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Comment & Response
August 9, 2021

Agent Orange Exposure and Dementia Diagnosis in US Veterans of the Vietnam Era—Reply

Author Affiliations
  • 1San Francisco Veterans Affairs Health Care System, San Francisco, California
  • 2Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco
  • 3Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
  • 4Northern California Institute for Research and Education, The Veterans Health Research Institute, San Francisco
  • 5Department of Neurology, University of California, San Francisco, San Francisco
JAMA Neurol. 2021;78(10):1277-1278. doi:10.1001/jamaneurol.2021.2609

In Reply We thank Schneiderman and colleagues for their interest in our article, in which we reported that US veterans of the Vietnam era with presumptive Agent Orange (AO) exposure have nearly a 2-fold increased risk of being diagnosed with dementia.1 They raise several concerns about our methods, which we address here.

First, they note that the period of service variable we used to identify veterans from the Vietnam era is based on self-reporting.1 We agree that linkage with Department of Defense data on dates and location of deployment would have improved the accuracy of our cohort identification. We would be interested in merging Department of Defense and Veterans Health Administration data to address this concern in the future. Nonetheless, there is no evidence or reason to believe that veterans would falsely report their period of service. Also, the age range of our cohort1 was consistent with what would be expected for veterans of the Vietnam era.

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