Limbic-predominant age-related TDP-43 encephalopathy (LATE)

Sir, Nelson et al. (2019) define limbic-predominant age-related TDP-43 encephalopathy (LATE) and list previously used designations for this condition, including hippocampal sclerosis, hippocampal sclerosis of ageing, hippocampal sclerosis dementia, cerebral age-related TDP-43 with sclerosis, and TDP-43 pathologies in the elderly. We suggest that LATE may also have been previously designated as ‘frontotemporal dementia in elderly individuals’ (Baborie et al., 2012). In a neuropathological series of 11 brains with ‘frontotemporal dementia in elderly individuals’, eight had either pure TDP-43 pathology (seven) or mixed TDP-43 and tau pathology (one) affecting the parahippocampal gyrus, temporal region and hippocampus. Of these eight patients (age at onset 65–86 years; female:male = 3:5), six had hippocampal sclerosis, whilst amyloid pathology was either sparse (four) or absent (four). A history of memory problems was noted in seven patients, as a presenting feature in five, and anterograde memory loss was documented in four. Alzheimer’s disease featured in the pre-mortem differential diagnosis of four patients (Baborie et al., 2012). We suggest that if a diagnosis of frontotemporal dementia is being considered in an elderly patient then LATE should also enter the differential diagnosis. There are no new data associated with this comment based on existing published data. The authors report no competing interests.