Live Discussion: Nomenclature Discussion
George Perry and Mark A. Smith led this live discussion on 14 August 2001. Readers are invited to submit additional comments by using our Comments form at the bottom of the page.
View Transcript of Live Discussion — Posted 30 August 2006View Comments By:
David Teplow — Posted 17 November 2000
David O. Norris — Posted 17 November 2000
Bart De Strooper — Posted 29 January 2001
Ming Chen — Posted 21 February 2001
Ming Chen — Posted 15 August 2001
By George Perry and Mark A. Smith
Use of standard language is essential to convey ideas
with the least encumbrance of misunderstanding. To this
end, the amyloid field has the Amyloid Nomenclature
Committee whose recommendations have been approved by
the World Health Organization (1). Unfortunately, their
recommendations (2), namely amyloid-β (Aβ) and Aβ protein
precursor (AβPP), have not been broadly adopted by those
who study Alzheimer disease. Variations in the nomenclature
used to describe amyloid-β and its precursor include
A4, βA, AP, APP, βPP, βAPP, AβPP and others. It would
assist readers, and certainly editors of journals, if
the field could adopt an accepted nomenclature for Aβ/AβPP
and other phenomena relevant to Alzheimer disease. To
this end, we propose that there be a discussion following
a poll to hopefully establish a nomenclature that is
accepted by the AD field.
(1993) Nomenclature of amyloid and amyloidosis. WHO-IUIS nomenclature sub-committee. Bull WHO Health Organization 71, 105-108. Abstract.
(1999) Westermark P, Araki S, Benson MD, Cohen AS, Frangione B, Masters CL, Saraiva MJ, Sipe JD, Husby G, Kyle RA, Selkoe D. Nomenclature of amyloid fibril proteins: Report from the meeting of the International Nomenclature Committee on Amyloidosis, August 8-9, 1998. Amyloid: Int J Exp Clin Invest 6, 63-66.
View PubMed record..
Q. Is the failure by the field to adopt standard nomenclature the result of philosophical differences, or just ignorance or sloppiness (to which I plead guilty)? If the former, then it could be productive to have a discussion of the rationales for preferring one terminology over another, and to conduct a poll. If the latter, the solution would be to educate researchers in correct usage. We could issue a style sheet to journal editors, which would be given to authors. I'll begin right here on the ARF by adopting the WHO-approved nomenclature and carrying out a search and replace mission on all outlawed forms. (But someone will have to show me how to type Greek letters!)—June Kinoshita.
A. My opinion is that the failure to adopt a standard nomenclature is
the result of an
indifference to the need for uniformity of terms. Your approach to have
a discussion and a
poll may finally lead to a nomenclature that all can adopt.
Comment by Robert Kisilevsky—Posted 9 January 2001
The use of APP (amyloid precursor protein) by the "Alzheimer" research
community is most unfortunate as there are about 25 different amyloid
precursor proteins (APPs) at least half of which were discovered before
the Alzheimer's form. To claim this general name for the Alzheimer's
form is at best inappropriate and confusing. My preference
(beta-protein) is the term coined by George Glenner who was the first to
identify this protein. Thus the precursor becomes the beta-precursor
protein or betaPP. Abeta is also acceptable (but is a compromise) in
which case the precursor is designated AbetaPP.
Comment by Merrill Benson—Posted 15 January 2001
The recommendation by the Amyloidosis Nomenclature Committee
to use Abeta for the fibril protein and AbetaPP for
the precursor was a compromise that seemed good at the
time. It still seems a good idea. The suggestion to
strongly recommend that journals use this designation
may help resolve the issue.
Comment by Juan F. Gomez-M—Posted 16 March 2001
Theoretical work about nomenclature is essential in any mature (?)
discipline. But to develop an "axiomatic discourse" (hopefully,
something with some superficial similarity to the Euclides'work on
geometry!) we have to define the "primitives." It seems, however,
that there are still problems in the basic definitions. Dr. Ming Chen
propose fundamental differences between AD and senile dementia. Is this
a condition or a disease? If we still do not agree about it, how we can
agree about the name of a molecule (Presenilin, gamma-secretase) or its
precursors (APP, betaPP or AbetaPP)?
