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However, it is unclear whether clinical improvements after surgery can effectively reduce the long-term care burden (LTCB). In this study, we determined whether shunt surgery was effective in decreasing LTCB. We also investigated the degree of variability in patients and hospitals, using data from the iNPH multicenter study. This study involved 69 participants who underwent lumboperitoneal shunt surgery with follow-up for 12\u00a0months. A generalized linear mixed model was applied to analyze the fixed and random effects simultaneously. Regarding LTCB, the disability grades improved significantly. Although the dementia grades also improved, it was not statistically significant. The differences in the LTCB grades in most patients were within the range of the 95% confidence intervals, while in the case of hospitals, some were often out of the range. Further studies are needed to improve dementia in patients with iNPH. The incorporation of random variables, such as hospitals, is important for the analysis of data from multicenter studies.<\/jats:p>","DOI":"10.1038\/s41598-021-90911-2","type":"journal-article","created":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T10:15:03Z","timestamp":1622715303000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Improvement in the long-term care burden after surgical treatment of patients with idiopathic normal pressure hydrocephalus: a supplementary study"],"prefix":"10.1038","volume":"11","author":[{"given":"Masatsune","family":"Ishikawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeki","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masakazu","family":"Miyajima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Kazui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Etsuro","family":"Mori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,6,3]]},"reference":[{"key":"90911_CR1","first-page":"987","volume":"102","author":"A Marmarou","year":"2005","unstructured":"Marmarou, A. et al. 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SY received research funding from FUJIFILM Corporation and G-7 Scholarship Foundation. MM had no conflicts to declare. HK received honoraria from Eisai, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Novartis, Janssen, Takeda, Otsuka, MSD, UCB, Eli Lilly, Towa, Integra Japan, and Nihon Medi-Physics. EM has received grant support from MHWL and Eisai; affiliation with an endowed chair from Sosei Heptares and Mentis Cura; personal compensation as a consultant\/scientific advisory board member for Sosei Heptares and Mentis Cura; and honoraria from Eisai, Sumitomo Dainippon Pharma, Integra Japan, and Nihon Medi-Physics.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"11732"}}