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November 16, 2010

Host: Ted Simons

Alzheimer’s Research

  |   Video
  • The Banner Alzheimer’s Institute in Phoenix has launched a research initiative to treat Alzheimer’s disease before symptoms appear. Doctors Eric Reiman and Pierre Tariot discuss the Alzheimer’s Prevention Initiative.
  • Dr. Eric Reiman
  • Dr. Pierre Tariot
Category: Medical/Health

View Transcript
Ted Simons: The Banner Alzheimer's Institute in Phoenix is working to stop Alzheimer's disease from claiming yet another generation of victims. The institute launched the Alzheimer's Prevention Initiative to conduct clinical trials for people at high risk for developing dementia due to Alzheimer's disease. Here to talk with us is Dr. Eric Reiman from the Banner Alzheimer's Institute, and Dr. Pierre Tariot, the institute's associate director. Thanks for joining us.

Eric Reiman and Pierre Tariot: Thanks for having us.

Ted Simons: What are we talking about here in grand scope?

Eric Reiman: We think now is the time to launch the year of Alzheimer's prevention research. We think there are a number of ways to reduce the risk of Alzheimer's disease but we need a rapid way to evaluate them and find out which treatments work. Right now it takes too many healthy people and too many years to conduct trials to see what develop symptoms. We think we can accelerate that process and see what works sooner than you might think.

Ted Simons: Explain what that means, these kinds of trials?

Eric Reiman: We use the term pre-symptomatic treatment to refer to intervention that is started before people develop memory and thinking problems. It is designed to reduce the risk or completely prevent those symptoms from occurring.

Ted Simons: How do you figure out who these people are? Who qualifies?

Pierre Tariot: The way we're proposing is genetic background. So there are certain genetic profiles that you can have that increase your risk. We can even predict about what age the symptoms will emerge.

Ted Simons: So when you look for a genetic background, is there -- for us laymen, is there a single gene? Is there something -- what exactly are you looking for?

Pierre Tariot: So to oversimplify the story a little, there are a few rare mutations in your genes. If you have one of those, you are going to develop what's called early-onset Alzheimer's disease. It will happen if you live long enough. That's one type. The other major type is what Eric refers to as the susceptibility factor. It's a genetic variation, not a mutation, that makes it more likely that you will get late-onset Alzheimer's disease, particularly if you have two copies, one from mom and one from dad. If you have two of that particular type of variation, and you're above let's say the age of 60, your odds are close to getting Alzheimer's disease in the next 10 years or so.

Ted Simons: My goodness. We have a graphic showing -- correct me if I'm wrong here -- someone with symptomatic Alzheimer's. And then a young adult on the right now, the young adult, is that the one that looks like -- that is brain activity there, right?

Eric Reiman: So you're looking at brain maps that we've generated using an imaging technique so that we can peer into the head and study the inner workings of the brain. We have seen these characteristic reductions in brain activity from people with Alzheimer's activity. On the right, young adults who carry this common gene that one out of four of us have, almost five decades before the average age of onset of symptoms.

Ted Simons: 90% at 60 and 70 years of age, that's pretty certain stuff. Seems like Alzheimer's was full of question marks in the past. Getting to learn more all the time?

Eric Reiman: There's tremendous progress being made in the scientific understanding of Alzheimer's disease. The understanding of both genetic and non-genetic risk factors, and the discovery of promising but not yet established ways to slow down the disease itself.

Ted Simons: There are a lot of images on this one. This deals with plaque, if I'm not mistaken. What are we looking at?

Pierre Tariot: Amyloidal plaque is a term that referred to abnormal protein deposits that occur to the brain, outside of the brain cells. At the very bottom of the picture are two images of a brain, of a person with Alzheimer's disease, showing dense amyloidal plaque deposition. At the top is somebody completely free of plaque. The next one is a person with one copy of the susceptibility gene. They are already showing this early plaque deposition. The next is someone who's memory and thinking is okay but they have two copies of the gene. It's showing the evolution of the deposits of these proteins over time as the disease progresses.

Ted Simons: Interesting stuff. Let's define some terms here. The difference between dementia and Alzheimer's disease, talk about that.

Eric Reiman: Dementia refers to a disabling impairment in memory and other thinking abilities. There are a number of causes that could account for this impairment in memory and thinking abilities. In Alzheimer's disease, it accounts for about 60% of people who have that problem late in life. We do a medical evaluation to characterize the extent to which somebody has memory and thinking problems, to consider some of the reversible contributions to those problems, and to also help determine whether somebody has Alzheimer's disease or a different form of memory and thinking problems.

