Open AccessNationwide hospital‐based survey of idiopathic normal pressure hydrocephalus in Japan: Epidemiological and clinical characteristics
Author(s) -
Kuriyama Nagato,
Miyajima Masakazu,
Nakajima Madoka,
Kurosawa Michiko,
Fukushima Wakaba,
Watanabe Yoshiyuki,
Ozaki Etsuko,
Hirota Yoshio,
Tamakoshi Akiko,
Mori Etsuro,
Kato Takeo,
Tokuda Takahiko,
Urae Akinori,
Arai Hajime
Publication year - 2017
Publication title -
brain and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.915
H-Index - 41
ISSN - 2162-3279
DOI - 10.1002/brb3.635
Subject(s) - medicine , diabetes mellitus , epidemiology , comorbidity , hydrocephalus , normal pressure hydrocephalus , pediatrics , disease , cognitive impairment , dementia , surgery , endocrinology
Objectives There have been no nationwide epidemiological studies of idiopathic normal pressure hydrocephalus ( iNPH ) in Japan. Therefore, a nationwide epidemiologic survey of iNPH was performed to determine the number of cases and clinical characteristics by sex and diagnostic level. Methods The first survey examined the numbers of cases that met the diagnostic criteria of iNPH and those who underwent shunt operations in 2012. The second survey gathered patients' details to clarify their clinical background characteristics. Results The estimated number of cases meeting the diagnostic criteria in 2012 was 12,900, with 6,700 undergoing shunt operations. The estimated crude prevalence was 10.2/100,000 persons. The age of onset was in the 70s in more than 50% of both men and women. Significantly higher ( p < .05) frequencies of gait impairment in men and cognitive decline in women were observed as initial symptoms. At the time of definitive diagnosis, gait impairment was observed most frequently in patients with definite iNPH (77.7%). Hypertension was the most frequent comorbidity (40.0%), followed by diabetes mellitus (17.8%) and Alzheimer's disease (14.8%). Hypertension was observed more frequently in men, but diabetes was observed more frequently in women ( p < .05). An LP shunt was the first‐choice (55.1%) treatment of iNPH , followed by a VP shunt (43.2%). Conclusion This study showed that iNPH occurs most frequently in the 70s, gait impairment and cognitive decline are the most frequent initial symptoms in men and women, respectively, and hypertension and diabetes are the most frequent comorbidities in men and women, respectively.