{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:56:43Z","timestamp":1790287003109,"version":"4.1.0"},"reference-count":48,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-ncnd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Int Neuropsychol Soc"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1355617722000868_as1\"><jats:title>Objective:<\/jats:title><jats:p>Alzheimer\u2019s disease (AD) is highly comorbid with idiopathic normal pressure hydrocephalus (iNPH) and may diminish the benefits of shunting; however, findings in this area are mixed. We examined postoperative outcomes, with emphases on cognition and utilization of novel scoring procedures to enhance sensitivity.<\/jats:p><\/jats:sec><jats:sec id=\"S1355617722000868_as2\"><jats:title>Methods:<\/jats:title><jats:p>Using participant data from an iNPH outcome study at Butler Hospital, a mixed effect model examined main and interaction effects of time since surgery (baseline, 3 months, 12 months, and 24\u201360 months) and AD comorbidity (20 iNPH and 11 iNPH+AD) on activities of daily living (ADLs) and iNPH symptoms. Regression modeling explored whether baseline variables predicted improvements 3 months postoperatively.<\/jats:p><\/jats:sec><jats:sec id=\"S1355617722000868_as3\"><jats:title>Results:<\/jats:title><jats:p>There were no group differences in gait, incontinence, and global cognition over time, and neither group showed changes in ADLs. Cognitive differences were observed postoperatively; iNPH patients showed stable improvements in working memory (<jats:italic>p<\/jats:italic> = 0.012) and response inhibition (<jats:italic>p<\/jats:italic> = 0.010), while iNPH + AD patients failed to maintain initial gains. Regarding predicting postoperative outcomes, baseline AD biomarkers did not predict shunt response at 3 months; however, older age at surgery predicted poorer cognitive outcomes (<jats:italic>p<\/jats:italic> = 0.04), and presurgical Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) (<jats:italic>p<\/jats:italic> = 0.035) and Mini-Mental Status Examination (MMSE) scores (<jats:italic>p<\/jats:italic> = 0.009) predicted improvements incontinence.<\/jats:p><\/jats:sec><jats:sec id=\"S1355617722000868_as4\"><jats:title>Conclusion:<\/jats:title><jats:p>iNPH + AD may be linked with greater declines in aspects of executive functioning postoperatively relative to iNPH alone. While baseline AD pathology may not prognosticate shunt response, younger age appears linked with postsurgical cognitive improvement, and utilizing both brief and comprehensive cognitive measures may help predict improved incontinence. These results illustrate the potential benefits of surgery and inform postoperative expectations for those with iNPH + AD.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1355617722000868","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T09:35:07Z","timestamp":1671010507000},"page":"751-762","source":"Crossref","is-referenced-by-count":21,"title":["Longitudinal post-shunt outcomes in idiopathic normal pressure hydrocephalus with and without comorbid Alzheimer\u2019s disease"],"prefix":"10.1017","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4662-7824","authenticated-orcid":false,"given":"Dov","family":"Gold","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Wisialowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Piryatinsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Malloy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Correia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Salloway","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Klinge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles E.","family":"Gaudet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison","family":"Niermeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8828-8701","authenticated-orcid":false,"given":"Athene","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,12,14]]},"reference":[{"key":"S1355617722000868_ref33","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2007.123620"},{"key":"S1355617722000868_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"S1355617722000868_ref36","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617715001125"},{"key":"S1355617722000868_ref16","volume-title":"Stroop color and word test adult version a manual for clinical and experimental uses","author":"Golden","year":"2002"},{"key":"S1355617722000868_ref28","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000175724.00147.10"},{"key":"S1355617722000868_ref40","doi-asserted-by":"publisher","DOI":"10.1159\/000087092"},{"key":"S1355617722000868_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.05.183"},{"key":"S1355617722000868_ref37","first-page":"1","article-title":"Effect of comorbid Parkinson\u2019s disease and Parkinson\u2019s disease dementia on the course of idiopathic normal pressure hydrocephalus","volume":"1","author":"Sakurai","year":"2022","journal-title":"Journal of Neurosurgery"},{"key":"S1355617722000868_ref41","volume-title":"WAIS-IV