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Cognitive impairment and dementia in prisoners of war

Reply from the Authors: It is important to note that our study used a retrospective-prospective cohort design with an exposure group of POWs and a control group of non-POW combatants, all of whom had been recruited by random sampling of community-living veterans in 1982. Our study thus avoids biases in other research lacking control groups or involving POWs drawn from patient populations.

Abalan and Ellison suggest that our failure to find a difference in cognitive performance between POWs and non-POWs might be due to excess deaths in the POW group. For this to be valid, the excess deaths would have to be related to a propensity toward cognitive decline in old age, specifically among POWs, and would need to have occurred either between the first and second phases of our study or within a decade or so prior to the first phase. Previously we have shown that, in the total pool from which our sample was drawn, there was significantly higher overall mortality among POWs in the …