"I was losing sleep and confused," said the mother of four and grandmother of eight. "I didn't recognize my own house -- not even my own bed."
For six years, she ignored the symptoms of memory loss and incontinence, as her husband struggled nightly to get her to the bathroom in the middle of the night.
"We thought she was just starting to get old and disoriented," said her husband Nildo Harper, now 83. "She was just sort of absent."
Her right hand and foot shook so badly that she could no longer read or play piano. She ended up in a wheelchair.
Her diabetes doctor noticed the changes and suspected both Alzheimer's and Parkinson's disease, putting her on medication. Eventually, Alicia was referred to a neurologist who made the correct diagnosis: NPH.
After shunt surgery in 2009 while recuperating at a rehabilitation center, the mental haze lifted.
"They took me in the morning to have surgery and by late afternoon I could see something was different," said Alicia, who is now 79. "I felt like going to the bathroom."
Soon, she was walking again and playing the piano. At a recent medical convention, Nildo Harper said, his wife played two stanzas of the Cuban national anthem, "from memory."
"Get a second opinion," he said. "It's easy to diagnose this as Alzheimer's, but after her surgery, all the symptoms disappeared completely. With Alzheimer's, you never recover."
The causes of NPH are unknown, though sometimes a head injury, stroke or brain tumor can interfere with drainage of spinal fluid -- even years later.
MRIs can be misleading, so clinical symptoms are "more helpful" in diagnosis, according to Zabramski.
One of the first tell-tale signs of NPH is the so-called "magnetic gait." Patients, like guitarist Wagner, do shuffling walk and take multi-step turns.
"It looks like their feet are stuck to the floor," Zabramski said.
At Barrow's Muhammad Ali Parkinson Center and Movement Disorder Clinic, intake patients are first screened for NPH.
"Last year we evaluated a hundred people in the clinic and 50 were shunted," Zabramski said.
But Dr. Mark Luciano, neurosurgery director at the Cleveland Clinic and founder of the first multidisciplinary clinic in the country to treat NPH, cautions against over-zealous diagnosis.
"I have mixed feelings," he said. "I want people to be aware of the possibility of NPH ... but it's a double-edged sword.
"We want to make sure we are not putting shunts in unnecessarily," he said. "It's only a small percentage [of patients who have NPH]."
Surgery is always a risk, particularly in the elderly, he said. Shunts can also become infected or blocked.
Shunts are also not the only available treatment. An endoscopic procedure, drilling a hole and bypassing the obstruction causing NPH and allowing drainage, can also be performed.
"It's more invasive in the short-term," he said. "But it's a more natural treatment, without a foreign body."
Patients should seek an evaluation from neurologists who have an expertise in NPH, according to Luciano. Enlarged ventricles on an MRI don't always mean NPH, and a follow-up spinal tap is a must before diagnosis.
"If the cognition and gait problems don't respond when they lose fluid, there shouldn't be a shunt put in," Luciano said.
Still, no one is more pleased about having a shunt than guitarist Dick Wagner.
"I am getting my timing back almost back to normal," he said. "It made a huge complete turnaround of my life."
And so is his doctor, who is a big music fan.
"He told me with big tears in his eyes that he wouldn't be able to play guitar anymore," Zabramski said. "His manager was just about ready to say, 'Dick, this is it.' We put a shunt in and the guy's playing again, flying around the world and producing records [on his independent label Desert Dreams Records] and playing in concerts again. It made a remarkable difference in his life."