Vascular risk factors in INPH: A prospective case-control study (the INPH-CRasH study)

Research output: Contribution to journalArticle

Standard

Vascular risk factors in INPH : A prospective case-control study (the INPH-CRasH study). / Israelsson, Hanna; Carlberg, Bo; Wikkelsö, Carsten; Laurell, Katarina; Kahlon, Babar; Leijon, Göran; Eklund, Anders; Malm, Jan.

In: Neurology, Vol. 88, No. 6, 07.02.2017, p. 577-585.

Research output: Contribution to journalArticle

Harvard

Israelsson, H, Carlberg, B, Wikkelsö, C, Laurell, K, Kahlon, B, Leijon, G, Eklund, A & Malm, J 2017, 'Vascular risk factors in INPH: A prospective case-control study (the INPH-CRasH study)', Neurology, vol. 88, no. 6, pp. 577-585. https://doi.org/10.1212/WNL.0000000000003583

APA

Israelsson, H., Carlberg, B., Wikkelsö, C., Laurell, K., Kahlon, B., Leijon, G., Eklund, A., & Malm, J. (2017). Vascular risk factors in INPH: A prospective case-control study (the INPH-CRasH study). Neurology, 88(6), 577-585. https://doi.org/10.1212/WNL.0000000000003583

CBE

Israelsson H, Carlberg B, Wikkelsö C, Laurell K, Kahlon B, Leijon G, Eklund A, Malm J. 2017. Vascular risk factors in INPH: A prospective case-control study (the INPH-CRasH study). Neurology. 88(6):577-585. https://doi.org/10.1212/WNL.0000000000003583

MLA

Vancouver

Israelsson H, Carlberg B, Wikkelsö C, Laurell K, Kahlon B, Leijon G et al. Vascular risk factors in INPH: A prospective case-control study (the INPH-CRasH study). Neurology. 2017 Feb 7;88(6):577-585. https://doi.org/10.1212/WNL.0000000000003583

Author

Israelsson, Hanna ; Carlberg, Bo ; Wikkelsö, Carsten ; Laurell, Katarina ; Kahlon, Babar ; Leijon, Göran ; Eklund, Anders ; Malm, Jan. / Vascular risk factors in INPH : A prospective case-control study (the INPH-CRasH study). In: Neurology. 2017 ; Vol. 88, No. 6. pp. 577-585.

RIS

TY - JOUR

T1 - Vascular risk factors in INPH

T2 - A prospective case-control study (the INPH-CRasH study)

AU - Israelsson, Hanna

AU - Carlberg, Bo

AU - Wikkelsö, Carsten

AU - Laurell, Katarina

AU - Kahlon, Babar

AU - Leijon, Göran

AU - Eklund, Anders

AU - Malm, Jan

PY - 2017/2/7

Y1 - 2017/2/7

N2 - Objective: To assess the complete vascular risk factor (VRF) profile of idiopathic normal pressure hydrocephalus (INPH) using a large sample of representative patients with INPH and population-based controls to determine the extent to which vascular disease influences INPH pathophysiology. Methods: All patients with INPH who underwent shunting in Sweden in 2008-2010 were compared to age- and sex-matched population-based controls. Inclusion criteria were age 60-85 years and no dementia. The 10 most important VRFs and cerebrovascular and peripheral vascular disease were prospectively assessed using blood samples, clinical examinations, and standardized questionnaires. Assessed VRFs were hypertension, hyperlipidemia, diabetes, obesity, psychosocial factors, smoking habits, diet, alcohol intake, cardiac disease, and physical activity. Results: In total, 176 patients with INPH and 368 controls participated. Multivariable logistic regression analysis indicated that hyperlipidemia (odds ratio [OR] 2.380; 95% confidence interval [CI] 1.434-3.950), diabetes (OR 2.169; 95% CI 1.195-3.938), obesity (OR 5.428; 95% CI 2.502-11.772), and psychosocial factors (OR 5.343; 95% CI 3.219-8.868) were independently associated with INPH. Hypertension, physical inactivity, and cerebrovascular and peripheral vascular disease were also overrepresented in INPH. Moderate alcohol intake and physical activity were overrepresented among the controls. The population-attributable risk percentage was 24%. Conclusions: Our findings confirm that patients with INPH have more VRFs and lack the protective factors present in the general population. Almost 25% of cases of INPH may be explained by VRFs. This suggests that INPH may be a subtype of vascular dementia. Targeted interventions against modifiable VRFs are likely to have beneficial effects on INPH.

AB - Objective: To assess the complete vascular risk factor (VRF) profile of idiopathic normal pressure hydrocephalus (INPH) using a large sample of representative patients with INPH and population-based controls to determine the extent to which vascular disease influences INPH pathophysiology. Methods: All patients with INPH who underwent shunting in Sweden in 2008-2010 were compared to age- and sex-matched population-based controls. Inclusion criteria were age 60-85 years and no dementia. The 10 most important VRFs and cerebrovascular and peripheral vascular disease were prospectively assessed using blood samples, clinical examinations, and standardized questionnaires. Assessed VRFs were hypertension, hyperlipidemia, diabetes, obesity, psychosocial factors, smoking habits, diet, alcohol intake, cardiac disease, and physical activity. Results: In total, 176 patients with INPH and 368 controls participated. Multivariable logistic regression analysis indicated that hyperlipidemia (odds ratio [OR] 2.380; 95% confidence interval [CI] 1.434-3.950), diabetes (OR 2.169; 95% CI 1.195-3.938), obesity (OR 5.428; 95% CI 2.502-11.772), and psychosocial factors (OR 5.343; 95% CI 3.219-8.868) were independently associated with INPH. Hypertension, physical inactivity, and cerebrovascular and peripheral vascular disease were also overrepresented in INPH. Moderate alcohol intake and physical activity were overrepresented among the controls. The population-attributable risk percentage was 24%. Conclusions: Our findings confirm that patients with INPH have more VRFs and lack the protective factors present in the general population. Almost 25% of cases of INPH may be explained by VRFs. This suggests that INPH may be a subtype of vascular dementia. Targeted interventions against modifiable VRFs are likely to have beneficial effects on INPH.

UR - http://www.scopus.com/inward/record.url?scp=85011685084&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000003583

DO - 10.1212/WNL.0000000000003583

M3 - Article

C2 - 28062721

AN - SCOPUS:85011685084

VL - 88

SP - 577

EP - 585

JO - Neurology

JF - Neurology

SN - 1526-632X

IS - 6

ER -