title: Impact of incarceration in Nazi concentration camps on multimorbidity of former prisoners.
abstract: OBJECTIVE
  To show the extent to which the health of former prisoners was affected by incarceration in extermination camps after 5 and 30 years of leaving the camp, and to determine the etiological factors underlying particular dysfunctions.
  
  
  METHODS
  Medical records of former prisoners developed in 1950 (n=250) and 1975 (n=120) were then, after several decades, retrospectively analyzed and compared with the control group, randomized and matched according to age, sex, occupation, and environment. None of the subjects in the control group was a prisoner either at a concentration camp or at any other prison or detention facility.
  
  
  RESULTS
  Multimorbidity affected mainly the central nervous system (CNS). Five years after leaving a camp, CNS dysfunctions were observed in 66% of former prisoners. Skeletal (42.4%) and cardiovascular system (34.4%) dysfunctions were the second and third most frequent dysfunctions. Thirty years after leaving a camp, the most prevalent coexisting conditions were also found within the CNS (80%), cardiovascular system (58.33%), and skeletal system (55%). Five and 30 years after leaving a camp, multiorgan lesions were found in 21.6% and 60% of survivors, respectively. Multimorbidity was more frequent in a group of prisoners who underwent the state of apathy and depression or who had been incarcerated longer than 24 months. The rate of CNS diseases was four times higher, and the rate of cardiovascular diseases or skeletal system dysfunctions was two times higher, in the study group after 30 years of leaving a camp compared with the control group.
  
  
  CONCLUSIONS
  The consequences of incarceration in concentration camps manifesting as multimorbidity, premature aging, and dramatic increase in mortality rate are observed in the majority of former prisoners. The multimorbidity mostly affected older prisoners who stayed at a camp for a longer time period.
authors: Department and Clinic of Internal Diseases, Geriatry and Allergology, Wroclaw Medical University, Wroclaw, Poland.
authors: Robert K
authors: RK
authors: Jablonski
authors: Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
authors: Jerzy
authors: J
authors: Leszek
authors: Department of Nervous System Diseases, Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland.
authors: Joanna
authors: J
authors: Rosińczuk
authors: Division of Nursing in Internal Medicine Procedures, Department of Clinical Nursing, Wroclaw Medical University, Wroclaw, Poland.
authors: Izabella
authors: I
authors: Uchmanowicz
authors: Department and Clinic of Internal Diseases, Geriatry and Allergology, Wroclaw Medical University, Wroclaw, Poland.
authors: Bernard
authors: B
authors: Panaszek
keywords: cachexia; concentration camp syndrome; low-grade systemic inflammation