Ted Simons: How do you -- someone's concerned about their memory or thinking right now.

Pierre Tariot: Uh-huh.

Ted Simons: Are there warning signs that are specific? We've learned so much. Used to be you didn't know. Are there warning signs now?

Pierre Tariot: Sure. If your wife starts to tell you, you know, honey, I told you that over and over again; there are really obvious deficits in remembering recent events, and it's getting more noticeable over time, that would be a trigger, losing the ability to make decisions effectively. Having more trouble managing financial or legal affairs, trouble driving. Maybe one of the ones that we should pay more attention to is changes in emotions. Turns out that can occur very early. Somebody's in their seventies and they start to be unusually depressed or cranky, that could be a clue, as well.

Ted Simons: And the idea of something causing Alzheimer's disease, or conversely a way to prevent Alzheimer's, where are we with that?

Eric Reiman: The progress has been rather significant. Based on these genetic discoveries and understanding some of the molecular processes that lead to abnormalities like plaques in the brain, we have a number of promising investigational and imaging therapies. Some of those target those plaques. They are being studied in many treatments in patients who already have symptoms. The concern is that some of these treatments might be too little, too late to have their most profound effect, until we start them before people develop symptoms and the disease has ravaged the brain.

Ted Simons: And thus the importance of finding out, getting the pre-symptomatic situation figured out, to know to go ahead and head this thing off at the pass a little bit.

Eric Reiman: Yes.

Ted Simons: As far as the trials and studies, looking for bio-markers obviously. When does all this start?

Pierre Tariot: We're in the planning stages now. Some key events have happened. We have found very visionary donors to kick-start this process, which has allowed us to begin creating registries of potential participants in the United States, as well as in a country in South America where there are a lot of folks with the early onset gene mutation.

Ted Simons: Talk about that quickly, a family in Columbia you're looking at?

Pierre Tariot: So there is a genetically isolated group of families that have lived in the same region in the state of Antiocia, Colombia, the family has been there for hundreds of years, haven't moved far away. There are 25 extended families numbering about 5,000 people. Among those, roughly 40% carry this genetic mutation.

Ted Simons: Have they had experience with Alzheimer's? Have the older --

Pierre Tariot: Absolutely. So every generation, half of every generation develops the disease at a very young age, in their forties.

Ted Simons: That has to be very important information.

Pierre Tariot: Yeah.

Eric Reiman: We already had a sense of urgency. We need to find a way to prevent this disorder for all of us. But you cannot help but visit these families and have a heightened sense of urgency to do something about it now. The stakes couldn't be higher. But in some respects the opportunity couldn't be greater right now.

Ted Simons: Talk about the collaborative nature of the initiative. Who are you working with, and talk about that process.

Eric Reiman: The Alzheimer's Prevention Initiative is an effort where we are collaborating with researchers not only with Colombia, but the United States and Europe. Here in Arizona we have been able to capitalize on some complementary strengths at each of our academic institutions around the state. We have the country's leading statewide collaboration known as the Arizona Alzheimer's Consortium. The early detection and tracking of the disease, and working on how to prevent it is occurring right here in this state.

Ted Simons: Someone listening, if they want to be part of the study, or want to know if they qualify to be part of the study, what do they do?

Pierre Tariot: Google Banner Alzheimer's Institute. We have a web page devoted to the prevention effort. For those not on the internet, 602-839-6900, that'll work, and ask for the prevention initiative.

Ted Simons: And obviously their DNA, there will be a sample to work with?

Eric Reiman: Ultimately we want to gather some information about our volunteers, collect DNA, and think about who would be suitable. People who would be interested in participating in prevention trials and other kinds of clinical research. In addition to participation in studies like we have going on in the Alzheimer's Prevention Initiative, there are other studies going on in which we want to make a transformational difference in the fight against this terrible disorder.

Ted Simons: Very good. Thank you both very much, good stuff.

Eric Reiman: Appreciate it.

Tempe Centerpoint Condominiums

  |   Video
  • A deal to sell the vacant Centerpoint condominium towers is dead. Mark Winkleman, CEO of the company brokering the deal, tells us what went wrong and what’s next for the troubled real estate project.
  • Mark Winkleman
Category: Business/Economy   |   Keywords: real estate,

View Transcript
Ted Simons: Tonight on "Horizon," a deal for the Centerpoint Towers in Tempe falls through. I'll talk to the CEO of the company that still owns the vacant buildings. And find out about local research to fight Alzheimer's disease before symptoms appear, next on "Horizon". Good evening, and welcome to "Horizon," I'm Ted Simons. A deal to sell the vacant Centerpoint Towers in Tempe recently fell through when the title insurance company backed out of the proposed sale because of $20 million in liens against the property. That in turn prompted the buyer, Ohio-based Zaremba Group, to call off the sale. Here's how the towers looked a few months ago when producer David Majure took a tour.

