Alzheimer's disease comorbidity in normal pressure hydrocephalus: prevalence and shunt response
Open accessAbstract
The clinical impact of Alzheimer's disease pathology at biopsy was investigated in 56 cognitively impaired patients undergoing shunt surgery for idiopathic normal pressure hydrocephalus (NPH). Cognition was measured by means of the global deterioration scale (GDS), the mini mental status examination (MMSE) and a battery of six psychometric tests. Gait was assessed using objective measurements of velocity and the ambulatory index (AI). The prevalence of cases exhibiting neuritic plaques (positive biopsies) increased in parallel with dementia severity from 18% for patients with GDS 3 to 75% for patients with GDS scores > or =6. Patients with positive biopsies were more cognitively impaired (higher GDS and lower MMSE scores) as well as more gait impaired (higher AI scores and slower velocities) than patients with negative biopsies. After surgery, gait velocity and AI scores improved significantly and to a comparable degree for patients with and without positive biopsies. Similar proportions of positive and negative biopsy patients also had improved gait as assessed by means of subjective video tape comparisons. There were no significant differences between the biopsy groups in the magnitude of postoperative psychometric change or in the proportion of cases exhibiting improved urinary control. Alzheimer's disease pathology is a common source of comorbidity in older patients with idiopathic NPH where it contributes to the clinical impairment associated with this disorder. For patients accurately diagnosed with NPH, concomitant Alzheimer's disease pathology does not strongly influence the clinical response to shunt surgery.
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There is large overlap of typical findings in brain specimens of patients with Alzheimer's disease and iNPH.
“There is large overlap of typical findings in brain specimens of patients with Alzheimer's disease and iNPH (68).”
From Brain-wide glymphatic enhancement and clearance in humans assessed with MRI. (2018) · cites this paper as [68]
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- Authors
- Golomb, J.
- Affiliations
- New York University (US)
- Corresponding author
- Golomb, J
- ORCID
- Golomb, J
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2000-06-01
- Volume
- 68
- Issue
- 6
- Pages
- 778-781
- ISSN
- 0022-3050 (ISSN-L)
- PMC
- PMC1736969
- OpenAlex
- W2120054797
- Cited by
- 279
- References
- 17
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 10 · 2023: 13 · 2022: 12 · 2021: 13 · 2020: 16 · 2019: 16 · 2018: 17 · 2017: 17 · 2016: 13 · 2015: 12 · 2014: 13 · 2013: 6 · 2012: 16
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Cerebrospinal fluid and hydrocephalus
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- Alzheimer's disease, normal pressure hydrocephalus, comorbidities, shunt surgery, neuritic plaques, dementia severity, gait disturbance, urinary incontinence, cognitive function, postoperative outcomes
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Biopsy, Cerebral Cortex, Female, Follow-Up Studies, Humans, Hydrocephalus, Normal Pressure, Male, Postoperative Complications, Comorbidity, Ventriculoperitoneal Shunt, Plaque, Amyloid
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