{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T02:02:14Z","timestamp":1794276134434,"version":"4.9.0"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T00:00:00Z","timestamp":1722297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009778","name":"Region J\u00e4mtland H\u00e4rjedalen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009778","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009778","name":"Region J\u00e4mtland H\u00e4rjedalen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009778","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009778","name":"Region J\u00e4mtland H\u00e4rjedalen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009778","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Syskonen Perssons donationsfond"},{"name":"J\u00e4mtlands cancer och omv\u00e5rdnadsfond"},{"name":"Stiftelsen Forskningsfonden f\u00f6r klinisk neurovetenskap vid NUS"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Maximising quality of life is a central goal for all healthcare, especially when dealing with dementing disorders. In this study we aimed to compare health-related quality of life (HRQoL), depressive symptoms and functional impairment between individuals with and without idiopathic normal pressure hydrocephalus (iNPH) from the general population.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A total of 122 individuals, 30 with iNPH (median age 75 years, 67 females) underwent neurological examinations and computed tomography of the brain with standardised rating of imaging findings and clinical symptoms. The participants completed the Geriatric Depression Scale (GDS-15) and the HRQoL instrument EQ5D-5L. In addition, the modified Rankin Scale (mRS) was used to evaluate functional impairment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Compared with participants without iNPH, those with iNPH reported a higher score on GDS-15 (median 3 <jats:italic>vs<\/jats:italic> 1) and mRS (median 2 <jats:italic>vs<\/jats:italic> 1) (p &lt; 0.05). Further, those with iNPH rated lower on EQ5D-5L (index 0.79, VAS 70) than those without iNPH (index 0.86, VAS 80) (p &lt; 0.05). In logistic regression models, low HRQoL was associated with more depressive symptoms, a higher degree of iNPH symptoms, and lower functional status.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In this population-based sample, those with iNPH had more depressive symptoms, lower functional status, and worse quality of life compared to those without iNPH. The strongest association with low HRQoL was found for depressive symptoms, functional level, and degree of iNPH symptoms. These results underline the value of shunt surgery because of its potential to reduce symptoms and disability in iNPH and therefore improve HRQoL.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0308079","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T17:30:26Z","timestamp":1722360626000},"page":"e0308079","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Depressive symptoms, functional impairment, and health-related quality of life in idiopathic normal pressure hydrocephalus: A population-based study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4107-3818","authenticated-orcid":true,"given":"Johanna","family":"Andersson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Maripuu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathilda","family":"Sj\u00f6vill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Lindam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Laurell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,7,30]]},"reference":[{"key":"pone.0308079.ref001","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1016\/j.wneu.2015.07.005","article-title":"Epidemiology of Idiopathic Normal Pressure Hydrocephalus: A Systematic Review of the Literature.","volume":"84","author":"R Martin-Laez","year":"2015","journal-title":"World neurosurgery."},{"issue":"5","key":"pone.0308079.ref002","doi-asserted-by":"crossref","first-page":"e0217705","DOI":"10.1371\/journal.pone.0217705","article-title":"Prevalence of idiopathic normal pressure hydrocephalus: A prospective, population-based study.","volume":"14","author":"J Andersson","year":"2019","journal-title":"PloS one."},{"key":"pone.0308079.ref003","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/0022-510X(65)90016-X","article-title":"The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics.\u2014PubMed\u2014NCBI","author":"S Hakim","year":"1965","journal-title":"J Neurol Sci"},{"key":"pone.0308079.ref004","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1007\/s00701-013-1835-5","article-title":"Systematic review of the outcome of shunt surgery in idiopathic normal-pressure hydrocephalus","volume":"155","author":"AK Toma","year":"2013","journal-title":"Acta neurochirurgica"},{"key":"pone.0308079.ref005","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1080\/02688697.2016.1229749","article-title":"Incidence and outcome of surgery for adult patients with hydrocephalus in Sweden","volume":"31","author":"N Sundstr\u00f6m","year":"2017","journal-title":"British journal of neurosurgery"},{"issue":"4","key":"pone.0308079.ref006","first-page":"217","article-title":"A review of cognitive impairment and differential diagnosis in idiopathic normal pressure hydrocephalus","volume":"30","author":"M Picascia","year":"2015","journal-title":"Functional neurology"},{"issue":"1","key":"pone.0308079.ref007","doi-asserted-by":"crossref","first-page":"18203","DOI":"10.1038\/s41598-020-75381-2","article-title":"Wide temporal horns are associated with cognitive dysfunction, as well as impaired gait and incontinence.","volume":"10","author":"O Lilja-Lund","year":"2020","journal-title":"Scientific reports."