David Majure: The 22- and 30-story Centerpoint Towers are just the beginning of what's supposed to be a four-tower complex. With 788 residential units, it promised take the town to new heights but never really got off the ground. Nobody lives here. Construction started in 2005 and ended in 2008 before the project was finished.

Dan Tilton: It stopped because the lender just didn't have any more funds. It essentially exhausted the funds they had. We're at the first level here, plaza level.

David Majure: It's a mixed-use project with space for a public grocery store and restaurant on the first floor.

Dan Tilton: Really a place to gather people from around the entire neighborhood.

David Majure: Dan Tilton took us on the tour.

Dan Tilton: Maybe up to some of the first units that are finished.

David Majure: The condominiums range in size from 500 square feet to more than 4,000 in the penthouse.

Dan Tilton: We're on the top floor of the first story. Just beyond us is the second phase 30-story tower. Out here this, parking lot is going to be the sit of two more 30-story towers.

David Majure: This tower is 90% complete, the taller tower about 75%.

Dan Tilton: Even though the building hasn't been air conditioned and has been dormant since October of 2008, the millwork is in great shape, and the appliances look fine. We have been trying to keep the project as stable as we can during this down time, but it's -- it's way more finished and in much better shape than a lot of people have thought. Very generous balconies. You can see all of downtown Tempe, really not a bad view, a great view.

David Majure: Views are fantastic in just about every direction. What are people willing to pay for the view? We won't know until a buyer comes along who's willing to complete the project and put the condos up for sale.

Ted Simons: Here now to talk about the Centerpoint project is Mark Winkleman, CEO of M-L Manager, the owner of the towers. It fell through. What happened here?

Mark Winkleman: One of the more shocking deals that I've been involved in, and I've been in the commercial real estate business for 27 years. I've seen a lot of deals. But I don't know that I've ever been more surprised for one that looked like this deal was going to be finished, and we were just on the verge of closing. The title company did a 180 on us.

Ted Simons: Did a 180 in the sense of what? Explain the liens on the property, where are these from?

Mark Winkleman: That's the problem, the liens. A variety of subcontractors that worked on the project ultimately didn't get paid what they were owed. Like anybody, they'd like to be paid. I don't blame them. I've got over 1,000 investors that put $125 million in this and they haven't been paid a nickel. There are a lot of sad stories. Anybody that buys it wants to have clear title, free and clear of these liens. Before we started a marketing process last spring, we went and said, assure our potential buyers that you will insure over these liens. The bold print says these liens will be removed or insured over. That was the deal. We went down the path for several months. We culled it down from 400 initially down to the Zaremba Group that we chose. We worked for two months, solving the problems, getting ready to go. We were in constant contact with the title company. A little less than 48 hours from the close, the closing documents, the deeds had been signed, the money was transferred. And we get an e-mail on a Monday afternoon from the title company going, you know what? We are reconsidering this. It was one of the more shocking things that I've seen in my real estate career.

Ted Simons: Could the title company not have defended against the liens in court? I don't quite understand what the last-minute problem was, if the problem was there all along.

Mark Winkleman: We're all scratching our heads about that. The answer is yes, they can and they have been. They have been defending against these liens. Any time a lender makes a loan they want to make sure their money is in first position, that they have priority. Mortgages Limited got insurance against this very thing. When it all fell apart and the liens were asserted we tendered the defense to our insurance company. They have been battling it in court, that goes on. I think the title company thinks they will ultimately prevail and wipe out the liens completely. At this point that legal battle is still going on. The title company, who is assuring us that they were going to issue a clean policy and insure over these liens, on the eve of closing, changed their mind.

Ted Simons: A disconnect between the you guys and the title company? A disconnect within the title company?

Mark Winkleman: My guess is it's a disconnect between the title company. I think the claims department perhaps wasn't talking to the folks that we were dealing with. For us, it's a title company. We were literally on the phone and working with them constantly. So when they sent this, we were taken by surprise. But I think the guys with the title company themselves that had been working on this were probably equally surprised. They just assessed the risk and decided they weren't willing to insure that at that point in time.

Ted Simons: Who is responsible for these liens, when push comes to shove? I understand the problem, but eventually, who's responsible for these?

