A – 8 Quality of Life for Patients and Caregivers with Suspected Idiopathic Normal Pressure Hydrocephalus

Abstract Objective Idiopathic Normal Pressure Hydrocephalus (iNPH) is characterized by a triad of cognitive, urinary, and gait symptoms and can also manifest with neuropsychiatric symptoms. These symptoms may impact quality of life (QoL) and caregiver burden. We sought to identify the predictors of patient QoL and caregiver burden in individuals with suspected NPH. Method Patients (N=242, M age=74.49±8.66 years, M education=14.40±3.60, % female=37.3, % White=91.3) were evaluated in a multidisciplinary NPH clinic and self-reported information about mobility, urinary symptoms, neuropsychiatric symptoms (depression, anxiety, and apathy), and QoL. Caregivers reported on burden. Presence of cognitive impairment (binary) was determined via neuropsychological evaluation. Multivariate linear regressions examined the association between mobility, urinary, cognitive, and neuropsychiatric symptoms (predictors) and QoL and caregiver burden (outcomes) in separate models. Results Patient QoL and caregiver burden were significantly associated (r=-.492, p<.001). A multivariate model with mobility, urinary, cognitive, and neuropsychiatric symptoms as predictors explained 71% of the variance in QoL (R2=0.708); mobility, urinary difficulties, and apathy were significant predictors (β’s=.157-.447, p’s=.001-.046). A replicate model explained 33% of the variance in caregiving burden (R2=0.334), with patient depression and apathy predicting burden (β’s=.304-.321, p’s=.002-.017). Conclusion Patient QoL in iNPH is most associated with symptoms that tend to improve with shunting (i.e., urinary symptoms and gait changes), while caregiver burden is more closely tied to neuropsychiatric symptoms than physical symptoms. Because less is known about post-shunt changes in neuropsychiatric symptoms, despite them being predictors of caregiver burden, future studies should seek to examine treatment response for neuropsychiatric symptoms in iNPH.