To make the things more
confusing, these proteins are also involved in normal function and
neurogenesis. The problem can produce in the long-term skepticism and a
crisis in AD research: a collection of opinions instead of well-defined
facts. Clear building-block concepts is fundamental to construct
databases with the fundamental facts, and it is important that the
researchers answer those questions "before the literature base becomes
much larger" (Dr. Norris). Moreover, thousands of dollars in
experiments can have a better use if we know more precisely about what
is exactly what we are researching. This discussion deserves more
Comment by Colin L Masters and Konrad Beyreuther—Posted 13 August 2001
While the International Committee on Amyloidosis has
grappled with the complexities of unifying a disparate
field, its conclusions relating to the proteins which
accumulate in the two most important diseases [Alzheimer's
disease (AD) and Creutzfeldt-Jakob disease (CJD)] are
at variance with current usage.
In AD, APP is widely recognised as the precursor of Ab amyloid. This nomenclature allows for the designation of the a- and b-secretase products (APPa, APPb) whereas the proposed AbPP makes these extremely confusing. The alternate splice products (L-APP, APP-KPI, etc) are manageable, and the related family members (APLP 1, 2; APPL, etc) are easily accommodated. We suggest the APP be taken to mean "Alzheimer Precursor Protein", and thereby avoid the difficulties perceived in the Committee's deliberations.
In CJD, the PrP protein nomenclature is established, with a superscript to denote the various subtypes (Sc, CJD, GSS, FFI, etc). At which stage the normal cell product (PrPc) converts into the protease-resistant/b-sheet-enriched conformer, and then progresses eventually into a polymerised PrP amyloid fibril, is not fully understood. To indicate that APrPSc should be used for all categories of PrP other than PrPc is clearly problematic.
Finally, the Committee's decision to exclude all intracellular aggregates with the histochemical and other properties of amyloid is not helpful. These intracellular aggregates (and their precursors) may yet prove far more relevant in disease causation than extracellular accumulations. Amyloidologists are not doing themselves a favor by relegating them to the "too hard basket."
Live discussion held 14 August 2001, 5 p.m. EST
Participants: Colin Masters, Nico Stanculescu (host), Richard Bowen,
Glenda Bishop, "J.P. Morgan", Mark Smith, George Perry, David Teplow, S.H. Kim,
Steve DeKosky, Ming Chen, Craig Atwood, June Kinoshita
Note: Transcript has been edited for clarity and accuracy.
Colin Masters: I'm now on line. Clear skies in Melbourne...no foggy issues
surrounding amyloid nomenclature. Anyone there?
Nico: Hello there!
Colin Masters: G'dday, who's leading off?
Nico: Hello! I just spoke to the Case group (Smith and Perry) - they're on
their "way" in...
Colin Masters: great
Nico: It must be very early there... almost 7, right?
Colin Masters: Yes, sun not yet up.
Nico: Oh, lord.... time for another sip of coffee then!
Nico: Hello Glenda!
Glenda Bishop: Hello Nico
Nico: We're just waiting another 10 minutes and we should be ready to go....
Glenda Bishop: Nico, I hear from Steve that the conference went well.
Nico: You mean, the one in Cincinnati?
Glenda Bishop: Yes
Nico: Oh, yes, I think it was... the different "flavor" that was good....
the interaction with the audience, the two sides (and more!) to a hypothesis,
Glenda Bishop: I was disappointed not to go. Too expensive for me here in
Nico: So sorry about that, Glenda.... Initially, we also wanted to do a webcast
of it but it was too expensive and we didn't have too many register for that....But
perhaps next time we can have some scholarships for cases like yours.
Glenda Bishop: Hopefully next time won't be an issue. I should be working
in America then
Nico: WOW! That's great!
Glenda Bishop: Hello Colin. It's nice and early here in Melbourne
Msmith: Hi guys
Nico: Hey, Mark!
Nico: Hello Professor Perry!
Glenda Bishop: Hi Mark
J. P. Morgan enters
Nico: Hey Steve! Thanks for coming!
Dekosky: Thanks for having me. The dean was kind enough to cancel a meeting.
Gperry: We should present our opening positions as Colin and Konrad have already
Colin Masters: That would be useful.
Teplow: Hello all!
Colin Masters: Our position was actually a rejoinder to the amyloid committee.
Gperry: As I see it the major issue is one of standardization for indexing,
editing and better conveyance of meaning. I agree the Amyloid nomenclature committee
did not consult with the AD community , but the AD community did not fill the
niche. Colin Masters: My position is that a utilitarian approach will always
win over the impractical.
