Estimated incidence is 3.0 to 5.5 cases per 100,000 people per year, and prevalence estimates range from 0.02% to almost 9%.
In a survey of a rural Bavarian population, NPH prevalence was reported to be 0.4% in people >65 years of age; however, the diagnostic criteria used in this study were not clear.[2]Trenkwalder C, Schwarz J, Gebhard J, et al. Starnberg trial on epidemiology of Parkinsonism and hypertension in the elderly. Prevalence of Parkinson's disease and related disorders assessed by a door-to-door survey of inhabitants older than 65 years. Arch Neurol. 1995 Oct;52(10):1017-22.
http://www.ncbi.nlm.nih.gov/pubmed/7575219?tool=bestpractice.com
A Norwegian study reported a lower prevalence (0.02%) and an incidence of 5.5 per 100,000 per year; however, the authors noted that these values should be regarded as minimum estimates, and that the prevalence increased with increasing age.[3]Brean A, Eide PK. Prevalence of probable idiopathic normal pressure hydrocephalus in a Norwegian population. Acta Neurol Scand. 2008 Jul;118(1):48-53.
http://www.ncbi.nlm.nih.gov/pubmed/18205881?tool=bestpractice.com
In an elderly Japanese rural community-dwelling population, an NPH prevalence estimate of 2.9% among residents has been reported.[4]Hiraoka K, Meguro K, Mori E. Prevalence of idiopathic normal-pressure hydrocephalus in the elderly population of a Japanese rural community. Neurol Med Chir (Tokyo). 2008 May;48(5):197-99
http://www.ncbi.nlm.nih.gov/pubmed/18497491?tool=bestpractice.com
A study in patients in the north of Spain estimated a crude incidence rate of NPH for the 10-year period was 3.25 per 100,000 people per year.[5]Martín-Láez R, Caballero-Arzapalo H, Valle-San Román N, et al. Incidence of idiopathic normal-pressure hydrocephalus in Northern Spain. World Neurosurg. 2016 Mar;87:298-310.
https://www.doi.org/10.1016/j.wneu.2015.10.069
http://www.ncbi.nlm.nih.gov/pubmed/26548835?tool=bestpractice.com
Another Spanish study estimated the annual incidence rate of NPH at 4.43 per 100,000 people, with the incidence highest in patients aged between 70 to 80 years.[6]Aragonès JM, Altimiras J, Alonso F, et al. [Idiopathic normal pressure hydrocephalus: high incidence in people over 80 years of age]. [in spa]. Rev Esp Geriatr Gerontol. 2018 Mar - Apr;53(2):85-8.
http://www.ncbi.nlm.nih.gov/pubmed/28734501?tool=bestpractice.com
A Swedish study demonstrated a prevalence of 0.2% in patients aged 70-79 years, and 5.9% in those aged 80 years and older.[7]Jaraj D, Rabiei K, Marlow T, et al. Prevalence of idiopathic normal-pressure hydrocephalus. Neurology. 2014 Apr 22;82(16):1449-54.
http://www.ncbi.nlm.nih.gov/pubmed/24682964?tool=bestpractice.com
A 2019 study of 1000 randomly selected participants in Jämtland, Sweden, found a prevalence of 2.1% in those aged 65-79 years, and 8.9% in those aged 80 years and older.[8]Andersson J, Rosell M, Kockum K, et al. Prevalence of idiopathic normal pressure hydrocephalus: A prospective, population-based study. PLoS One. 2019 May 29;14(5):e0217705.
http://www.ncbi.nlm.nih.gov/pubmed/31141553?tool=bestpractice.com
Between 1996 and 1998, surgery for NPH was undertaken in 1.6 per 100,000 adults in Sweden.[9]Tisell M, Hoglund M, Wikkelso C. National and regional incidence of surgery for adult hydrocephalus in Sweden. Acta Neurol Scand. 2005 Aug;112(2):72-5.
http://www.ncbi.nlm.nih.gov/pubmed/16008530?tool=bestpractice.com
As only a minority of patients with NPH are suitable for surgery (partly due to the unwillingness of older adults to undergo cranial surgery, and partly because of associated vascular risk factors), the prevalence of the condition in this population was likely to be many times higher. The condition is estimated to be about five times more common than idiopathic Parkinson's disease.