DUTCH NORMAL-PRESSURE HYDROCEPHALUS STUDY - BASE-LINE CHARACTERISTICSWITH EMPHASIS ON CLINICAL FINDINGS

We present the baseline characteristics of 101 patients with normal pr essure hydrocephalus (NPH), entering a study that evaluates the diagno stic reliability of CSF outflow resistance. Patients were assessed by a gait scale consisting of 10 features of walking and the number of st eps and seconds necessary for 10 m, a dementia scale comprising the 10 word test, trail making, digit span and finger tapping, the modified Mini Mental State Examination (3MSE) and the modified Rankin scale (MR S). Inclusion criteria were a gait and dementia scale greater than or equal to 12 (range 2-40), a MRS greater than or equal to 2 and a commu nicating hydrocephalus on CT. Gait disorder and dementia varied from m ild to severe leading to MRS 2 in 17%, MRS 3 in 34%, MRS 4 in 21%, MRS 5 in 16% and MRS 6, including akinetic mutism, in 12%. Only one patie nt showed both normal tandem walking and turning. Small steps, reduced foot floor clearance and wide base were also frequently seen in the 6 7 patients walking independently; 34 needed assistance or could not wa lk at all. Applying the 3MSE, 64% were demented; the remaining 36% exh ibited a milder cognitive deficit. The 10 word test and trail making d ecreased with increasing dementia. Digit span and finger tapping decli ned in the most demented patients. This group of elderly patients with NPH, mostly of the idiopathic type, proved to be vulnerable because o f considerable disability and comorbidity.