Msmith: Sorry! Not a computer nerd!
Colin Masters: where did he come from?
Msmith: What did I miss? Is it over and done? We have a standard nomenclature?
Colin Masters: C'mon George, act the statesman.
Gperry: The Amyloid nomenclature was endorsed by the WHO and several journals.
If a new nomenclature is adopted, it must be utilitarian, practical, and represent
a consensus. That is the point of this session.
Colin Masters: I think a consensus has actually emerged
Msmith: Not on Medline!
Teplow: What is the argument? That we, in fact, need a new nomenclature?
Msmith: And that really is the point. We do not need new...just standard to
which everyone adheres (even though it may not be their pet name!).
Gperry: There are currently many terms used even for Abeta.
Colin Masters: And it doesn't include AbetaPP
Teplow: Every article I review I refer the authors to the WHO nomenclature.
Colin Masters: Who uses AbetaPP in any useful way?
Gperry: You served on the committee that recommended AbetaPP.
Msmith: Colin...why is AbetaPP so bad?
Msmith: Whoops…something I said?
Teplow: I did not serve on the committee, but I feel that they did a good
job and that the consistency they bring to the field is worth implementing.
Gperry: The WHO nomenclature is used in less than half the manuscripts I review.
Msmith: Colin was on the WHO committee.
Teplow: If we, as editors and reviewers, work towards the goal of implementing
this standard, we should be successful, eventually.
Gperry: David, I agree in lieu of any other consensus, the WHO seemed on track.
Msmith: David, well said. The goal, I guess, is that once a standard nomenclature
is agreed upon, it must become standard. At present this is clearly not the
case...I blame the journals. Editors must be told that this is the standard…
Teplow: I agree. The problem is to eliminate the egocentric behavior of coining
your own terms in favor of a consistent and logical lexicon.
Gperry: Yes, but it is a major effort for me to standardize words in JAD now
and for the previous 7 years at AJP.
Msmith: But then what do we rename Msmith protein (or its precursor!)
Teplow: George, I wonder if you could provide style sheets, which list nomenclature,
much as JBC does. That is, to the authors.
Msmith: Better yet to all journal editors.
Msmith: Who then enforce authors through style sheets.
Teplow: I like it!
Colin Masters enters
Gperry: At JAD and AJP we adopted the WHO standard, and it appeared in the
instructions. Even then half used divergent terms.
Teplow: How would we implement this strategy?
Colin Masters: I missed something, now back on line. Is there any agreement
on the use of AbetaPP?
Gperry: Go David!!!!!
Msmith: With the advent of electronic manuscript submissions, I think is easier
than you might think...also, if editors insist on this revision then it will
get done...only a small hoop.
Teplow: Could we set up some sort of working group at Neuroscience this year
to implement this strategy?
Msmith: Great idea.
Msmith: Colin, what, in your view, is wrong with the WHO system?
Gperry: Colin, in AJP and JAD we use AbetaPP until a new standard emerges.
Colin Masters: I think the standard is already out there in everyday use.
Msmith: Colin, what is this standard?
Teplow: Colin, I disagree.
Gperry: Colin get real, Abeta, betaA, A4, what is it?
Teplow: Go George!!!
Colin Masters: Abeta for the peptide, APP for the precursor.
Msmith: But that's neither the WHO standard, nor everyone's standard ...and
that's the problem.
Colin Masters: Listen guys, just see what everyone uses.
June: But who is "everyone"?
Colin Masters: Everyone I communicate with.
Teplow: I think a major problem is the fact that only 12 of the converted are
even discussing the issue here.
Gperry: How can a standard use three terms for the same thing?
Colin Masters: Right on, brother.
Dekosky: I agree with Colin that Abeta and APP are the terms most used, in
my experience. George, if people are not using the 'standard' terms even in
journals that require them, it is clear that there is not a standard USE, even
though there may be a Standard (by WHO or WHOever).
Gperry: Yes, David the rest go on using what is convenient, not what links
Colin Masters: It's not a matter of convenience, it's what works.
Richard Bowen: I think Colin has a good idea. Pick certain journals and for
a specified time period see what is the most common usage in the submitted manuscripts.
Msmith: If I can throw a wrench in here...beta is impossible to e-mail or
Richard Bowen: Good point
June: That's a problem for all Greek letters.
Gperry: Steven the point of this session is to lay the groundwork for a standard
usage that all could accept. That should be done?
