Music icon Billy Joel has announced that he’s been diagnosed with normal pressure hydrocephalus (NPH)—a relatively rare brain condition that primarily affects people over 65.

In a statement on his social media channels, the 76-year-old singer explained that the condition had worsened during recent concert performances, leading to trouble with hearing, vision, and balance. Under his physician’s care, Joel is now undergoing physical Therapy and pressing pause on performing. “Under his doctor’s instructions, Billy is undergoing specific physical therapy and has been advised to refrain from performing during this recovery period,” the statement said.

So what, exactly, is NPH, and what symptoms do we need to be aware of? We break it down here.

What is normal pressure hydrocephalus?

Normal pressure hydrocephalus is a brain disorder caused by a buildup of cerebrospinal fluid (CSF) in the brain’s ventricles—fluid-filled spaces that help cushion and protect the brain and spinal cord. In NPH, the ventricles become enlarged, even though the pressure of the fluid appears normal (hence the name).

This swelling can push on nearby brain tissue, leading to a range of symptoms, especially in older adults. While NPH can look a lot like Alzheimer’s or Parkinson’s. (In fact, according to the Alzheimer’s Association, less than 20 percent of people with the condition are properly diagnosed.) The key difference is that NPH is often treatable—and sometimes even reversible.

Symptoms to watch for

Doctors often use the phrase “wet, wobbly, and wacky” to describe the hallmark symptoms of NPH:

1. Wobbly (Walking Issues):
   Difficulty walking, shuffling steps, or feeling like your feet are stuck to the floor. Many people report poor balance or frequent falls.
2. Wacky (Cognitive Changes):
   Trouble thinking clearly, memory problems, confusion, or mood changes. These symptoms often resemble dementia.
3. Wet (Urinary Problems):
   A sudden, urgent need to urinate—or even bladder accidents—can also be a key warning sign.

These symptoms can come on gradually and often go overlooked or mistaken for Aging.

How is it diagnosed?

NPH is tricky to diagnose because it mimics other neurological conditions. But a good medical team can usually figure it out through:

• Brain scans like MRI or CT to check for enlarged ventricles
• A spinal tap (lumbar puncture) to temporarily remove fluid and observe if symptoms improve
• Gait and memory tests to track changes in walking and cognition

How is it treated?

The main treatment is surgery to implant a shunt—a tiny tube that drains excess fluid from the brain into another part of the body (usually the belly), where it’s reabsorbed. Many patients see significant improvements in walking, thinking, and urinary control after surgery.

Recovery may also involve physical therapy, occupational therapy, as well as follow-up care to make sure the shunt is working properly

Can NPH be prevented?

There’s no surefire way to prevent NPH, but certain steps may help:

• Protect your head from injury (e.g., wear a helmet when biking or skiing)
• Manage Chronic Conditions like high blood pressure and Diabetes
• Seek medical advice early if you notice changes in walking, memory, or bladder function

The bottom line

Billy Joel’s diagnosis shines a light on a condition that’s often missed or misunderstood. While NPH can look like untreatable dementia, it doesn’t have to be. With early diagnosis and treatment, many people get their lives back. So if you or a loved one is experiencing strange changes in balance, memory, or bladder control—don’t wait. Talk to a doctor and ask if NPH could be the cause.

And while we’ll miss seeing Billy Joel on stage for a little while, we’re all rooting for his full and speedy recovery!

More stories on brain health

Tiny invaders: Microplastics may be harming our brains, researchers say

Scientists discover new key to halting brain damage in Alzheimer’s

Better brain-training: Researchers identify best activities to benefit cognitive function

FDA approves first blood test to help with Alzheimer’s diagnosis

Debunking 8 medical myths about dementia and Alzheimer’s disease

How your personality type may protect you from dementia

Top 10 foods to boost brain health and ward off cognitive decline

Content on this site is for informational purposes only and is not a substitute for professional medical advice. Always check with your qualified healthcare providers with any questions or concerns regarding a medical condition.

David Cravit SuperAging News

Our mission is to curate the avalanche of news, research reports, expert advice and other content about longevity and healthy aging, to give our readers a practical blueprint for "getting older without getting old." In a short period of time, we have seen steady audience growth and, in particular, strong growth in our social media presence, which is now generating over 200,000 impressions a month. We offer a mix of original content and links to useful content from a wide range of sources.