BACKGROUND: The short- and long-term impact of cerebrospinal fluid shunting onquality of life (QoL) in idiopathic normal pressure hydrocephalus (INPH) is poorly understood.OBJECTIVE: To investigate QoL in shunted INPH patients compared to the population andto investigate which factors influence QoL in INPH.METHODS: INPH patients consecutively shunted in Sweden during 2008-2010 were scrutinized. Population-based controls were age- and sex-matched to the patients. Includedparticipants were thefollowing: 176 INPH patients and 368 controls. QoL was assessed usingthe EuroQol 5-dimension 5-level (EQ5D5L) instrument, which measures overall QoL andhealth status in 5 dimensions. Independency (accommodation and/or need for in-homecare) and comorbidities were assessed. Patients were followed up 6-45 mo after surgery(mean follow-up time: 21 mo).RESULTS: Shunting improved QoL (P < .001) and health status in all dimensions (P < .005).Shunted INPH patients had lower QoL than controls (P < .001). The patients’ health statusin mobility, self-care, daily activities, and anxiety/depression was worse than the controlsboth before and after surgery (P < .001). The main predictors of low QoL in INPH weresymptoms of depression (P < .001) and severity of gait disturbance (P = .001). Fewer INPHpatients than controls lived independently (45% vs 85%, P < .001). Time after shunting hadno influence on QoL.CONCLUSION: QoL remains improved in shunted INPH patients at a mean follow-up timeof 21 mo, but the patients do not reach the same QoL as the population. Symptoms ofdepression and severity of gait disturbance are the strongest predictors of low QoL in INPH.