{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T18:30:26Z","timestamp":1767205826972,"version":"build-2238731810"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cognition and frailty are sparsely studied in patients with idiopathic normal pressure hydrocephalus (iNPH). We aimed to describe the preoperative cognitive function compared with normative data and frailty profile in iNPH patients accepted for shunt surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      All patients were diagnosed according to international guidelines and underwent a standardized cognitive and physical examination and a geriatric assessment prior to surgery.\n                      <jats:italic>Z<\/jats:italic>\n                      -scores for the cognitive tests were calculated based on age and education adjusted population norms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study cohort included 276 iNPH patients accepted for shunt surgery. Mean \u00b1 SD age was 73.1\u202f\u00b1\u202f5.7 years, education 12.5\u202f\u00b1\u202f3.8 years, and 61% were male. The median (IQR) score on the Mini-Mental State Evaluation was 27 (24\u201329), and the median (IQR) Clock Drawing test score was 4 (3\u20135). Mean (SD)\n                      <jats:italic>z<\/jats:italic>\n                      -score for immediate verbal recall was \u22121.74 (0.98), for delayed recall \u22121.66 (1.01), for figure copying \u22120.85 (1.35) for Trail Making Test A -1.50 (1.09), for Trail Making Test B \u22121.88 (1.03), for phonemic fluency \u22121.46 (1.10), and for semantic fluency \u22121.59 (1.20). Cluster analysis identified three groups, mainly differing regarding visuospatial function. The mean (SD) Frailty Index score was 0.23 (0.13), indicating mild frailty. The frailty domain most affected was physical function.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>iNPH patients showed reduced cognitive function across all domains. The patient group is rather heterogeneous regarding cognitive symptoms, and no specific cognitive profile was identified. Cognitive assessment offers limited utility for diagnosing a typical pattern specific for iNPH but is important due to the complex needs for this patient group. Whether cognitive and frailty profile can be used to identify shunt responders, must be assessed in longitudinal studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1644507","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T14:47:37Z","timestamp":1756997257000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cognitive profile and frailty in patients with idiopathic normal pressure hydrocephalus"],"prefix":"10.3389","volume":"16","author":[{"given":"Magnhild S.","family":"Dejgaard","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Per Kristian","family":"Eide","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gro Gujord","family":"Tangen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Skovlund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geir","family":"Selb\u00e6k","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torgeir Bruun","family":"Wyller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"63","DOI":"10.2176\/nmc.st.2020-0292","article-title":"Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus (third edition): endorsed by the Japanese Society of Normal Pressure Hydrocephalus","volume":"61","author":"Nakajima","year":"2021","journal-title":"Neurol Med Chir"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"S2-4","DOI":"10.1227\/01.NEU.0000168185.29659.C5","article-title":"Diagnosing idiopathic normal-pressure hydrocephalus","volume":"57","author":"Relkin","year":"2005","journal-title":"Neurosurgery"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"653964","DOI":"10.3389\/fnagi.2021.653964","article-title":"Gait assessment using three-dimensional acceleration of the trunk in idiopathic Normal pressure hydrocephalus","volume":"13","author":"Yamada","year":"2021","journal-title":"Front Aging Neurosci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"894617","DOI":"10.3389\/fneur.2022.894617","article-title":"Update on the cognitive presentations of iNPH for clinicians","volume":"13","author":"Langheinrich","year":"2022","journal-title":"Front Neurol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1449","DOI":"10.1212\/WNL.0000000000000342","article-title":"Prevalence of idiopathic normal-pressure hydrocephalus","volume":"82","author":"Jaraj","year":"2014","journal-title":"Neurology"},{"key":"ref6","doi-asserted-by":"publisher","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":"Andersson","year":"2019","journal-title":"PLoS One"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e208037","DOI":"10.1212\/WNL.0000000000208037","article-title":"Prevalence of possible idiopathic Normal pressure hydrocephalus in Sweden: a population-based MRI study in 791 70-year-old participants","volume":"102","author":"Constantinescu","year":"2024","journal-title":"Neurology"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/jnnp-2013-306117","article-title":"Natural course of idiopathic normal pressure hydrocephalus","volume":"85","author":"Andr\u00e9n","year":"2014","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1016\/j.jalz.2017.01.013","article-title":"Mortality and risk of dementia in normal-pressure hydrocephalus: a population study","volume":"13","author":"Jaraj","year":"2017","journal-title":"Alzheimers Dement"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1110","DOI":"10.3171\/2023.7.JNS23767","article-title":"Risk analysis index as a preoperative frailty tool for elective ventriculoperitoneal shunt surgery for idiopathic normal pressure hydrocephalus","volume":"140","author":"Courville","year":"2024","journal-title":"J