Colin Masters: Exactly why we tried to avoid it in the beginning, but were
Teplow: I think a survey is irrelevant. The point is that we need a standard
and that the standard needs to be implemented. I advocate our discussing HOW
to implement the standard.
Dekosky: Yes, I was going to comment that people use it even though it is
difficult to use the Greek character and awkward to spell out.
Colin Masters: The JAD can come to its own opinion and publish.
June: What's the problem with the WHO standard?
Msmith: June...it's not standard!
Colin Masters: Too many greek letters. Msmith: Too easy and too rude
Gperry: The problem with only addressing what works is that it does not integrate
our AD work into the amyloidosis field as a whole. A term such as APP forsakes
other amyloids as significant.
Richard Bowen: Have any other fields had the same problem recently and what
have they done?
Msmith: Immunology! A complete disaster...
Colin Masters: Does anyone really like AbetaPP?
Gperry: Not really, but APP is elitist.
Teplow: Colin, I like APP, but I always use ABPP for the reasons I mentioned
June: AbetaPP certainly doesn't trip off the tongue. Is there an alternative
Gperry: Colin, who suggested AbetaPP originally, or is that a secret?
Colin Masters: George, the original idea came as a memorial to the work of
Gperry: Yes Glenner is deserving of honor, but the group should suggest terms
that are workable and speakable. Abeta is difficult in either regard.
Colin Masters: I don't think we can ever get away now from the Abeta usage
June How about beta-APP and beta-amyloid?
Colin Masters: Beta amyloid is fine, but the beta APP is nonsense
Teplow: June, I argue that we should not revisit the entire issue.
Craig: I don't believe that we should be elitist and separate ourselves from
other amyloids. Abeta is only one amyloid after all.
Teplow: No takers on my suggestion to move towards mechanisms of implementation?
Colin Masters: Yes, we should show some leadership here.
Msmith: David...I think the Neuroscience idea is great...but what to recommend?
Teplow: Well, I would volunteer to coordinate a meeting among us, or other
Colin Masters: I'd support that.
Gperry: Great idea David!!!! We could publish the consensus in JAD.
Teplow: George, that's wonderful. Also, as a board member at Amyloid, maybe
I could get Alan to also publish something.
Gperry: Great maybe we could co-publish it.
Colin Masters: As a courtesy, you should probably invite someone from the
Gperry: June we invited several to this session. Only Colin was so kind as
Colin Masters: Hey. I'm not in that club.
June: Well, we can prevail on Dennis Selkoe and John Hardy.
Colin Masters: They're not in that club either.
Gperry: Selkoe and Masters were pictured and named with the group.
Colin Masters: I deny it
Teplow: Maybe all of you that are interested in this working group could email
me and then I could establish a list.
Gperry: Teplow's suggestion of a working group is a good one if augmented with
an analysis of the frequency of use of various terms and most importantly involves
the major opinion makers and Journals.
June: But if you are looking at frequency of use, this suggests you do want
to reopen the question of choosing standard terminology.
Teplow: As I said, this is an important issue to me, and therefore I would
be happy to coordinate the effort in collaboration with you guys.
Gperry: Beta-amyloid is now used much less than Abeta. Colin Masters: We also
need to consider the use of alpha, beta gamma delta and epsilon for the secretase
Teplow: The first question we need to answer is, "What are the important questions?'
June: How about: Can we agree on the WHO standards, or do they need to be changed?
Gperry: The major issue is reaching a consensus on standard terms that can
be universally adopted.
Colin Masters: This needs a face-to-face meeting
Msmith: Over a few beers.
Colin Masters: How about in Stockholm next year?
Msmith: Are all [of you] going to Neuroscience?
Teplow: Prior to this meeting, it would help if a list of issues could be assembled
for discussion. This should be done pre facto so people can come prepared.
Colin Masters: Yes, that would be good
Msmith: Perhaps June could incorporate David's suggestion by way of a online
June: Sure, I can create an online questionnaire. This has to involve a representative
cross section of the community.
Gperry: Prior to a meeting, a list of terms and alternatives might be assembled.
Teplow: I suggest Neuroscience, at least initially. Then, if necessary, our
European colleagues who can't attend could be informed in Sweden next summer.
Gperry: Neuroscience should be the start, but Stockholm should iron out the
Craig: Is the issue about what the AD community wants or what is a standard
for amyloid diseases in general.
