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Mortality and risk of dementia in normal‐pressure hydrocephalus: A population study
Author(s) -
Jaraj Daniel,
Wikkelsø Carsten,
Rabiei Katrin,
Marlow Thomas,
Jensen Christer,
Östling Svante,
Skoog Ingmar
Publication year - 2017
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2017.01.013
Subject(s) - asymptomatic , dementia , medicine , hydrocephalus , hazard ratio , confidence interval , normal pressure hydrocephalus , population , pediatrics , cardiology , surgery , disease , environmental health
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.