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Observational Study
. 2024 Oct;124(5):1623-1629.
doi: 10.1007/s13760-024-02583-0. Epub 2024 May 18.

Sarcopenia in older patients with idiopathic normal pressure hydrocephalus: an observational study from a single geriatric clinic in Turkey

Ali Ekrem Aydin  1 , Fatma Sena Dost  2 , Derya Kaya  3 , Esra Ates Bulut  4 , Feyza Mutlay  5 , Ahmet Turan Isik  6
Affiliations
Observational Study

Sarcopenia in older patients with idiopathic normal pressure hydrocephalus: an observational study from a single geriatric clinic in Turkey

Ali Ekrem Aydin et al. Acta Neurol Belg. 2024 Oct.

Abstract

Objective: Idiopathic normal pressure hydrocephalus (iNPH), a classical triad of gait abnormality, cognitive disturbance, and urinary incontinence, increases in prevalence with aging. Sarcopenia is also characterized by low muscle strength and mass, contributing to gait difficulty. Gait abnormality and lower physical activity also lead to the development of sarcopenia. Therefore, this study aims to investigate the relationship between sarcopenia and iNPH.

Methods: A total of 327 participants were included in this retrospective cross-sectional study. Demographic and clinical characteristics, including age, sex, comorbidity index, number of medications, recurrent falls in the last year, laboratory findings and comprehensive geriatric assessment (CGA) parameters were recorded. Sarcopenia was defined according to the EGWSOP2 criteria. The relationship between sarcopenia and iNPH was assessed with regression analysis.

Results: There were 51 participants with iNPH, 49% female, mean age 78 years (SD 5.7) and 276 control participants, 74% female, mean age 72 years (SD 6.1). The sarcopenia rates in patients with iNPH and controls were 19.6% and 2.5%, respectively (p < 0.01). The odds of probable sarcopenia were 3.89 times, and the slow gait speed was 8.47 times higher in iNPH patients than in controls after adjusting for age, sex, and the other confounders. The Mini-Mental State Examination score (p = 0.042, OR = 0.869 with 95% CI:0.759-0.995) was associated with probable sarcopenia among patients with iNPH.

Conclusion: This study demonstrated that sarcopenia was common in older patients with iNPH, which seems to be closely associated with decreased muscle strength and slowed gait speed. Thus, considering the potential untoward effects of both diseases, it is important for physicians to evaluate sarcopenia routinely in the follow-up and treatment of older patients with iNPH.

Keywords: Elderly; Gait; Muscle mass; Muscle strength; Normal pressure hydrocephalus.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no conflicts of interest. Ethical approval: The study was approved by the ethics committee for Non-Interventional Studies. Informed consent was taken from all participants or parents/legal guardians. The study conformed to the ethical norms and standards in the Declaration of Helsinki.

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