This is a form of dementia that often overlaps with Alzheimer’s but is a distinct and clearly another condition. Although in medicine, the most common form of dementia is Alzheimer’s, recent years have brought a new addition to the possibilities: LATE. It may be “late” to the field, but LATE (which stands for limbic-predominant age-related TDP-43 encephalopathy) is likely the third most frequent cause of dementia, after Alzheimer’s and vascular dementia. Importantly, too, many people whose memory loss and other dementia symptoms might be blamed on Alzheimer’s actually have LATE—or a combination of the two. LATE dementia isn’t some really rare disorder, but it’s not been on most doctors’ radar. It comprises about 15% to 20% of dementia cases, so it’s relatively common. But one important difference is that a LATE dementia diagnosis can indicate that memory loss will progress more slowly than it would with Alzheimer’s.
LATE dementia was widely recognized by experts in 2019 with its naming by Harvard neurologist Dr. Reisa Sperling, but the disease has attracted increasing research since the early 2000s. Prominent neurologists, including Dr. Sperling, published the first formal criteria in 2025 to help doctors spot LATE, which together with Alzheimer’s share certain traits, and both are characterized by progressive memory loss. But when LATE dementia is the culprit, memory loss typically develops more slowly and is less severe. LATE also tends to appear in the oldest old, i.e. people 80 and beyond. The typical LATE cases happen without the significant amyloid lumps, or tau tangles, characteristic of Alzheimer’s, referring to typically abnormal protein accumulations found in the brains of dementia patients at autopsy. If LATE occurs alone, it acts like a less aggressive version of Alzheimer’s, but people affected simultaneously by both types show the fastest decline.
Unlike Alzheimer’s, LATE dementia can’t yet be definitively diagnosed while someone is alive. Alzheimer’s can usually be identified through spinal fluid samples, MRI and PET scans, and more recently, blood tests for amyloid or tau. But confirming a LATE diagnosis would require the impossibility of a brain autopsy to spot clumps of a protein called TDP-43 that characterize the condition. Thus, if tests show no evidence of Alzheimer’s in someone who is experiencing progressive memory loss, the person likely has LATE It’s still exceedingly challenging for doctors to determine, however, if someone has a combination of Alzheimer’s and LATE. Because scientists haven’t yet zeroed in on a specific bio-marker—a biological signal—they can target with a test, no promising therapies have yet been discovered for LATE. Research is just beginning, and breakthroughs may come down the road. But for now, there isn’t a great understanding about why it happens or how to treat it. With both Alzheimer’s and LATE currently incurable and causing overlapping symptoms, it may seem pointless to understand whether someone has LATE—but that’s not the case, because the distinction matters since people with only LATE might not benefit from emerging Alzheimer’s therapies that target amyloid or tau in the brain. In addition, it can help doctors to know the prognosis. If someone is 85, say, and has had progressive memory loss for many years, but tests for Alzheimer’s show nothing, that means it’s likely this person will progress slower, and that is important to know. Also, that insight can also help patients and their loved ones understand what to expect. For some patients, having a name for their disease is important to them, in addition to knowing the prognosis. It will be very helpful for patients to understand they may have LATE, not only to give them some reassurance that their memory loss is likely slower than it would be with Alzheimer’s, but also so they don’t undergo therapies that probably won’t be effective.
HABITS THAT CAN HELP LOWER DEMENTIA RISK
There’s no silver bullet that guarantees we can avoid dementia, but these basic lifestyle habits can lower one’s risk.
Regular exercise. Done on a consistent basis, activities such as walking, running, swimming, and cycling help by increasing blood flow to the brain, supporting blood vessels, and reducing inflammation. Resistance (strength) training can also help maintain memory, attention, and concentration.
Healthy eating. Several diets are believed to promote brain health, all of which emphasize eating plenty of fruits, vegetables, and fish high in omega-3 fatty acids, while avoiding red meat and processed foods.
Quality sleep. Our brains clear out harmful amyloid proteins while we sleep—a process disrupted by conditions such as insomnia, sleep apnea, or other frequent awakenings.
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