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Vascular risk factors in INPH A prospective case- control study (the INPH-CRasH study)
Umeå University, Sweden.
Umeå University, Sweden.
University of Gothenburg, Sweden.
Umeå University, Sweden.
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2017 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 88, no 6, 577-585 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To assess the complete vascular risk factor (VRF) profile of idiopathic normal pressure hydrocephalus (INPH) using a large sample of representative patients with INPH and populationbased controls to determine the extent to which vascular disease influences INPH pathophysiology. Methods: All patients with INPH who underwent shunting in Sweden in 2008-2010 were compared to age-and sex-matched population-based controls. Inclusion criteria were age 60-85 years and no dementia. The 10 most important VRFs and cerebrovascular and peripheral vascular disease were prospectively assessed using blood samples, clinical examinations, and standardized questionnaires. Assessed VRFs were hypertension, hyperlipidemia, diabetes, obesity, psychosocial factors, smoking habits, diet, alcohol intake, cardiac disease, and physical activity. Results: In total, 176 patients with INPH and 368 controls participated. Multivariable logistic regression analysis indicated that hyperlipidemia (odds ratio [OR] 2.380; 95% confidence interval [CI] 1.434-3.950), diabetes (OR 2.169; 95% CI 1.195-3.938), obesity (OR 5.428; 95% CI 2.502-11.772), and psychosocial factors (OR 5.343; 95% CI 3.219-8.868) were independently associated with INPH. Hypertension, physical inactivity, and cerebrovascular and peripheral vascular disease were also overrepresented in INPH. Moderate alcohol intake and physical activity were overrepresented among the controls. The population-attributable risk percentage was 24%. Conclusions: Our findings confirm that patients with INPH have more VRFs and lack the protective factors present in the general population. Almost 25% of cases of INPH may be explained by VRFs. This suggests that INPH may be a subtype of vascular dementia. Targeted interventions against modifiable VRFs are likely to have beneficial effects on INPH.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS , 2017. Vol. 88, no 6, 577-585 p.
National Category
Geriatrics
Identifiers
URN: urn:nbn:se:liu:diva-136314DOI: 10.1212/WNL.0000000000003583ISI: 000397342100013OAI: oai:DiVA.org:liu-136314DiVA: diva2:1087956
Available from: 2017-04-10 Created: 2017-04-10 Last updated: 2017-04-11

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Leijon, Göran
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NeurologyDepartment of NeurologyFaculty of Medicine and Health Sciences
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CiteExportLink to record
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Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
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  • Other locale
More languages
Output format
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