The symptoms are insidious and can be very similar to normal ageing. This means it's difficult to detect iNPH.
Early symptoms may be discrete, motor and memory difficulties are hardly noticeable to anyone other than he who suffers. The symptoms are also similar to those seen in, for example, vascular dementia, Alzheimer's disease, Parkinson's disease and dementia, which can lead to misdiagnosis. It is not uncommon for people with iNPH to have to wait long before diagnosis can be made. Most often, all three symptoms occur (see above). Sometimes some symptoms may be missing, such as urinary incontinence. The severity of the disease varies greatly from discrete memory difficulties and mild balance problems, to inability to walk and pronounced fatigue.
Walking and balancing difficulties
Patients experience the aisle as uncertain, stiff and slow. The feet may be perceived as glued to the substrate or that the legs feel heavy like logs. It can be difficult to climb stairs or on uneven surfaces such as in the forest and land. Patients often have poor balance with repeated falls and injuries. The aisle is distinctly slow, wide-gauge (wide between the feet) with short rushing steps and decreased movements in the hip, knee and ankles. As with Parkinson's disease, the aisle can lock in, which can manifest itself as turning with sometimes many extra steps. Walking difficulties are the most easily identified symptom and therefore many patients describe walking difficulties as onset symptoms.