Researchers are raising awareness about a lesser-known but prevalent memory loss condition called limbic-predominant age-related TDP-43 encephalopathy, or LATE, which is often misdiagnosed as Alzheimer’s.
A recent report in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association highlights the urgent need to develop objective criteria to diagnose and stage all types of dementia, including LATE.
This condition, though similar in symptoms to Alzheimer’s, differs significantly in its underlying pathology, according to Dr. Rebecca M. Edelmayer, vice president of scientific engagement at the Alzheimer’s Association.
“LATE is defined by changes in the TDP-43 protein in brain tissue and frequently co-exists with Alzheimer’s disease changes, such as the buildup of beta amyloid plaques and tau tangles,” Edelmayer explained.
These overlapping characteristics often complicate diagnosis, but distinguishing between the two conditions is critical for tailoring treatment strategies and improving outcomes.
Unlike Alzheimer’s, which is characterized by a more rapid decline, LATE tends to progress more slowly, according to Dr. David Wolk, professor of neurology at the University of Pennsylvania and lead author of the report.
However, when LATE co-occurs with Alzheimer’s—a scenario estimated in about one-third of cases—it may accelerate the overall progression of cognitive decline.
Despite its prevalence, LATE remains underdiagnosed. Dr. Wolk noted that over 25% of individuals aged 80 and older are affected by this form of dementia. Yet most clinicians and patients are unfamiliar with the condition, rarely considering it when assessing memory loss.
“Knowing whether LATE is present alongside Alzheimer’s impacts prognosis and may influence the effectiveness of treatments,” Wolk said. Previously, LATE could only be confirmed posthumously through autopsy. The new criteria introduced in the report provide a framework for diagnosis during a patient’s lifetime, which could revolutionize both clinical care and research.
Unlike Alzheimer’s, for which diagnostic tests exist, no definitive test is available for LATE. The newly proposed criteria offer varying levels of diagnostic certainty but require further validation in clinical settings. Dr. Wolk highlighted the importance of these criteria as a first step toward improved diagnosis and treatment.
Edelmayer highlighted the promise of advancements in biological markers, which may soon allow clinicians to differentiate between types of dementia more accurately. In the interim, she said, the criteria outlined in the report serve as a valuable tool for providing personalized care and enrolling patients in clinical studies.
The new recommendations not only aim to enhance diagnostic precision but also lay the groundwork for future research. As Edelmayer put it, “These recommendations create a roadmap that identifies opportunities for further research and addresses the challenges that remain for accurately diagnosing individuals with LATE.”
For seniors experiencing memory loss, this information serves as a reminder that not all cognitive decline stems from Alzheimer’s.