Posts Tagged ‘late’

Doctors have newly outlined a type of dementia that could be more common than Alzheimer’s among the oldest adults, according to a report published Tuesday in the journal Brain.

The disease, called LATE, may often mirror the symptoms of Alzheimer’s disease, though it affects the brain differently and develops more slowly than Alzheimer’s. Doctors say the two are frequently found together, and in those cases may lead to a steeper cognitive decline than either by itself.

In developing its report, the international team of authors is hoping to spur research — and, perhaps one day, treatments — for a disease that tends to affect people over 80 and “has an expanding but under-recognized impact on public health,” according to the paper.

“We’re really overhauling the concept of what dementia is,” said lead author Dr. Peter Nelson, director of neuropathology at the University of Kentucky Medical Center.

Still, the disease itself didn’t come out of the blue. The evidence has been building for years, including reports of patients who didn’t quite fit the mold for known types of dementia such as Alzheimer’s.

“There isn’t going to be one single disease that is causing all forms of dementia,” said Sandra Weintraub, a professor of psychiatry, behavioral sciences and neurology at Northwestern University Feinberg School of Medicine. She was not involved in the new paper.

Weintraub said researchers have been well aware of the “heterogeneity of dementia,” but figuring out precisely why each type can look so different has been a challenge. Why do some people lose memory first, while others lose language or have personality changes? Why do some develop dementia earlier in life, while others develop it later?

Experts say this heterogeneity has complicated dementia research, including Alzheimer’s, because it hasn’t always been clear what the root cause was — and thus, if doctors were treating the right thing.

What is it?

The acronym LATE stands for limbic-predominant age-related TDP-43 encephalopathy. The full name refers to the area in the brain most likely to be affected, as well as the protein at the center of it all.

“These age-related dementia diseases are frequently associated with proteinaceous glop,” Nelson said. “But different proteins can contribute to the glop.”

In Alzheimer’s, you’ll find one set of glops. In Lewy body dementia, another glop.

And in LATE, the glop is a protein called TDP-43. Doctors aren’t sure why the protein is found in a modified, misfolded form in a disease like LATE.

“TDP-43 likes certain parts of the brain that the Alzheimer’s pathology is less enamored of,” explained Weintraub, who is also a member of Northwestern’s Mesulam Center for Cognitive Neurology and Alzheimer’s Disease.

“This is an area that’s going to be really huge in the future. What are the individual vulnerabilities that cause the proteins to go to particular regions of the brain?” she said. “It’s not just what the protein abnormality is, but where it is.”

More than a decade ago, doctors first linked the TDP protein to amyotrophic lateral sclerosis, otherwise known as ALS or Lou Gehrig’s disease. It was also linked to another type of dementia, called frontotemporal lobar degeneration.

LATE “is a disease that’s 100 times more common than either of those, and nobody knows about it,” said Nelson.

The new paper estimates, based on autopsy studies, that between 20 and 50% of people over 80 will have brain changes associated with LATE. And that prevalence increases with age.

Experts say nailing down these numbers — as well as finding better ways to detect and research the disease — is what they hope comes out of consensus statements like the new paper, which gives scientists a common language to discuss it, according to Nelson.

“People have, in their own separate bailiwicks, found different parts of the elephant,” he said. “But this is the first place where everybody gets together and says, ‘This is the whole elephant.’ ”

What this could mean for Alzheimer’s

The new guidelines could have an impact on Alzheimer’s research, as well. For one, experts say some high-profile drug trials may have suffered as a result of some patients having unidentified LATE — and thus not responding to treatment.

In fact, Nelson’s colleagues recently saw that firsthand: a patient, now deceased, who was part of an Alzheimer’s drug trial but developed dementia anyway.

“So, the clinical trial was a failure for Alzheimer’s disease,” Nelson said, “but it turns out he didn’t have Alzheimer’s disease. He had LATE.”

Nina Silverberg, director of the Alzheimer’s Disease Research Centers Program at the National Institute on Aging, said she suspects examples like this are not the majority — in part because people in clinical trials tend to be on the younger end of the spectrum.

“I’m sure it plays some part, but maybe not as much as one might think at first,” said Silverberg, who co-chaired the working group that led to the new paper.

Advances in testing had already shown that some patients in these trials lacked “the telltale signs of Alzheimer’s,” she said.

In some cases, perhaps it was LATE — “and it’s certainly possible that there are other, as yet undiscovered, pathologies that people may have,” she added.

“We could go back and screen all the people that had failed their Alzheimer’s disease therapies,” Nelson said. “But what we really need to do is go forward and try to get these people out of the Alzheimer’s clinical trials — and instead get them into their own clinical trials.”

