A global team of specialists has established guidelines aimed at raising both scientific and public awareness about a brain disorder that manifests with symptoms similar to Alzheimer’s disease. While this condition is not newly discovered, recent research and clinical trials have brought it to greater prominence. The disorder, known as Limbic-predominant Age-related TDP-43 Encephalopathy (LATE), has been newly recognized as another path leading to dementia. The team includes researchers funded by the National Institutes of Health (NIH) and other global institutions. They speculate that LATE may have an equal, if not greater, public health impact as Alzheimer’s disease for individuals in their mid-80s and beyond.
In a report published in the journal Brain, the team provided the first formal definition of LATE and proposed guidelines for its diagnosis and future research. Despite progress in Alzheimer’s research, scientists still face challenges in determining when Alzheimer’s is not truly Alzheimer’s in older adults, as noted by Richard J. Hodes, M.D., director of the National Institute on Aging. While LATE clinically resembles Alzheimer’s, postmortem analysis reveals distinct effects on brain tissue, with the accumulation of a protein called TDP-43 being a primary difference. This protein, when misfolded, can impair cognitive functions, and approximately 25% of those over 85 years old experience memory problems due to this issue.
One additional distinction between LATE and Alzheimer’s is that LATE is often associated with hippocampal sclerosis, which causes tissue loss in the hippocampus, leading to cognitive impairments. During a 2018 workshop in Atlanta, Georgia, an international group of experts in fields such as brain imaging, genetics, and neuropsychology developed the guidelines for LATE. Dr. Nina Silverberg, co-chair of the workshop, highlighted the importance of recognizing that not all assumed Alzheimer’s cases are Alzheimer’s and the need to understand other contributors to dementia.
The report calls for further research into the development and progression of LATE and the creation of biomarkers and animal models for the disorder. The group also stresses the importance of distinguishing LATE from Alzheimer’s in clinical trials to improve outcomes and gain new insights. Dr. Hodes emphasized the crucial role of brain tissue donations and expressed gratitude to organ donors, their families, and clinical trial participants, all of whom are vital for advancing research towards treatments and cures.