},{"issue":"1","key":"pone.0308079.ref008","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1111\/nyas.12669","article-title":"Diagnosis and treatment of depression and cognitive impairment in late life","volume":"1345","author":"SS Morimoto","year":"2015","journal-title":"Annals of the New York Academy of Sciences"},{"issue":"3","key":"pone.0308079.ref009","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1155\/2009\/791491","article-title":"Neuropsychiatric symptoms in patients with idiopathic normal pressure hydrocephalus","volume":"21","author":"Y Kito","year":"2009","journal-title":"Behavioural neurology"},{"key":"pone.0308079.ref010","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1227\/NEU.0000000000001093","article-title":"Symptoms of depression are common in patients with idiopathic normal pressure hydrocephalus: The INPH-CRasH study.","volume":"78","author":"H Israelsson","year":"2016","journal-title":"Neurosurgery."},{"issue":"10","key":"pone.0308079.ref011","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1111\/ene.12755","article-title":"Health-related quality of life in patients with idiopathic normal pressure hydrocephalus","volume":"22","author":"A Junkkari","year":"2015","journal-title":"European journal of neurology"},{"key":"pone.0308079.ref012","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.jns.2016.01.001","article-title":"Effect of lumbo-peritoneal shunt surgery on neuropsychiatric symptoms in patients with idiopathic normal pressure hydrocephalus","volume":"361","author":"H Kanemoto","year":"2016","journal-title":"Journal of the neurological sciences"},{"key":"pone.0308079.ref013","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.archger.2016.04.009","article-title":"Factors influencing quality of life of elderly people with dementia and care implications: A systematic review.","volume":"66","author":"W Jing","year":"2016","journal-title":"Archives of gerontology and geriatrics"},{"issue":"9","key":"pone.0308079.ref014","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1007\/s00701-022-05309-4","article-title":"Gait, falls, cognitive function, and health-related quality of life after shunt-treated idiopathic normal pressure hydrocephalus-a single-center study.","volume":"164","author":"C Hallqvist","year":"2022","journal-title":"Acta neurochirurgica."},{"issue":"4","key":"pone.0308079.ref015","doi-asserted-by":"crossref","first-page":"776","DOI":"10.3171\/2014.6.JNS132003","article-title":"Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus","volume":"121","author":"J Petersen","year":"2014","journal-title":"Journal of neurosurgery"},{"issue":"7","key":"pone.0308079.ref016","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1007\/s00701-022-05149-2","article-title":"Motor skills, cognitive impairment, and quality of life in normal pressure hydrocephalus: early effects of shunt placement.","volume":"164","author":"M H\u00fclser","year":"2022","journal-title":"Acta neurochirurgica."},{"key":"pone.0308079.ref017","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1111\/j.1600-0404.2012.01677.x","article-title":"A new scale for assessment of severity and outcome in iNPH.","volume":"126","author":"P Hellstr\u00f6m","year":"2012","journal-title":"Acta neurologica Scandinavica."},{"issue":"3","key":"pone.0308079.ref018","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1111\/ene.13555","article-title":"The idiopathic normal-pressure hydrocephalus Radscale: a radiological scale for structured evaluation","volume":"25","author":"K Kockum","year":"2018","journal-title":"European journal of neurology"},{"key":"pone.0308079.ref019","doi-asserted-by":"crossref","first-page":"775","DOI":"10.2176\/nmc.52.775","article-title":"Guidelines for management of idiopathic normal pressure hydrocephalus: second edition.","volume":"52","author":"E Mori","year":"2012","journal-title":"Neurologia medico-chirurgica."},{"key":"pone.0308079.ref020","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.ensci.2017.04.002","article-title":"Challenges in diagnosing normal pressure hydrocephalus: Evaluation of the diagnostic guidelines.","volume":"7","author":"J Andersson","year":"2017","journal-title":"eNeurologicalSci."},{"issue":"12","key":"pone.0308079.ref021","first-page":"956","article-title":"Screening accuracy for late-life depression in primary care: a systematic review.","volume":"52","author":"LC Watson","year":"2003","journal-title":"The Journal of family practice"},{"issue":"1\u20133","key":"pone.0308079.ref022","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jad.2009.08.019","article-title":"Diagnostic validity and added value of the Geriatric Depression Scale for depression in primary care: a meta-analysis of GDS30 and GDS15","volume":"125","author":"AJ Mitchell","year":"2010","journal-title":"Journal of affective disorders"},{"key":"pone.0308079.ref023","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1161\/01.STR.19.5.604","article-title":"Interobserver agreement for the assessment of handicap in stroke patients","volume":"19","author":"JC van Swieten","year":"1988","journal-title":"Stroke; a journal of cerebral circulation"},{"issue":"10","key":"pone.0308079.ref024","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L).","volume":"20","author":"M Herdman","year":"2011","journal-title":"Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation."},{"issue":"1","key":"pone.0308079.ref025","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1002\/hec.3564","article-title":"Valuing health-related quality of life: An EQ-5D-5L value set for England.","volume":"27","author":"NJ Devlin","year":"2018","journal-title":"Health Econ."},{"key":"pone.0308079.ref026","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.clineuro.2008.10.001","article-title":"CSF neurotransmitter metabolites and neuropsychiatric symptomatology in patients with normal pressure hydrocephalus","volume":"111","author":"M Markianos","year":"2009","journal-title":"Clinical neurology and neurosurgery"},{"issue":"6","key":"pone.0308079.ref027","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1590\/0004-282X20140047","article-title":"Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus.","volume":"72","author":"MF Oliveira","year":"2014","journal-title":"Arquivos de neuro-psiquiatria."