Silverberg describes the new paper as “a roadmap” for research that could change as we come to discover more about the disease. And researchers can’t do it without a large, diverse group of patients, she added.

“It’s probably going to take years and research participants to help us understand all of that,” she said.

https://www.cnn.com/2019/04/30/health/dementia-late-alzheimers-study/index.html

by John Haltiwanger

I woke up at 6 am this morning, three hours before I’m supposed to be in the office, and was still 10 minutes late to work.

This is pretty standard for me. I’m almost always a few minutes late. I don’t mean anything by it, and I certainly don’t think I deserve a different set of rules than everyone else — it’s just the way I am.

I wake up early and try to fill the time before I leave for the office with as many activities as possible: a short workout, breakfast, catching up on the news, daydreaming while struggling to put my socks on, etc.

I’ll look at the clock and think, “Oh, I still have plenty of time.” One or two tasks later, I’ve only got 40 minutes to get to work and a 45 minute commute.

This has been the case with every single job I’ve ever had and is typically true when it comes to social meetings as well. I’m habitually unpunctual, and apparently I’m not alone.

As management consultant Diana DeLonzor states:

Most late people have been late all their life, and they are late for every type of activity — good or bad.

Surprisingly little scientific research has been done on tardiness, but some experts subscribe to the theory that certain people are hardwired to be late and that part of the problem may be embedded deep in the lobes of the brain.

So if you’re chronically late, I feel for you and sympathize with the onslaught of criticism you likely receive on a consistent basis.

I know you’re not a lazy, unproductive, inconsiderate or entitled person. I know you’re not attempting to insult anyone by your tardiness.

Your lateness is simply a consequence of your psychology and personality — nothing more, nothing less.

With that said, while those of us who are continuously tardy should work to overcome this trait, there are also hidden benefits.

Chronically late people aren’t hopeless, they’re hopeful.

People who are continuously late are actually just more optimistic. They believe they can fit more tasks into a limited amount of time more than other people and thrive when they’re multitasking. Simply put, they’re fundamentally hopeful.

While this makes them unrealistic and bad at estimating time, it also pays off in the long-run in other ways.

Researchers have found optimism has a myriad of physical health benefits, from reducing stress and diminishing the risk of cardiovascular disease to strengthening your immune system.

Indeed, happiness and positivity have been linked to a longer life in general.

Maintaining a positive outlook is also vital to achieving personal success. Research shows happiness increases overall productivity, creativity and teamwork in the workplace.

All of this makes a great deal of sense, as a study conducted at San Diego State University has also connected lateness with Type B personalities, or people who tend to be more laid-back and easygoing.

In other words, people who are habitually late don’t sweat over the small stuff, they concentrate on the big picture and see the future as full of infinite possibilities.

Time is relative, learn to live in the moment.

We should also note punctuality is a relative concept. Time and lateness mean different things in different cultures and contexts.

In the United States, we often interpret lateness as an insult or a sign of a poor work ethic.

When people are late, it’s assumed they feel their time is more important or valuable. Americans believe time is money and money is time.

But if you head over to Europe, it’s almost as if the notion of time magically mutates each time you enter a new country.

In Germany, the land of perpetual efficiency, punctuality is of the utmost importance.

When Russian President Vladimir Putin was late to a meeting with German Chancellor Angela Merkel, for example, she left because that’s how Germans roll.

If you venture over to Spain, however, you’ll find time has taken a completely different character. The Spanish run by their own clock and are famous for eating dinner at 10 pm.

Sail on down to Latin America, and you’ll discover punctuality bears little to no importance.

The point here being, we all do things our own way.

It’s fair to contend unpunctuality is bad for economic growth and that schedules are vital to maintaining efficiency.

But when we look at the fact Americans work extensive hours yet exhibit low levels of productivity, this argument feels somewhat empty and void.

As both societies and individuals, we all need to find the healthy balance between punctuality and lateness. Schedules are important, but breaking them isn’t the end of the world.

People with a tendency for tardiness like to stop and smell the roses, and those with a propensity for punctuality could learn a thing or two from them (and vice versa).

Life was never meant to be planned down to the last detail. Remaining excessively attached to timetables signifies an inability to enjoy the moment.

Living in the present is vital to our sanity. Sometimes it’s much more beneficial to go with the flow.

We can’t spend all of our time dwelling on the past or dreaming of the future, or we end up missing out on the wonderful things occurring around us.

http://elitedaily.com/life/culture/optimistic-people-have-one-thing-common-always-late/1097735/