Association of social determinants of health for normal pressure hydrocephalus: a single institution retrospective cohort study

INTRODUCTION: Normal pressure hydrocephalus (NPH) is a reversible cause of dementia which may be treated with CSF diverting shunts. Identification of specific barriers to diagnosis and treatment may allow for formation of targeted programs to increase rates of accurate, timely diagnosis to restore functional status and independence. METHODS: 135 patients with a confirmed diagnosis of NPH were reviewed for symptom onset, demographic characteristics, presence of comorbidities as well as time to treatment. RESULTS: Patients undergoing ventriculoperitoneal shunt (VPS) placement for NPH were slightly more likely to be male (42% vs 58%), with an overall median age of 76 years old (median of 78 years for men and 76 years for women; p-value 0.90). Median time to treatment from symptoms onset reported by the patients was 24 months (range 4-72 months). However, median time to treatment was lower for women than for men (12 vs 24 months; p-value: 0.056), but statistically significant in multivariate regression using a Gamma distribution when controlling for demographic variables (p-value: 0.004). CONCLUSION: Although men and women report symptoms onset at a similar age, there appears to be a delay in time to diagnosis or treatment among men and rural inhabitants with no difference in age at surgery.