},{"key":"pone.0308079.ref028","first-page":"22","article-title":"A computerized neuropsychological test battery designed for idiopathic normal pressure hydrocephalus.","volume":"11","author":"A Behrens","year":"2014","journal-title":"Fluids and"},{"key":"pone.0308079.ref029","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jad.2017.06.011","article-title":"Prevalence of depression: Comparisons of different depression definitions in population-based samples of older adults","volume":"221","author":"L Sj\u00f6berg","year":"2017","journal-title":"Journal of affective disorders"},{"key":"pone.0308079.ref030","first-page":"806","article-title":"Natural course of idiopathic normal pressure hydrocephalus","volume":"85","author":"K Andr\u00e9n","year":"2014","journal-title":"Journal of Neurology"},{"issue":"6","key":"pone.0308079.ref031","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.3171\/2015.10.JNS151894","article-title":"One-year outcome in patients with idiopathic normal-pressure hydrocephalus: comparison of lumboperitoneal shunt to ventriculoperitoneal shunt","volume":"125","author":"M Miyajima","year":"2016","journal-title":"Journal of neurosurgery"},{"key":"pone.0308079.ref032","article-title":"Intraventricular infusion test accuracy in predicting short- and long-term outcome of iNPH patients: a 10-year update of a three-decade experience at a single institution.","author":"G Trevisi","year":"2021","journal-title":"Neurosurgical review."},{"issue":"3","key":"pone.0308079.ref033","doi-asserted-by":"crossref","first-page":"591","DOI":"10.3171\/2015.8.JNS151112","article-title":"Idiopathic normal pressure hydrocephalus: diagnostic and predictive value of clinical testing, lumbar drainage, and CSF dynamics.","volume":"125","author":"CV Mahr","year":"2016","journal-title":"Journal of neurosurgery"},{"key":"pone.0308079.ref034","article-title":"Preoperative Predictive Factors of Short-Term Outcome in Idiopathic Normal Pressure Hydrocephalus.","author":"T Kimura","year":"2021","journal-title":"World Neurosurg."},{"issue":"1","key":"pone.0308079.ref035","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1007\/s00415-017-8680-z","article-title":"Long-term effects of complications and vascular comorbidity in idiopathic normal pressure hydrocephalus: a quality registry study","volume":"265","author":"K Andr\u00e9n","year":"2018","journal-title":"Journal of neurology"},{"key":"pone.0308079.ref036","article-title":"Cerebrospinal Fluid Shunting Improves Long-Term Quality of Life in Idiopathic Normal Pressure Hydrocephalus.","author":"H Israelsson","year":"2019","journal-title":"Neurosurgery"},{"issue":"1","key":"pone.0308079.ref037","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1111\/ene.13130","article-title":"Health-related quality-of-life outcome in patients with idiopathic normal-pressure hydrocephalus\u2014a 1-year follow-up study","volume":"24","author":"A Junkkari","year":"2017","journal-title":"European journal of neurology"},{"key":"pone.0308079.ref038","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.wneu.2017.08.170","article-title":"Why Does the Health-Related Quality of Life in Idiopathic Normal-Pressure Hydrocephalus Fail to Improve Despite the Favorable Clinical Outcome?","volume":"108","author":"A Junkkari","year":"2017","journal-title":"World Neurosurg."},{"issue":"2","key":"pone.0308079.ref039","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1007\/s00701-021-05085-7","article-title":"Waiting time for surgery influences the outcome in idiopathic normal pressure hydrocephalus\u2014a population-based study","volume":"164","author":"C Chidiac","year":"2022","journal-title":"Acta neurochirurgica"},{"issue":"3","key":"pone.0308079.ref040","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1111\/ane.13052","article-title":"Structural correlates of cognitive impairment in normal pressure hydrocephalus.","volume":"139","author":"KA Peterson","year":"2019","journal-title":"Acta neurologica Scandinavica."},{"issue":"9","key":"pone.0308079.ref041","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1038\/mp.2013.20","article-title":"The vascular depression hypothesis: mechanisms linking vascular disease with depression","volume":"18","author":"WD Taylor","year":"2013","journal-title":"Molecular psychiatry"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0308079","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T17:31:00Z","timestamp":1722360660000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0308079"}},"subtitle":[],"editor":[{"given":"Jing A.","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,7,30]]},"references-count":41,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0308079","relation":{"has-part":[{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.g001","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.g002","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.t001","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.t002","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.t003","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.t004","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.t005","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.t006","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.s001","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.s002","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.s003","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.r001","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.r002","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.r003","asserted-by":"subject"},{"id-type":"doi","id":"https:\/\/doi.org\/10.1371\/journal.pone.0308079.r004","asserted-by":"subject"}]},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,30]]}}}