administration and scoring manual (Wechsler adult intelligence scale","author":"Wechsler","year":"2008"},{"key":"S1355617722000868_ref42","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a006171"},{"key":"S1355617722000868_ref43","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(01)00026-5"},{"key":"S1355617722000868_ref44","first-page":"579","article-title":"Diagnosis and treatment of idiopathic normal pressure hydrocephalus","volume":"22","author":"Williams","year":"2016","journal-title":"Continuum : Lifelong Learning in Neurology"},{"key":"S1355617722000868_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2016.08.040"},{"key":"S1355617722000868_ref35","volume-title":"The Halstead-Reitan neuropsychological test battery: Theory and clinical interpretations","author":"Reitan","year":"1993"},{"key":"S1355617722000868_ref5","doi-asserted-by":"publisher","DOI":"10.1590\/0004-282X20130173"},{"key":"S1355617722000868_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2014.07.003"},{"key":"S1355617722000868_ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-021-05544-0"},{"key":"S1355617722000868_ref46","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2008.02127.x"},{"key":"S1355617722000868_ref11","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2012-301682"},{"key":"S1355617722000868_ref38","volume-title":"PSE syndrome test manual","author":"Schomerus","year":"1999"},{"key":"S1355617722000868_ref47","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182288"},{"key":"S1355617722000868_ref13","doi-asserted-by":"publisher","DOI":"10.3758\/BF03193146"},{"key":"S1355617722000868_ref31","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-016-8097-0"},{"key":"S1355617722000868_ref10","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.11.1621"},{"key":"S1355617722000868_ref30","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617720000387"},{"key":"S1355617722000868_ref7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.2008"},{"key":"S1355617722000868_ref34","volume-title":"Repeatable battery for the assessment of neuropsychological status (RBANS)","author":"Randolph","year":"1998"},{"key":"S1355617722000868_ref8","doi-asserted-by":"publisher","DOI":"10.1093\/arclin\/acv040"},{"key":"S1355617722000868_ref4","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2015.00345"},{"key":"S1355617722000868_ref17","volume-title":"FrSBe, frontal systems behavior scale: Professional manual","author":"Grace","year":"2001"},{"key":"S1355617722000868_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.exger.2009.10.010"},{"key":"S1355617722000868_ref26","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/9.3_Part_1.179"},{"key":"S1355617722000868_ref48","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/20.6.649"},{"key":"S1355617722000868_ref12","doi-asserted-by":"publisher","DOI":"10.3758\/BRM.41.4.1149"},{"key":"S1355617722000868_ref2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2006.095117"},{"key":"S1355617722000868_ref39","doi-asserted-by":"publisher","DOI":"10.1093\/arclin\/acy025"},{"key":"S1355617722000868_ref3","doi-asserted-by":"publisher","DOI":"10.1385\/MN:24:1-3:087"},{"key":"S1355617722000868_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.nrleng.2015.10.004"},{"key":"S1355617722000868_ref45","doi-asserted-by":"publisher","DOI":"10.3171\/2019.2.JNS183538"},{"key":"S1355617722000868_ref24","doi-asserted-by":"publisher","DOI":"10.1242\/bio.20135447"},{"key":"S1355617722000868_ref32","doi-asserted-by":"publisher","DOI":"10.3171\/2015.2.JNS142318"},{"key":"S1355617722000868_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2010.12.008"},{"key":"S1355617722000868_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2018.01.017"},{"key":"S1355617722000868_ref21","doi-asserted-by":"publisher","DOI":"10.1002\/gps.4751"},{"key":"S1355617722000868_ref27","doi-asserted-by":"publisher","DOI":"10.1186\/2045-8118-10-22"},{"key":"S1355617722000868_ref9","volume-title":"Delis-Kaplan executive function systemTM (D-KEFSTM)\u2014D-KEFS examiner\u2019s manual","author":"Delis","year":"2001"},{"key":"S1355617722000868_ref29","doi-asserted-by":"publisher","DOI":"10.1097\/NEN.0b013e31825018f7"},{"key":"S1355617722000868_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afu096"}],"container-title":["Journal of the International Neuropsychological Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1355617722000868","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T12:56:39Z","timestamp":1694436999000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1355617722000868\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,14]]},"references-count":48,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["S1355617722000868"],"URL":"https:\/\/doi.org\/10.1017\/s1355617722000868","relation":{},"ISSN":["1355-6177","1469-7661"],"issn-type":[{"value":"1355-6177","type":"print"},{"value":"1469-7661","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,14]]}}}