Limbic-predominant Age-related TDP-43 Encephalopathy (LATE) is a neurodegenerative disease that impacts individuals typically over the age of 80.
The most common symptoms of LATE include cognitive and memory difficulties, impact on decision making capacity, trouble finding words, and activities of daily living, such as driving. While these are similar to those of Alzheimer’s disease (AD), the cause of LATE is different.
Biomarkers are small proteins in the brain that can build up or tangle, and are hallmarks of disease. LATE is characterized by the build-up of TDP-43—a protein that was discovered in 2006 by University of Pennsylvania researchers. Patients with LATE exhibit TDP-43 buildup in brain regions associated with memory and cognition. AD, on the other hand, is caused by the build-up of the biomarkers known as beta-amyloid and tau.
Current research suggests that LATE impacts individuals at an older age than patients with AD. On average, LATE tends to affect individuals over the age of 80.
It is also common for LATE to coincide with AD. For example, 55 percent of patients with AD also have LATE pathology. When a person has both AD and LATE, this synergy causes faster cognitive decline than if the person had only one or the other. On its own, LATE tends to have a slower symptom progression than AD. Current research indicates that patients with just LATE have a more stable course and live longer than patients with AD or patients with both LATE and AD.
TDP-43 buildup is also found in amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTD). These diseases are each related to specific symptoms.
How is LATE diagnosed?
A probable diagnosis of LATE can be supported by cognitive examination and brain imaging, though definitive diagnosis currently requires a brain autopsy. In fact, more than 30 percent of autopsied brains of people older than 80 show the presence of LATE-related pathology. There are promising imaging tests such as magnetic resonance imaging (MRI) and positron emission tomography (PET) to help detect probable LATE in living people, and further research is needed to better understand these markers.
Treatment available for LATE
Because LATE is currently only diagnosed after death, there is no specific treatment for LATE. However, if an individual has concerns about their memory or cognitive abilities, it is important to discuss these concerns with a memory specialist.
You can learn more about medications prescribed for memory from the Alzheimer’s Association here. Beyond memory medications, many people with cognitive decline may benefit from medications to help with anxiety or depression, should they experience mood changes.
Healthy brain aging strategies are beneficial to anyone experiencing memory problems and cognitive decline. Learn more about ways to optimize your brain health from AARP’s Global Council on Brain Health. Research has shown physical exercise, a heart-healthy diet, limiting alcohol intake, getting good sleep, mood management, and staying socially and mentally active optimize brain health.
Resources:
- NIA information on LATE
- 2019 Proposed guidelines for LATE
- UCSF managing behavior and personality changes
- Home safety checklist
- NIH legal and protective planning for individuals with dementia
- Family caregiver alliance