Colin Masters: Okay, but some of us can't get to San Diego.
Msmith: And some are not going to Sweden, especially the B club.
Teplow: That's why I'm suggesting some sort of email coordination of the effort.
June: The standards need to work for amyloid diseases in general (and beyond).
Gperry: Question: Should we be concerned about the standardization with the
amyloid community or adopt our own terms?
Craig: Does neuroscience cover all amyloid diseases?
Teplow: By no means.
June: No, Neuroscience does not cover all amyloid diseases.
Gperry: I think Neuroscience only covers AD, prion and amyloids related to
neuropathy, that is unless one also includes tau and synuclein.
June: Maybe we should invite someone from National Library of Medicine. One
reason for standard nomenclature is you need a controlled vocabulary to search
Msmith: Agreed. Okay, so everything pre-medline is out!
June: I can live with that. Colin Masters: Just review the last hundred papers.
Msmith: Colin...even if everyone uses it...is it right?
Craig: Everyone moved from using ICE to caspase.
June: Sometimes these things happen organically. But in the case of APP, problem
is non-AD people use it to mean other things.
June: So, step 1. Can we form a working group, with Dave Teplow as chair?
Gperry: The consensus is to have a meeting, face to face, at Neuroscience
to see where we go from here. Prior to that meeting, facts and a draft document
could be made. David, I would be happy to co-chair this with you.
Teplow: That's great.
Colin Masters: Looks good.
June: I can post the draft documents on the www.alzforum.org site and invite
comments from the community.
Teplow: I think that would be very helpful.
Colin Masters That's okay with me.
Craig: Sounds good, but will it be dominated by AD workers and not other workers
June: Then we should make sure to invite some other amyloidists.
Gperry: As the hour comes to an end I am delighted we now have the framework
to go ahead.
Msmith: Is there an AmyloidForum.Org?
June: Unfortunately, not. But there must be some kind of scientific society
for the study of amyloidoses.
Gperry: We should decide whether all amyloid should be represented.
Msmith: Okay, I for one would be happy to be part of the working group but
must go soon to fix a leaking bathtub!
June: I have to go break up a fight.
Colin Masters: We have enough problems just with AD.
Craig: Not if we did it at an amyloid meeting.
Gperry: Colin you may be correct in us dealing with our problem and then reaching
June: So, George, will you email all of those participating in today's chat,
plus other "stakeholders," and get the ball rolling?
Gperry: Together with Teplow, correct David?
June: And Colin?
Colin Masters: Look forward to hearing from you. We must solve this one way or another.
Gperry: Go Colin!!!!
Craig: I could represent the underrepresented on the working group!!!
Msmith: Great...wrench in hand, I sign off.Shalom!
June: I've got to go throw water on my daughters. Thanks to all for showing
Colin Masters leaves
Gperry: Of course you are in Colin. Should it be a three-way chair?
Gperry: I am too late.
Craig: As always, Perry!
Richard Bowen leaves
Teplow: It looks like things are winding down. Why don't you and I get the
ball rolling George.
Gperry: I also need to leave. I will work with David to get facts to form
the basis of a questionnaire and a draft.
Teplow: Alright, "see" you all later. Cheers!
||Comments on Live Discussion
Comment by: David Teplow
Submitted 17 November 2000
Posted 17 November 2000
There is nothing that upsets me faster than scientists using inappropriate
and imprecise terminology and nomenclature. With respect to the
Alzheimer's disease lexicon, the WHO and the International Nomenclature
Committee on Amyloidosis have ALREADY dealt with this issue. I refer you
to Bull. WHO 71:105-108 (1993) and Amyloid: Int. J. Exp. Clin. Invest.
6:63-66 (1999). You may also get a kick out a recent short commentary I
wrote concerning the suggestion of altering the amyloid term itself (see
Teplow Neurobiol. Aging 21:563-564 (2000)
). The issues of BACE,
gamma-secretase, etc., does need clarification.
View all comments by David Teplow
Comment by: David O. Norris
Submitted 17 November 2000
Posted 17 November 2000
Yes, at least some consensus would be appreciated, especially for people new
to this field. For example, at the recent Neuroscience meeting in New
Orleans, people were hedging on the latter case (presenilin-1 or gamma-
secretase?) even to the extent of questioning whether or not they are the same
protein. And then what about beta-secretase? And there should be agreement
on the abbreviations used as well. A position statement from somewhere on
this terminology indeed would be welcome before the literature base becomes
much larger.View all comments by David O. Norris
Comment by: Bart De Strooper, ARF Advisor
Submitted 29 January 2001
Posted 29 January 2001
I agree that it would be useful to accept a uniform nomenclature. For
instance literature searches in Pub med would be more efficient.
