What question did this study set out to answer?

The analysis aims to evaluate mortality trends and risk factors associated with normal pressure hydrocephalus in the U.S.

March 26, 2026

1518: Normal Pressure Hydrocephalus Related Mortality in the United States

Key Points

The analysis aims to evaluate mortality trends and risk factors associated with normal pressure hydrocephalus in the U.S.
Retrospective cross-sectional study using CDC WONDER Multiple Cause of Death database.
Included individuals with NPH listed as a cause of death on death certificates.
Performed descriptive analyses on demographic variables and geographic distribution.
Constructed regression models to examine mortality trends over time.
Crude mortality rates from NPH were highest among adults aged 85 and older, significantly increasing over time (p < 0.0001).
Increased mortality rates were noted in the 75–84 age group; rates remained low in younger groups.
Males exhibited consistently higher mortality rates than females.
White individuals had the highest mortality rates, followed by Black individuals; other racial groups had low rates.
Higher crude mortality was observed in small metro and non-metro areas compared to large urban centers.

Abstract

Introduction: Normal pressure hydrocephalus (NPH) is a progressive neurological disorder that disproportionately affects older adults and represents a growing public health concern in aging populations. Despite advances in our understanding of its pathophysiology, clinical diagnosis, and management, national patterns of NPH-related mortality remain poorly characterized. To address this critical knowledge gap, we conducted a population-level analysis to evaluate age-stratified trends and potential risk factors associated with NPH-related mortality in the United States. Methods: We conducted a retrospective cross-sectional study using the CDC WONDER Multiple Cause of Death database to examine mortality patterns related to normal pressure hydrocephalus (NPH) in the United States. Individuals were included if NPH was listed as a cause of death on the death certificate. We performed descriptive analyses to characterize demographic variables (age, sex, race/ethnicity), geographic distribution (urban vs. rural), and temporal trends (by year). We constructed regression models to examine mortality trends over time. Results: Between 1999 and 2023, crude mortality rates from NPH were highest among adults aged 85 and older, with a statistically significant increase over time (p < 0.0001). Rates also increased among those aged 75–84, while remaining low and stable in younger age groups. Males had consistently higher mortality rates than females. White individuals had the highest crude rates across the study period, followed by Black individuals; rates for other racial groups were low. Crude mortality was slightly higher in small metro and non-metro areas compared to large urban centers. Conclusions: NPH-related mortality was most prevalent among males and non-Hispanic White individuals, with a strong concentration in those aged 65 and older, especially in those over 85 years. Limited reporting among Black and Asian populations, as well as in non-urban geographic areas, may reflect broader issues of underdiagnosis and access to care. These findings underscore the need for improved awareness, diagnostic equity, and continued demographic surveillance to better understand and address NPH mortality trends.

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