Neurosurg"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1093\/braincomms\/fcaa187","article-title":"Magnetic resonance imaging biomarkers of cerebrospinal fluid tracer dynamics\u2002in idiopathic normal pressure hydrocephalus","volume":"2","author":"Eide","year":"2020","journal-title":"Brain Commun"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1227\/01.NEU.0000363408.69856.B8","article-title":"Diagnostic intracranial pressure monitoring and surgical management in idiopathic normal pressure hydrocephalus: a 6-year review of 214 patients","volume":"66","author":"Eide","year":"2010","journal-title":"Neurosurgery"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e058810","DOI":"10.1136\/bmjopen-2021-058810","article-title":"Cohort profile: the Norwegian registry of persons assessed for cognitive symptoms (NorCog) - a national research and quality registry with a biomaterial collection","volume":"12","author":"Medb\u00f8en","year":"2022","journal-title":"BMJ Open"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\"Mini-mental state\". A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J Psychiatr Res"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1002\/1099-1166(200006)15:6<548::AID-GPS242>3.0.CO;2-U","article-title":"Clock-drawing: is it the ideal cognitive screening test?","volume":"15","author":"Shulman","year":"2000","journal-title":"Int J Geriatr Psychiatry"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1076\/1380-3395(200004)22:2;1-1;FT286","article-title":"Edouard Clapar\u00e8de and the auditory verbal learning test","volume":"22","author":"Boake","year":"2000","journal-title":"J Clin Exp Neuropsychol"},{"key":"ref17","first-page":"641","article-title":"Consortium to establish a registry for Alzheimer's disease (CERAD) clinical and neuropsychological assessment of Alzheimer's disease","volume":"24","author":"Morris","year":"1988","journal-title":"Psychopharmacol Bull"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.1080\/13854046.2022.2106890","article-title":"Regression-based normative data for the Rey auditory verbal learning test in Norwegian and Swedish adults aged 49-79 and comparison with published norms","volume":"37","author":"Espenes","year":"2022","journal-title":"Clin Neuropsychol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"321","DOI":"10.3233\/JAD-220672","article-title":"The CERAD word list memory test: normative data based on a Norwegian population-based sample of healthy older adults 70 years and above. The HUNT study","volume":"91","author":"Wagle","year":"2023","journal-title":"J Alzheimers Dis"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1080\/13854046.2019.1574902","article-title":"Demographically adjusted CERAD wordlist test norms in a Norwegian sample from 40 to 80 years","volume":"33","author":"Kirsebom","year":"2019","journal-title":"Clin Neuropsychol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1037\/neu0000440","article-title":"Age-, sex-, and education-specific norms for an extended CERAD neuropsychological assessment battery-results from the population-based LIFE-adult-study","volume":"32","author":"Luck","year":"2018","journal-title":"Neuropsychology"},{"key":"ref22","author":"Strobel","year":"2023"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1080\/13854046.2020.1829068","article-title":"Demographically adjusted trail making test norms in a Scandinavian sample from 41 to 84 years","volume":"34","author":"Espenes","year":"2020","journal-title":"Clin Neuropsychol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1080\/13854040500351008","article-title":"Norwegian norms and factor-structure of phonemic and semantic word list generation","volume":"20","author":"Egeland","year":"2006","journal-title":"Clin Neuropsychol"},{"key":"ref25","first-page":"167","article-title":"Normative data stratified by age and education for two measures of verbal fluency: FAS and animal naming","volume":"14","author":"Tombaugh","year":"1999","journal-title":"Arch Clin Neuropsychol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1192\/bjp.140.6.566","article-title":"A new clinical scale for the staging of dementia","volume":"140","author":"Hughes","year":"1982","journal-title":"Br J Psychiatry"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1111\/j.1532-5415.1991.tb01616.x","article-title":"The timed \"up & go\": a test of basic functional mobility for frail elderly persons","volume":"39","author":"Podsiadlo","year":"1991","journal-title":"J Am Geriatr Soc"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"M85","DOI":"10.1093\/geronj\/49.2.M85","article-title":"A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission","volume":"49","author":"Guralnik","year":"1994","journal-title":"J Gerontol"},{"key":"ref29","doi-asserted-by":"publisher","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":"Hellstr\u00f6m","year":"2012","journal-title":"Acta Neurol Scand"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1001\/jama.2010.1970","article-title":"Role of gait speed in the assessment of older patients","volume":"305","author":"Cesari","year":"2011","journal-title":"JAMA"},{"key":"ref31","author":"Rostoft","year":"2023"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1093\/gerona\/62.7.722","article-title":"Frailty in relation to the accumulation of deficits","volume":"62","author":"Rockwood","year":"2007","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1093\/gerona\/gly197","article-title":"Validation of a claims-based frailty index against physical performance and adverse health outcomes in the health and retirement study","volume":"74","author":"Kim","year":"2019","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1093\/ageing\/afw039","article-title":"Development and validation of an electronic frailty index using routine primary care electronic health