Sloppiness is probably the most important reason for the current
situation and the forum is a good place to discuss the problem. The
beta-symbol is a problem in electronic documents. A good starting point
for the discussion would be a proposal not only for A-beta-PP, but also
for the presenilins in different species, and the mutations. Also the
different rules for protein or genes in different species (capitals or
not, italics or not, etc.) is a problem. I am not very good in those
things, but maybe you can ask somebody to make a proposal. Once there is
some consensus I will certainly use the nomenclature in all next papers
from my laboratory.View all comments by Bart De Strooper
Comment by: Ming Chen
Submitted 21 February 2001
Posted 21 February 2001
Question: Are Alzheimer's Disease and "Senile Dementia" the Same Disease?
This perhaps is the most important "nomenclature" problem. AD used to refer
to "pre-senile" dementia (PSD; middle age dementia). This name clearly
distinguished it from senile dementia (SD; dementia after age 60).
However, since 1970s, they are redefined as the same disease (AD), mainly
because they have the same symptoms and same hallmarks (plaques and
tangles). This definition is the basis for AD research today.
However, it recently came to our attention that if PSD/AD and SD are the
same disease, then it would be difficult to explain:
1. After intensive studies, it has been confirmed that AD does exist in two
major forms: early-onset and late-onset, corresonding essentially to PSD
2. Most PSD has been successfully linked to gene mutations, head injury and
other severe insults, but SD remains largely as a mystery. If they are the
same disease, then they should have the same causes (like AIDS).
3. While PSD remains a rare disease in the middle age people today, SD rate
has increased exponentially and surpassed 50% after age 90. This makes SD
in sharp contrast to conventional diseases (no more than a few percent).
If they are the same disease, then why does one increase so much, but the
So, while it is usually correct to define diseases by pathologies but not
by patients'ages (like AIDS or influenza), is it also correct for AD?
View all comments by Ming Chen
Comment by: Ming Chen
Submitted 15 August 2001
Posted 15 August 2001
Clarification of the confusing terms such as Aβ, βA,
APP, βAPP or AβPP will help the field if they can be
standardized. But here, I would like to reiterate the
key importance of another "nomenclature" problem, i.e.,
"Alzheimer's disease" or "senile dementia"? The latter
condition had been known since ancient time, but the
former was defined by Dr. Alois Alzheimer in a 56-year-old
patient. Dr. Alzheimer considered such rare cases as
"pre-senile" or "midlife" dementia thus quite different
from "senile dementia". So, the term "Alzheimer's disease"
was defined mainly on the basis of its onset age difference
from senile dementia.
But since 1970s, the two conditions have been re-defined as the "same disease" on the rationale that they both exhibit the same symptoms and same hallmarks. According to this new definition, senile dementia should be caused by similar pathogens that are known today to underlie pre-senile dementia such as gene mutations, vascular diseases or other severe insults.
But, is this definition correct? We know that vision, hearing, or heart failures can also strike juvenile or middle-aged persons in rare cases, and these are certainly caused by inherited or invading pathogenic factors. But if the "same" failures occur in VERY OLD people, are they also due to the same factors? Yet, juvenile-onset cataracts (lens protein deposition) can affect young people in rare cases which have exactly the same symptoms and hallmarks of SENILE cataracts. Do we, therefore, believe that they have the same underlying causes?
Failure of a new or middle-aged car is apparently due to manufacture error or accident, but is the eventual failure of a VERY OLD car or its parts also due to the same reasons? If they are not but officially defined as such, then what will happen to our investigations which are desperately looking for the cause of mainly the LATE-ONSET sporadic dementia because only this type of dementia has a horribly high prevalence and thus threats society the most today?
The AD research field may need to face these difficult questions. Very recently, we have discussed them in more details (Ref. 1).
1. Chen, M., Fernandez, H.L. Alzheimer movement re-examined 25 years later: is it a "disease" or a "senile condition" in medical nature? Front. Biosci. 2001; 6, e30-40 (free full text): http://www.bioscience.org/2001/v6/e/chen2/fulltext.htm
View all comments by Ming Chen