Lifestyle

Early Signs of Normal Pressure Hydrocephalus, a Treatable Condition Often Mistaken for Dementia

By Erica Coleman · October 22, 2026

When an older parent starts shuffling, forgetting things and rushing to the bathroom, families often assume it is the start of dementia, or simply age. In some people, the cause is a buildup of fluid in the brain that doctors can sometimes treat.

The condition is normal pressure hydrocephalus, or NPH. Extra cerebrospinal fluid collects in the brain’s fluid-filled chambers, called ventricles, but the fluid pressure is usually normal, which is how it got its name, according to MedlinePlus from the National Library of Medicine. The National Institute of Neurological Disorders and Stroke says NPH can occur at any age but is most common in older adults, that it can be hard to diagnose, and that many people do not receive proper treatment.

The Hydrocephalus Association says NPH is often misdiagnosed as Alzheimer’s or Parkinson’s disease, and that symptoms are sometimes written off as normal aging. The group cites an estimate that 800,000 older Americans may be living with NPH and that more than 80% of cases go unrecognized or untreated.

Doctors look for three classic problems: walking, thinking and bladder control. These five signs come from that picture.

Feet that feel stuck to the floor. MedlinePlus describes difficulty starting to walk and a feeling that the feet are stuck to the ground. NINDS uses the same word, “stuck.” The Hydrocephalus Association says walking trouble is often the first symptom to appear.

Short, shuffling steps and more falls. The association describes slow, short, wide steps, trouble with stairs and turns, and reaching for walls or furniture for balance. It says a slower reaction to losing balance contributes to falls.

Rushing to the bathroom. Bladder problems may start as a frequent, urgent need to urinate and can progress to accidents, according to the association. The Alzheimer’s Association says loss of bladder control tends to show up somewhat later than the walking and thinking changes.

Forgetfulness and slower thinking. MedlinePlus lists forgetfulness and difficulty paying attention. The Alzheimer’s Association describes an overall slowing of thought, short-term memory loss and trouble with planning and decisions.

Losing interest and pulling back. MedlinePlus lists apathy. The Hydrocephalus Association describes loss of interest in daily activities, feeling withdrawn, talking less and mood changes.

Not everyone has all three classic problems, and they may not appear at the same time, according to both associations.

Diagnosis starts with a physical exam and questions about symptoms. MedlinePlus says tests can include a CT or MRI scan and a spinal tap, with careful testing of a person’s walking before and right after fluid is removed. The Hydrocephalus Association says improvement after fluid removal suggests surgery is likely to help.

The usual treatment is surgery to place a thin tube called a shunt that drains extra fluid from the brain to the abdomen. MedlinePlus says surgery improves symptoms in some people, that those with mild symptoms do best, and that walking is the symptom most likely to improve. The Hydrocephalus Association estimates that more than 80% of people who are properly diagnosed and screened as good shunt candidates improve, though it may take weeks or months. The Alzheimer’s Association is more cautious, noting that shunting does not help everyone and that thinking and bladder changes are less likely to improve than walking. Without treatment, symptoms often get worse, MedlinePlus says.

If you or someone you love has growing problems with memory, walking or bladder control, MedlinePlus advises calling a health care provider. It is reasonable to ask whether NPH has been considered.

This article is for general information and is not medical advice. Talk with your doctor about any symptoms or changes in memory, walking or bladder control. This article was produced with the assistance of AI and fact-checked against the sources cited by LightWave Reports.