Alzheimer's expert

Ken Kosik is renowned internationally for almost two decades of research into the biology of Alzheimer's disease.

After completing a medical degree, Kosik did his neurology residency at Tufts New England Medical Centre in 1979, before embarking on a purely research career at the Harvard Medical School, becoming professor of neurology and neuroscience in 1996.

He joined a group there trying to understand the pathobiology of Alzheimer's disease, and exactly what it is that slowly tangles components of the brain to gradually but inevitably dement the person's thoughts and personality.

Kosik and colleagues discovered that the neurofibrillary tangles that characterise Alzheimer's are composed of a protein called tau and that loss of this protein function inhibits neuronal plasticity. Subsequent studies of the tau protein and its pathological fate as a neurofibrillary tangle have been a pillar of Alzheimer's disease research.

In parallel to this work, Kosik is very interested in the underlying cellular mechanisms by which plasticity is lost in the course of neurodegeneration. In 2004, Kosik moved to the University of California Santa Barbara to co-direct the Neuroscience Research Institute and take up a chair in neuroscience research.

Interestingly, Ken Kosik began his university education as a literature major, but then decided that studying literature was not the path to his dream of becoming a writer. Over 25 years later, Kosik has certainly made an indelible mark not only on the scientific 'literature', but ultimately, through his work, on the human mind.

In his spare time, Kosik has embarked on setting up a centre for patients with Alzheimer's disease, the Centre for Innovative Therapy (cFIT). "I describe it like research is my day job, that is what I get paid for, but I continue to have a long-standing interest in clinical problems, and particularly Alzheimer's-type conditions," he says.

"So, I spend probably five to 10 per cent of my time and effort working with other people in my community in Santa Barbara in developing a new approach to clinical aspects of AD.

"I have always been a little troubled by the fact that we were not doing a very good job for people with this disease. And that problem was not just the absence of a cure, but the fact that people were very frustrated with the whole system they had to deal with - a very sophisticated and complicated medical system, big hospitals, and tertiary care centres, which are set up for people that require cardiac transplants or advanced surgery and high-level clinical cases, but not for patients with diseases like Alzheimer's.

"The problem does not require surgical or significant drug therapy, it is more about cognition, and so is not a problem from which hospitals can ever expect to make money, and precious hospital real estate is not readily handed over to physicians interested in that problem.

"It occurred to me that we needed to approach the problem in a novel way, to move the issue of AD and cognitive impairment out of the hospital and into a setting that was more friendly - sort of like a living room, but that had all the medical expertise needed for that specific disease.

"It also has to be a place where we are comfortable with genetic risk factors, the latest research - whether you want to take supplements or be engaged in clinical trials going on somewhere - so we want to reshuffle the deck a bit and 'de-medicalise' the problem, and move it into an information-rich rather than a procedure-oriented environment.

"This place does not exist yet anywhere -- a place where you can take a problem that doesn't fit into the traditional medical model of treatment, such as AD, and in a single location, provide comprehensive services; a place that combines both sophisticated information for patients with the level of medical and other care that is really needed."