====== Caregiver burden in idiopathic normal pressure hydrocephalus ======

Shunt operations reduced the [[caregiver burden]] of iNPH patients
((Kazui H, Mori E, Hashimoto M, Ishikawa M, Hirono N, Takeda M. Effect of shunt 
operation on idiopathic normal pressure hydrocephalus patients in reducing
caregiver burden: evidence from SINPHONI. Dement Geriatr Cogn Disord.
2011;31(5):363-70. doi: 10.1159/000328625. Epub 2011 May 27. PubMed PMID:
21625136.)).
((Petersen J, Hellström P, Wikkelsø C, Lundgren-Nilsson A. Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus. J Neurosurg. 2014 Oct;121(4):776-84. doi:10.3171/2014.6.JNS132003. Epub 2014 Jul 18. PubMed PMID: 25036194.)).

Thirty-seven [[patient]]s (median age 70 years, range 50-89 years) with [[Idiopathic normal pressure hydrocephalus]] were evaluated before and 6 months after surgery. [[Symptom]]s and [[sign]]s were assessed by the [[iNPH scale]], activities of daily living (ADL) with the [[Functional Independence Measure]] (FIM) and [[Assessment of Motor and Process Skills]] (AMPS), autonomy and participation with [[Impact on Participation and Autonomy]] (IPA), and caregiver burden with the [[Caregiver Burden Scale]] (CBS). [[HRQOL]] was evaluated with the [[EQ-5D]] (EuroQol Group-5 Dimension health survey). 

Twenty-four patients (65%) improved clinically ([[iNPH scale]] score) and 31 (86%) improved their HRQOL after surgery, almost to the same level as found in the normal population. The patients became more independent in physical and [[cognition]], and participation and autonomy improved. The caregiver burden was decreased among caregivers to male patients but remained unchanged on the overall group level.  After shunt surgery, patients with iNPH showed improvement in most aspects of social life, they became more independent, and their quality of life returned to nearly normal
((Petersen J, Hellström P, Wikkelsø C, Lundgren-Nilsson A. Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus. J Neurosurg. 2014 Oct;121(4):776-84. doi:10.3171/2014.6.JNS132003. Epub 2014 Jul 18. PubMed PMID: 25036194.)).