Shih-Hsiu “Jerry” Wang’s, MD, PhD, latest paper on LATE (Limbic-predominant TDP-43 encephalopathy) was published in Acta Neuropathologica on May 12: Neuropathological associations of limbic-predominant age-related TDP-43 encephalopathy neuropathological change (LATE-NC) differ between the oldest-old and younger-old | SpringerLink.
LATE is a common but under-recognized brain pathology in the elderly, characterized by misfolded TDP-43 proteins predominantly in the amygdala and hippocampus, brain structures involved in memory formation. LATE causes a type of dementia syndrome characterized by impaired memory, similar to Alzheimer’s disease (AD).
While LATE typically affects individuals over 85, it is increasingly recognized in younger individuals as well. Wang’s paper is the first to directly compare LATE pathology across a wide age range (60-106 years old), uncovering important differences between the oldest old (>90) and younger-old (60-90).
Overall, LATE is closely linked to a specific type of cerebrovascular pathology, called arteriolosclerosis, in both age groups; however, in the younger-old, LATE almost invariably co-existed with other neurodegenerative diseases such as AD and Lewy body disease, whereas in the oldest-old, LATE can exist independent of significant AD. In fact, about 10% of individuals over 90 have “pure LATE” suggesting that LATE may be the most important driver of dementia in this select population.
“I think we are well-positioned to become one of the centers that can contribute significantly to this field, and I wanted to highlight the unique resources here at Duke,” said Wang.