Re: Fatigue and Lewy Body Dementia
There is also one article suggesting that physical frailty, including fatigue, is not so specifically associated with the presence of Lewy bodies at post mortem. This was in the Rush Memory and Aging Project, which I helped to design some years back, and gets post mortem on all participants so really does have confirmed diagnosis. Note the population is a good deal older (mean age 88) and not a lot of the variation in frailty was accounted for by brain pathology. At least with my mother, I think that sleep disturbances definitely affect her fatigue level because she is much worse after a bad night. (Anecdotal, not research driven.) These folks are really solid researchers and have probably the world's most extensive collection of post-mortem-confirmed, longitudinal data on cognitive aging.
Here is the abstract:
Neurology. 2008 Aug 12;71(7):499-504.
Physical frailty in older persons is associated with Alzheimer disease pathology.
Buchman AS, Schneider JA, Leurgans S, Bennett DA.
Rush Alzheimer's Disease Center, Rush University Medical Center, Armour Academic Facility, Suite 1038, 600 S Paulina St, Chicago, IL 60612, USA. firstname.lastname@example.org
We examined the extent to which physical frailty in older persons is associated with common age-related brain pathology, including cerebral infarcts, Lewy body pathology, and Alzheimer disease (AD) pathology.
We studied brain autopsies from 165 deceased participants from the Rush Memory and Aging Project, a longitudinal clinical-pathologic study of aging. Physical frailty, based on four components, including grip strength, time to walk 8 feet, body composition, and fatigue, was assessed at annual clinical evaluations. Multiple regression analyses were used to examine the relation of postmortem neuropathologic findings to frailty proximate to death, controlling for age, sex, and education.
The mean age at death was 88.1 years (SD = 5.7 years). The level of AD pathology was associated with frailty proximate to death ( = 0.252, SE = 0.077, p = 0.001), accounting for 4% of the variance of physical frailty. Neither cerebral infarcts ( = -0.121, SE = 0.115, p = 0.294) nor Lewy body disease pathology ( = 0.07, SE = 0.156, p = 0.678) was associated with frailty. These associations were unchanged after controlling for the time interval from last clinical evaluation to autopsy. The association of AD pathology with frailty did not differ by the presence of dementia, and this association was unchanged even after considering potential confounders, including physical activity; parkinsonian signs; pulmonary function; or history of chronic diseases, including vascular risk factors, vascular disease burden, falls, joint pain, or use of antipsychotic or antihypertensive medications.
Physical frailty in old age is associated with Alzheimer disease pathology in older persons with and without dementia.