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New Dementia: LATE Changes Diagnosis Landscape
29 Nov
Summary
- LATE dementia affects a third of people 85 and older.
- It can mimic Alzheimer's but is usually less severe.
- A trial for LATE treatment is underway at the University of Kentucky.
A recently identified dementia, known as LATE, is significantly altering perceptions of cognitive decline and improving diagnostic capabilities for patients. Current guidelines suggest LATE impacts about 10 percent of individuals aged 65 and older, and approximately one-third of those 85 and above. Experts note that some patients previously diagnosed with Alzheimer's may actually have LATE. This condition, while often less severe than Alzheimer's individually, can drastically worsen outcomes when it co-occurs with Alzheimer's pathology, leading to more rapid symptom progression and a more severe prognosis.
Biologically distinct from Alzheimer's, which involves amyloid and tau proteins, LATE is characterized by the abnormal accumulation of TDP-43 protein. Diagnosis typically involves brain imaging and ruling out Alzheimer's pathology. Patients with pure LATE may not qualify for newly approved Alzheimer's drugs, which target amyloid. The interaction between LATE and Alzheimer's also complicates treatment decisions for patients with both conditions.
Efforts to understand and treat LATE are advancing, with the first clinical trial for a LATE-specific treatment now underway at the University of Kentucky. This trial is testing nicorandil, a drug approved for angina, with the hope it may protect brain tissue. Researchers continue to investigate the causes of LATE, with a genetic variant, APOE4, known to increase risk for both Alzheimer's and LATE.