Mark Winkleman: The problem is you've got a property that doesn't have enough value to pay everybody that's owed money. We're the biggest part of that. As I said, we had $125 million. We're not going to get that money back. These lien-holders have pledged $20-plus million that they are not going to get back, either. The borrower lost a lot of money. There's no shortage of people where this has been a disastrous situation. At the end of the day, not everybody is going to get paid. It's a battle between the lien-holders and us.

Ted Simons: How long will that battle last? As long as the battle is fought, those things sit empty, don't they?

Mark Winkleman: That's a question I don't know the answer to, other than our legal system tends to move rather slowly. I think this trial would be sometime next spring.

Ted Simons: So slowly that Zaremba Group just couldn't wait?

Mark Winkleman: You know, they were a terrific buyer. They did everything you could hope for, for a buyer to try and hang in there. When we got this notice we worked around the clock for a couple weeks, trying every angle we could think of to solve this. Trying to educate the title company in the error of their ways and change their mind. The buyer played a roll in that. Despite what I would say is Herculean efforts, the gap was too wide. At the end of the day we both decided it wasn't prudent to spend money anymore.

Ted Simons: Is this the situation where the fight rages on, and all of a sudden out of the blue, comes a white knight. And he says, I'll pay X, and that just covers and blankets everything. Is that even possible, if not realistic?

Mark Winkleman: I wish it were the case, it would make my life a lot easier. There's been no shortage of people calling me since word of this got out. Usually in these situations something happens with the buyer, they don't have financing or there's some problem and they go away. In this case we had a buyer that was absolutely ready, willing and able to perform, and doing everything they could. As I tell these people, here are the programs, we had folks that had $30 million cash ready to go, no contingencies. That wasn't enough money to bridge that gap. I don't think there is a deal to be made out there right now. Unfortunately, we've got to let the lawyers chip away at some of these barriers and bring some realism to the value of the claims by the mechanic lien-holders and the responsibility the title company has to insure us.

Ted Simons: I would imagine the longer they sit empty, the more they are exposed to the elements and the more that's going to need to be done, once the legal attack ends and the process begins again and maybe you find a buyer. I've had some folks that are pretty sharp, they know their business when it comes to finances. They are suggesting that these things, it might be wise just to tear them down. Last time I brought that up to you, you said there was no option there. Is it slowly becoming maybe an option?

Mark Winkleman: No, I think that's a ludicrous idea. You've got improvements, a well-designed project. $125 million was spent building it. We were willing to sell it for 30. Unless it's totally obsolete, why would you tear something like that down? I don't think anybody was suggesting that you couldn't at least rent those units if you finished them, if not sell them as condos. We need to blow it up and start over, people like to be dramatic. That's a complete waste of money already gone into the project, which is a well-designed project.

Ted Simons: A project that can bring a reasonable rate of return to a buyer, if not sooner than perhaps later?

Mark Winkleman: At some point. We are going to sell this. It doesn't appear we can do it right now. But as some of these legal situations resolve themselves, then we'll know where the programs are, and then price will be whatever it is. And we'll bring it back to the marketplace or put the deal that was already together back together and sell. We're not a long-term holder. This is going to end up in somebody else's hands and we'll get finished at some point, we all hope sooner rather than later. It’s hard to be real optimistic right now.

Ted Simons: We're looking at spring as far as the court dates are concerned?

Mark Winkleman: Well, things will happen before that then. If it has to go to trial, that's as soon as that could probably happen.

Ted Simons: You do have some stuff done here. The Chateau on Central, that was sold. What's going on with that project?

Mark Winkleman: That was sold last spring. We happened to have dinner with the owner of that project last week. He was very excited. They got their C of Os for the last two units. They expect to be fully marketing that and hopefully signing contracts for those units in the next two weeks. We sold a very significant project in downtown Scottsdale, another condominium project quite a bit further along than Centerpoint. We sold it for just under $120 million. Couldn't have gone more smoothly. We are very excited about that.

Ted Simons: Those are a couple of high-profile projects. What's going on with Tempe? Is it just so convoluted? Is it haunted?

Mark Winkleman: I don't know. It's more complex. There's more issues. We've got lien issues on a lot of ours, but none to the magnitude of 20-some million. With that and the size of the project, and the money it takes to finish it, the issues are magnified when it comes to Centerpoint. We will find the buyer and solve the problems and get this done.

Ted Simons: And we'll have you back and you will explain how it went smoothly and so well.

Mark Winkleman: Looking forward to that.

Ted Simons: Thanks for joining us.

Mark Winkleman: Thank you, Ted.