Cited by 281Cerebrospinal fluid and hydrocephalusDementia and Cognitive Impairment ResearchAlzheimer's disease research and treatments

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Alzheimer's disease comorbidity in normal pressure hydrocephalus: prevalence and shunt response

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Golomb, J·2000·Journal of Neurology, Neurosurgery & Psychiatry

DOI 10.1136/jnnp.68.6.778PMC PMC1736969

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Abstract

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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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)
DOI: 10.1136/jnnp.68.6.778
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: Health Sciences › Medicine › Clinical Neurology › Cerebrospinal fluid and hydrocephalus
Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › 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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Alzheimer's disease comorbidity in normal pressure hydrocephalus: prevalence and shunt response

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