to get out there even beyond the scope of the prize.

Truchard: Exactly, and to that point another aspect to the prize is getting the word out that Oskar Fischer also played a big role in the discovery of Alzheimer's.

How can this help researchers find better treatments for the disease?

Truchard: My background is in engineering, and there I learned that you always have to understand the fundamentals of what you're trying to do. One of the reasons there have been so many drug failures is that the attempts have often been shots in the dark without a clear target. The hope here is to get more clarity around what targets would be better to take a shot at.

To do that, a more fundamental big picture understanding the root causes and how all the components come together is needed.

The call for proposals will open in late Fall 2019 and will continue through the two-year term of the project. UTSA will work closely with an interdisciplinary committee of outstanding scientists from Texas and around the world to award the Oskar Fischer Prizes. Entries will be submitted via an online submission portal, for which more information will be made available after the formal criteria for the prize is established in the coming months.

Despite the high number of failures in Alzheimer's disease R&D, would you say you're optimistic about the future of the disease?

Truchard: I believe we will find answers. It's been over 113 years since Oskar Fischer and Alois Alzheimer first identified the disease, and maybe we got off to the wrong start originally, but a lot of research has been done in that time and so hopefully we can come up with good answers.

Perry: I think a good model is heart disease. When people have heart disease they are never cured, but they are effectively treated. From a public health perspective, heart disease has been going down every year, while Alzheimer's is the only common disease of the elderly that is increasing in prevalence every year.

We already know one thing Alzheimer's shares with heart disease is that lifestyle is a tremendously important component that really makes a difference.

Perhaps we if we go down a multi-component route, like in heart disease, it won’t be a single path that cures the disease but multiple paths that each reduce it by 10 or 20%. That can make a tremendous difference while we're still looking to understand the disease for a more definitive cure.

Truchard: Some people were proposing that we actually have heart & brain clinics, because there are so many elements, like exercise, that are used in improving heart health that can also be applied to brain health. Combining the two in a way that gets the common denominators in parallel looks like a good strategy.

About the interviewees

Dr. James Truchard is the co-founder and re0tired president of the U.S.-based technology company National Instruments. Dr. Truchard conceptualised and established the Oskar Fischer Prize to engage the world’s brightest minds.

Dr. George Perry is a professor and chief scientist from The University of Texas at San Antonio’s (UTSA) Brain Health Consortium, a world leader in brain health research and who will incubate the two-year challenge. At UTSA, Dr. Perry and team works with nearly 40 of the nation’s brightest scientists to conduct research on brain mechanisms and therapeutics.