record data","volume":"45","author":"Clegg","year":"2016","journal-title":"Age Ageing"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"CD014923","DOI":"10.1002\/14651858.CD014923.pub2","article-title":"Shunting for idiopathic normal pressure hydrocephalus","volume":"2024","author":"Pearce","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1159\/000328924","article-title":"Cognitive profile of idiopathic normal pressure hydrocephalus","volume":"1","author":"Saito","year":"2011","journal-title":"Dement Geriatr Cogn Dis Extra"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1136\/jnnp.67.6.723","article-title":"Specific patterns of cognitive impairment in patients with idiopathic normal pressure hydrocephalus and Alzheimer's disease: a pilot study","volume":"67","author":"Iddon","year":"1999","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1007\/s12264-022-00873-2","article-title":"Cognitive impairment in idiopathic Normal pressure hydrocephalus","volume":"38","author":"Xiao","year":"2022","journal-title":"Neurosci Bull"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.3233\/JAD-201363","article-title":"The CERAD neuropsychological battery in patients with idiopathic Normal pressure hydrocephalus compared with Normal population and patients with mild Alzheimer's disease","volume":"81","author":"Nerg","year":"2021","journal-title":"J Alzheimer's Dis"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1159\/000090510","article-title":"Cognitive impairment in patients with idiopathic normal pressure hydrocephalus","volume":"21","author":"Ogino","year":"2006","journal-title":"Dement Geriatr Cogn Disord"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"143","DOI":"10.11138\/FNeur\/2016.31.3.143","article-title":"Spectrum of cognitive disorders in idiopathic normal pressure hydrocephalus","volume":"31","author":"Picascia","year":"2016","journal-title":"Funct Neurol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1002\/mdc3.13608","article-title":"Clinical features of idiopathic Normal pressure hydrocephalus: critical review of objective findings","volume":"10","author":"Bluett","year":"2023","journal-title":"Mov Disord Clin Pract"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1016\/j.clineuro.2011.09.014","article-title":"The neuropsychology of iNPH: findings and evaluation of tests in the European multicentre study","volume":"114","author":"Hellstr\u00f6m","year":"2012","journal-title":"Clin Neurol Neurosurg"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1093\/arclin\/acs002","article-title":"Cognitive disturbances and neuropsychological changes after surgical treatment in a cohort of 185 patients with idiopathic normal pressure hydrocephalus","volume":"27","author":"Solana","year":"2012","journal-title":"Arch Clin Neuropsychol"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"217","DOI":"10.11138\/FNeur\/2015.30.4.217","article-title":"A review of cognitive impairment and differential diagnosis in idiopathic normal pressure hydrocephalus","volume":"30","author":"Picascia","year":"2015","journal-title":"Funct Neurol"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.1007\/s00415-016-8097-0","article-title":"The effect of shunt surgery on neuropsychological performance in normal pressure hydrocephalus: a systematic review and meta-analysis","volume":"263","author":"Peterson","year":"2016","journal-title":"J Neurol"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/2045-8118-11-19","article-title":"Increased prevalence of cardiovascular disease in idiopathic normal pressure hydrocephalus patients compared to a population-based cohort from the HUNT3 survey","volume":"11","author":"Eide","year":"2014","journal-title":"Fluids Barriers CNS"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1111\/anae.12494","article-title":"The impact of pre-operative comprehensive geriatric assessment on postoperative outcomes in older patients undergoing scheduled surgery: a systematic review","volume":"69","author":"Partridge","year":"2014","journal-title":"Anaesthesia"},{"key":"ref49","doi-asserted-by":"publisher","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":"Andersson","year":"2017","journal-title":"eNeurologicalSci"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1016\/j.wneu.2015.09.067","article-title":"Outcome of surgery for idiopathic Normal pressure hydrocephalus: role of preoperative static and pulsatile intracranial pressure","volume":"86","author":"Eide","year":"2016","journal-title":"World Neurosurg"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1898","DOI":"10.3390\/biomedicines12081898","article-title":"In vivo prevalence of Beta-amyloid pathology and Alzheimer's disease co-pathology in idiopathic Normal-pressure hydrocephalus-association with neuropsychological features","volume":"12","author":"Pyrgelis","year":"2024","journal-title":"Biomedicine"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"2898","DOI":"10.3390\/jcm11102898","article-title":"Callosal angle sub-score of the Radscale in patients with idiopathic Normal pressure hydrocephalus is associated with positive tap test response","volume":"11","author":"Pyrgelis","year":"2022","journal-title":"J Clin Med"}],"updated-by":[{"DOI":"10.3389\/fneur.2025.1708210","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000}}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1644507\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:45:23Z","timestamp":1762508723000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1644507\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,4]]},"references-count":52,"alternative-id":["10.3389\/fneur.2025.1644507"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1644507","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,4]]},"article-number":"1644507"}}