Normal Pressure Hydrocephalus DEMENTIA'S CAUSE'

Q rimary care providers (PCPs) often see elderly patients in their practice with symptoms of dementia, usually because of irreversible conditions. Normal pressure hydrocephalus (NPH) is an often unrecognized cause of dementia symptoms, and can be reversible with appropriate diagnosis and treatment, specifically ventriculoperitoneal (VP) shunting. It has been estimated that 375,000 Americans misdiagnosed with dementia or Parkinson's disease have symptoms that are actually caused by normal pressure hydrocephalus.' Some experts suggest that as many as 6% of nursing home residents may have NPH.^ These figures, however, are controversial since no precise data on the incidence and prevalence of NPH have been published.'* The diagnosis of NPH can be difficult, and is often based on a combination of clinical signs and symptoms, radiographic findings, and confirmatory testing.