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Is Experience as a Prisoner of War a Risk Factor for Accelerated Age‐Related Illness and Disability?
Author(s) -
Creasey Helen,
Sulway Mary Rose,
Psychol M.,
Dent Owen,
Broe G. Anthony,
Jorm Anthony,
Tennant Christopher
Publication year - 1999
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1999.tb01901.x
Subject(s) - medicine , dementia , cohort , prospective cohort study , disease , cohort study , retrospective cohort study , stroke (engine) , medical prescription , psychiatry , gerontology , mechanical engineering , engineering , pharmacology
OBJECTIVE : To determine whether the experience of internment as a Prisoner of War (POW) during World War II was associated with a higher prevalence of chronic disease and diminished functional performance in later life. DESIGN : A retrospective and prospective cohort design. SETTING : Concord Repatriation General Hospital, Sydney, Australia. PARTICIPANTS : A random sample of 101 Australian, male, ex‐prisoners of the Japanese and a comparison group of 107 non‐POW combatants from the same theatre of war. MEASUREMENTS : Outcome variables were self‐perceived health status, hospital admissions and length of stay, number of prescription medications used, number of somatic symptoms reported, number and types of medical diagnoses, a neurology of aging clinical examination, and the Instrumental Activities of Daily Living (IADL) and Physical Self Maintenance Scales (PSMS). RESULTS : Prisoners of War reported more somatic symptoms (mean 7.2 vs 5.4, P = .002) than non‐POWs, had more diagnoses (mean 9.4 vs 7.7 P < .001), and used a greater number of different medications (mean 4.5 vs 3.4, P = .001). There were no differences in hospital admissions or length of stay. Among 15 broad categories of diagnosis, differences were confined to gastrointestinal disorders (POWs 63% vs non‐POWs 49%, P = .032), musculoskeletal disorders (POWs 76% vs non‐POWs 60%, P = .011), and cognitive disorders (excluding head injury, dementia, and stroke) (POWs 31% vs non‐POWs 15%, P = .006). Of the 36 signs in the neurology of aging examination, POWs had a significantly higher proportion of seven extrapyramidal signs and six signs relating to ataxia. POWs were more likely to be impaired on the IADL scale than were non‐POWs (33% vs 17%, P = .012) but not significantly more likely to be impaired on the PSMS. CONCLUSIONS : There were few differences between POWs and controls, and those differences were relatively small. Our findings do not support a major role for a catastrophic life stress in the development of chronic illness and disability in later life. However it is possible that the POW experience played a part in premature, abnormal, or unsuccessful aging in some individuals.