Gait, Falls, Cognitive Function, and Health-related Quality of Life After Shunt-treated Idiopathic Normal Pressure Hydrocephalus-a Single-center Study

Overview

Journal Acta Neurochir (Wien)

Specialty Neurosurgery

Date 2022 Jul 13

PMID 35831723

Authors

Caroline Hallqvist

Helena Gronstedt

Lisa Arvidsson

Affiliations

Soon will be listed here.

Abstract

Background: Normal pressure hydrocephalus (NPH) is a neurological disorder, characterized by gait- and balance disturbance, cognitive deterioration, and urinary incontinence, combined with ventricular enlargement. Gait ability, falls, cognitive status, and health-related quality of life pre and post surgery have not previously been studied at Karolinska University Hospital.

Methods: One hundred and eighteen patients with iNPH that underwent shunt surgery at Karolinska University Hospital during the years from 2016 to 2018 were included. Results of walking tests, test for cognitive function, and self-estimated health-related quality of life, before and 3 months after surgery, were collected retrospectively as a single-center study.

Results: Walking ability, cognitive function, and health-related quality of life significantly increased 3 months after shunt surgery. A positive significant correlation was seen between a higher self-estimated quality of life and walking ability.

Conclusions: Patients with suspected iNPH treated with shunt surgery at Karolinska University Hospital improved their walking ability and cognitive functioning 3 months after shunt surgery. A positive significant correlation was seen between a higher self-estimated quality of life and walking ability but not with increased cognitive function. We then concluded that the selection of patients for shunting maintained a high standard.

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References

Adams R, Fisher C, Hakim S, Ojemann R, SWEET W . SYMPTOMATIC OCCULT HYDROCEPHALUS WITH "NORMAL" CEREBROSPINAL-FLUID PRESSURE. A TREATABLE SYNDROME. N Engl J Med. 1965; 273:117-26. DOI: 10.1056/NEJM196507152730301. View

Agerskov S, Hellstrom P, Andren K, Kollen L, Wikkelso C, Tullberg M . The phenotype of idiopathic normal pressure hydrocephalus-a single center study of 429 patients. J Neurol Sci. 2018; 391:54-60. DOI: 10.1016/j.jns.2018.05.022. View

Baltateanu D, Ciobanu I, Berteanu M . The Effects of Ventriculoperitoneal Shunt on Gait Performance. J Med Life. 2019; 12(2):194-198. PMC: 6713789. DOI: 10.25122/jml-2019-1004. View

Bohannon R . Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age Ageing. 1997; 26(1):15-9. DOI: 10.1093/ageing/26.1.15. View

Feng Y, Kohlmann T, Janssen M, Buchholz I . Psychometric properties of the EQ-5D-5L: a systematic review of the literature. Qual Life Res. 2020; 30(3):647-673. PMC: 7952346. DOI: 10.1007/s11136-020-02688-y. View

Folstein M, Folstein S, McHugh P . "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-98. DOI: 10.1016/0022-3956(75)90026-6. View

Garcia-Gordillo M, Adsuar J, Olivares P . Normative values of EQ-5D-5L: in a Spanish representative population sample from Spanish Health Survey, 2011. Qual Life Res. 2015; 25(5):1313-21. DOI: 10.1007/s11136-015-1164-7. View

Gavrilov G, Gaydar B, Svistov D, Korovin A, Samarcev I, Churilov L . Idiopathic Normal Pressure Hydrocephalus (Hakim-Adams Syndrome): Clinical Symptoms, Diagnosis and Treatment. Psychiatr Danub. 2020; 31(Suppl 5):737-744. View

Graham J, Ostir G, Fisher S, Ottenbacher K . Assessing walking speed in clinical research: a systematic review. J Eval Clin Pract. 2008; 14(4):552-62. PMC: 2628962. DOI: 10.1111/j.1365-2753.2007.00917.x. View

10.

Grochtdreis T, Dams J, Konig H, Konnopka A . Health-related quality of life measured with the EQ-5D-5L: estimation of normative index values based on a representative German population sample and value set. Eur J Health Econ. 2019; 20(6):933-944. DOI: 10.1007/s10198-019-01054-1. View

11.

Hulser M, Spielmann H, Oertel J, Sippl C . Motor skills, cognitive impairment, and quality of life in normal pressure hydrocephalus: early effects of shunt placement. Acta Neurochir (Wien). 2022; 164(7):1765-1775. PMC: 9233626. DOI: 10.1007/s00701-022-05149-2. View

12.

Israelsson H, Eklund A, Malm J . Cerebrospinal Fluid Shunting Improves Long-Term Quality of Life in Idiopathic Normal Pressure Hydrocephalus. Neurosurgery. 2019; 86(4):574-582. DOI: 10.1093/neuros/nyz297. View

13.

Israelsson H, Larsson J, Eklund A, Malm J . Risk factors, comorbidities, quality of life, and complications after surgery in idiopathic normal pressure hydrocephalus: review of the INPH-CRasH study. Neurosurg Focus. 2020; 49(4):E8. DOI: 10.3171/2020.7.FOCUS20466. View

14.

Jaraj D, Wikkelso C, Rabiei K, Marlow T, Jensen C, Ostling S . Mortality and risk of dementia in normal-pressure hydrocephalus: A population study. Alzheimers Dement. 2017; 13(8):850-857. DOI: 10.1016/j.jalz.2017.01.013. View

15.

Junkkari A, Sintonen H, Nerg O, Koivisto A, Roine R, Viinamaki H . Health-related quality of life in patients with idiopathic normal pressure hydrocephalus. Eur J Neurol. 2015; 22(10):1391-9. DOI: 10.1111/ene.12755. View

16.

Larsson J, Israelsson H, Eklund A, Lundin-Olsson L, Malm J . Falls and Fear of Falling in Shunted Idiopathic Normal Pressure Hydrocephalus-The Idiopathic Normal Pressure Hydrocephalus Comorbidity and Risk Factors Associated With Hydrocephalus Study. Neurosurgery. 2021; 89(1):122-128. DOI: 10.1093/neuros/nyab094. View

17.

Liu A, Sankey E, Jusue-Torres I, Patel M, Elder B, Goodwin C . Clinical outcomes after ventriculoatrial shunting for idiopathic normal pressure hydrocephalus. Clin Neurol Neurosurg. 2016; 143:34-8. DOI: 10.1016/j.clineuro.2016.02.013. View

18.

Nikaido Y, Urakami H, Akisue T, Okada Y, Katsuta N, Kawami Y . Associations among falls, gait variability, and balance function in idiopathic normal pressure hydrocephalus. Clin Neurol Neurosurg. 2019; 183:105385. DOI: 10.1016/j.clineuro.2019.105385. View

19.

Podsiadlo D, Richardson S . The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991; 39(2):142-8. DOI: 10.1111/j.1532-5415.1991.tb01616.x. View

20.

Pujari S, Kharkar S, Metellus P, Shuck J, Williams M, Rigamonti D . Normal pressure hydrocephalus: long-term outcome after shunt surgery. J Neurol Neurosurg Psychiatry. 2008; 79(11):1282-6. DOI: 10.1136/jnnp.2007.123620. View