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Mortality and risk of dementia in normal-pressure hydrocephalus: A population study.

Journal article
Authors Daniel Jaraj
Carsten Wikkelsö
Katrin Rabiei
Thomas Marlow
Christer Jensen
Svante Östling
Ingmar Skoog
Published in Alzheimer's & Dementia
Volume 13
Issue 8
Pages 850-857
ISSN 1552-5260
Publication year 2017
Published at Institute of Neuroscience and Physiology
Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Centre for Ageing and Health (Agecap)
Institute of Clinical Sciences, Section for Oncology, Radiation Physics, Radiology and Urology, Department of Radiology
Pages 850-857
Language en
Links https://doi.org/10.1016/j.jalz.2017...
https://www.ncbi.nlm.nih.gov/pubmed...
Keywords Normal-pressure hydrocephalus, Epidemiology, Mortality, Dementia, Outcome, Long-term outcome, Natural course
Subject categories Other Medical Sciences

Abstract

Introduction We examined mortality, dementia, and progression of hydrocephalic symptoms among untreated individuals with idiopathic normal-pressure hydrocephalus (iNPH) in a population-based sample. Methods A total of 1235 persons were examined between 1986 and 2012. Shunted individuals were excluded. We examined 53 persons with hydrocephalic ventricular enlargement (probable iNPH: n = 24, asymptomatic or possible iNPH: n = 29). Comparisons were made with individuals without hydrocephalic ventricular enlargement. Results The 5-year mortality was 87.5% among those with probable iNPH. The hazard ratio (HR) for death was 3.8 (95% confidence interval [CI]: 2.5–6.0) for probable iNPH. Those with possible iNPH and asymptomatic hydrocephalic ventricular enlargement had increased risk of developing dementia, HR 2.8 (95% CI: 1.5–5.2). Only two individuals with hydrocephalic ventricular enlargement remained asymptomatic. Discussion In the present sample, persons with clinical and imaging signs of iNPH had excess mortality and an increased risk of dementia. The data also suggest that radiological signs of iNPH might be more important than previously supposed.

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