Five-year incidence of surgery for idiopathic normal pressure hydrocephalus in Norway

Brean, Are; Fredø, Hege Linnerud; Sollid, Snorre; Müller, Tomm B.; Sundstrøm, Terje; Eide, Per Kristian

doi:10.1111/j.1600-0404.2009.01250.x

Cited by 75 publications

(36 citation statements)

References 9 publications

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“…Furthermore, several authors have argued that many with iNPH are not properly evaluated for their symptoms and do not receive the correct diagnosis. 6,23 This is supported by our finding that only 2 persons in the study population had previously undergone shunt surgery. Our study shows that many elderly persons possess the clinical and imaging features of iNPH.…”

Section: Resultssupporting

confidence: 78%

Section: Methodsmentioning

confidence: 99%

“…4 iNPH is thus one of the few causes of reversible dementia, but it is still underdiagnosed. 5,6 The prevalence of iNPH in selected populations and in community-based studies on young elderly varies between 0.1% and 2.9%.5,7-10 However, few large population-based studies have investigated the prevalence of iNPH, and most included few persons older than 80 years. Thus, the prevalence still has to be examined in population-based studies including many persons older than 80 years.…”

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confidence: 99%

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Prevalence of idiopathic normal-pressure hydrocephalus

Jaraj¹,

Rabiei²,

Marlow³

et al. 2014

Neurology

343

219

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Objectives: The aim of this study was to determine the prevalence of idiopathic normal-pressure hydrocephalus (iNPH) in elderly persons in a large population-based sample using radiologic and clinical examinations. Methods:We examined representative elderly populations aged 70 years and older that had undergone neuropsychiatric evaluations and CT of the brain between 1986 and 2000 (n 5 1,238). Gait was evaluated by clinical examination and history of walking difficulty. Cognitive function was evaluated with the Mini-Mental State Examination and urinary incontinence by selfreport. iNPH was diagnosed in concordance with the American-European iNPH guidelines. Exclusion criteria were history of meningitis, severe head trauma, and subarachnoid hemorrhage.Results: The prevalence of probable iNPH was 0.2% in those aged 70-79 years (n 5 2) and 5.9%(n 5 24) in those aged 80 years and older, with no difference between men and women. Only 2 of these persons had been treated for iNPH. Hydrocephalic ventricular enlargement, i.e., a CT image consistent with NPH, was found in 56 persons (4.5%). An Evans Index .0.3 was found in 256 (20.7%) and occluded sulci at the high convexity in 67 persons (5.4%). All of these findings were more common in the older age groups. The number of elderly and people with dementia is increasing in most parts of the world.1 It is therefore important to learn more about the prevalence of treatable causes of dementia. Idiopathic normal-pressure hydrocephalus (iNPH) is a treatable neurologic disorder first described by Salomón Hakim in 1965.2 iNPH is characterized by gait and balance impairment, cognitive deterioration, and urinary incontinence, and radiologically by a communicating ventricular enlargement.3 Treatment by diversion of CSF to the peritoneal cavity or heart is successful in reversing symptoms in more than 80% of the patients. 4 iNPH is thus one of the few causes of reversible dementia, but it is still underdiagnosed. 5,6 The prevalence of iNPH in selected populations and in community-based studies on young elderly varies between 0.1% and 2.9%.5,7-10 However, few large population-based studies have investigated the prevalence of iNPH, and most included few persons older than 80 years. Thus, the prevalence still has to be examined in population-based studies including many persons older than 80 years.The aim of this study was to determine the prevalence of iNPH by examining CT images of the brain and clinical signs of iNPH in a large representative elderly population.METHODS Study population. Between 1986 and 2000, studies on representative elderly populations in Gothenburg, Sweden, were conducted using identical examinations (including neuropsychiatric examinations and key informant interviews) at each

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Section: Resultssupporting

confidence: 78%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of idiopathic normal-pressure hydrocephalus

Jaraj¹,

Rabiei²,

Marlow³

et al. 2014

Neurology

343

219

View full text Add to dashboard Cite

show abstract

“…4 Similarly, low incidence figures have been described in several European reports. [5][6][7][8][9] Conversely, relatively high prevalence figures (0.4%-14%) have been estimated when members of a population are screened for compatible clinical or neuroimaging features. 10 -14 Because these findings are nonspecific, studies that simply tabulate gait disturbance, dementia, incontinence, and ventriculomegaly without broader reference to the overall clinical context probably overestimate NPH prevalence.…”

Section: Resultsmentioning

confidence: 99%

Normal pressure hydrocephalus

2011

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Objective: To determine our community's incidence of clinically suspected normal pressure hydrocephalus (NPH), the rate of shunting for NPH, and short-and long-term outcomes of shunting.Methods: A retrospective query of the Mayo Clinic medical records linkage system was conducted to identify residents of Olmsted County, Minnesota, undergoing an invasive diagnostic procedure for evaluation of suspected NPH from 1995 through 2003. Among patients with shunts, earlyand long-term outcomes were determined via a review of available medical records.

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“…3 The annual incidence of idiopathic NPH (iNPH) has been estimated at 1/100,000, but may be as high as 14% of the subpopulation of elderly patients living in nursing facilities. 4,5 Despite more than 40 years of experience in the treatment of iNPH, the diagnosis and management of this complex disorder remains controversial. 6 At present the diagnosis is made by clinical symptoms in the presence of enlarged ventricles on imaging, and is confirmed by a positive response to CSF diversion.…”

Section: Introductionmentioning

confidence: 99%