{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:16:56Z","timestamp":1793413016071,"version":"4.5.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The objective of this study was to describe the demographic characteristics of patients with idiopathic normal pressure hydrocephalus (iNPH) through an analysis of 3000 consecutive, surgically treated Swedish patients and a systematic review of the literature.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Data on age, sex, comorbidities, diagnostic delay, initial symptoms, and severity of symptoms at diagnosis were extracted from the Swedish Hydrocephalus Quality Registry. In addition, a systematic PRISMA-based review of the literature published from database inception until August 2019 was performed using the PubMed, Cochrane, and Scopus databases on the basis of two concepts: normal pressure hydrocephalus and demography and their association with related terms. Of 1020 unique articles, 16 were eligible for study inclusion and were assessed for quality using the Newcastle-Ottawa Scale. Mean and weighted mean values were calculated.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS <\/jats:title>\n<jats:p>The mean patient age at the time of surgery was 74.4 years, 79% of patients were in their 70s, and 60% of the patients were men. Almost 50% of the patients had symptoms from four main domains (i.e., balance, gait, cognition, and urinary dysfunction) at disease onset. Patients aged &lt; 60 years (2%) reported more headaches and fewer balance problems than those aged \u2265 60. Women were more impaired in function than men at the time of diagnosis. Dementia (Mini-Mental State Examination score &lt; 25) was found in 47% of the patients. Men had more diabetes, heart disease, hypertension, and stroke than women, and comorbidity correlated with increased impairment. The incidence of surgery for iNPH was 20%\u201340% of the disease incidence according to survey and operation-based studies.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Most iNPH patients undergo surgery in their 70s. Those aged &lt; 60 years show slightly different symptomatology and probably present with a specific disease entity, indicating that the lower age limit for iNPH should be 60 years. iNPH patients have severe impairment preceded by a long diagnostic delay. Even though the included study designs differed, the systematic review showed that the disorder has a very low treatment incidence. The importance of diagnosing and treating iNPH is further emphasized by the fact that iNPH may account for a considerable part of all cases of dementia.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.2.jns212063","type":"journal-article","created":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T17:57:35Z","timestamp":1650995855000},"page":"1310-1320","source":"Crossref","is-referenced-by-count":41,"title":["The demography of idiopathic normal pressure hydrocephalus: data on 3000 consecutive, surgically treated patients and a systematic review of the literature"],"prefix":"10.3171","volume":"137","author":[{"given":"Nina","family":"Sundstr\u00f6m","sequence":"first","affiliation":[{"name":"Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Ume\u00e5 University, Ume\u00e5;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Lundin","sequence":"additional","affiliation":[{"name":"Departments of Neurology and"},{"name":"Biomedical and Clinical Sciences, Link\u00f6ping University, Link\u00f6ping;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Arvidsson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Karolinska University Hospital, Stockholm;"},{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Tullberg","sequence":"additional","affiliation":[{"name":"Hydrocephalus Research Unit, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Wikkels\u00f8","sequence":"additional","affiliation":[{"name":"Hydrocephalus Research Unit, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Observations on cerebrospinal fluid hydrodynamics. 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