🧠 iNPHGS Calculator

Idiopathic Normal Pressure Hydrocephalus Grading Scale (Kubo et al., 2008 / Mori et al., 2012)
đŸšļ
1. Gait Disturbance
Evaluate walking stability, posture, cadence, and requirement of aids
Score: 0 / 4
0
Normal
No gait impairment; walks normally without instability.
1
Complaint of instability / unsteadiness
Subjective feeling of walking difficulty, dizziness or instability, but no objective gait impairment observed on physical examination.
2
Mild gait disturbance (Independent)
Objective gait impairment present (swaying, shuffling, widened base, turning difficulty), but capable of walking independently without walking aids or personal assistance.
3
Moderate gait disturbance (Requires aids/support)
Requires walking aids (cane, walker, crutches) or holding onto walls/furniture or personal support to walk.
4
Severe gait disturbance (Unable to walk)
Unable to walk even with walking aids; wheelchair-bound or bedridden.
🧠
2. Cognitive Impairment / Dementia
Evaluate psychomotor slowing, memory, attention, apathy, and daily independence
Score: 0 / 4
0
Normal
No cognitive complaints or objective impairment.
1
Subjective cognitive complaint or apathy
Complaint of memory decline, reduced spontaneity, or apathy, but no objective impairment on clinical interview or daily life activities.
2
Mild cognitive impairment
Definite cognitive impairment (forgetfulness, psychomotor slowing, disorientation), but fully independent in basic activities of daily living (ADLs) without supervision.
3
Moderate cognitive impairment
Requires partial assistance or supervision in daily living due to disorientation or dementia, but capable of meaningful communication.
4
Severe cognitive impairment
Severe dementia requiring continuous total care; unable to communicate or engage in meaningful conversation.
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3. Urinary Disturbance
Evaluate frequency, urgency, nocturia, and incontinence episodes
Score: 0 / 4
0
Normal
No urinary symptoms or frequency.
1
Pollakisuria (Frequency) / Urgency
Frequent urination (pollakisuria), nocturia, or subjective urinary urgency, without any incontinence.
2
Occasional urinary incontinence
Urgent incontinence or occasional incontinence episodes occurring less than once daily (e.g. 1 to several times a week).
3
Frequent urinary incontinence
Frequent urinary incontinence occurring daily (once or more per day, regularly requiring pads/diapers).
4
Complete urinary incontinence
Loss of all urinary control / continuous total incontinence or indwelling urinary catheter dependent.
Total iNPHGS Score
0 / 12
Normal (No Triad Symptoms)
Patient exhibits no clinical triad signs of normal pressure hydrocephalus.
đŸšļ Gait Disturbance 0 / 4
🧠 Cognitive Impairment 0 / 4
💧 Urinary Disturbance 0 / 4
📋 Clinical Documentation Summary
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