Learning From Leaders: Life-span Trends in Olympians and Supercentenarians

Limits to lifespan growth

A long-standing human lifespan debate is revival, and the consensus is yet to come on whether the maximum human lifespan is reaching a limit or not. This study discusses how mathematical constraints inherent in survival curves indicate a limit on maximum lifespans, implying that humans would have inevitable limits to lifespan growth.

Why Gilgamesh failed: the mechanistic basis of the limits to human lifespan

The purpose of this Perspective is to clarify for an interdisciplinary audience the fundamental concepts of human longevity and provide evidence for a limit to human lifespan. This observed limit is placed into a broader framework by showing how it has arisen through the process of evolution and by enumerating the molecular mechanisms that may enforce it. Finally, we look toward potential future developments and the prospects for possibly circumventing the current limit.

The curse of the plateau. Measuring confidence in human mortality estimates at extreme ages

In recent years, the importance of describing mortality at the limits of the life span has led to a number of relevant and controversial studies. Whereas considerable efforts have been devoted to collecting data and estimating models on the oldest-old individuals, the testing of statistical confidence about the conclusions of analyses at extreme ages has been largely neglected. How certain can we be in saying that the risk of dying increases, levels out, or, paradoxically, decreases over age 105? Can we recognize particular mortality age patterns at such high ages? In this paper, it is shown that very little can be confidently asserted about mortality at extreme ages. Instead of analysing actual data, we perform a series of simulation studies mimicking actual scenarios from controlled mechanisms. Our findings are thus robust with respect to factors such as particular observation schemes, heterogeneity, and data quality issues. Given the sample sizes currently available and the levels of mortality experienced in present populations, we show that before age 110, only a Gompertzian increase of mortality may be detected. Afterwards a plateau will be regularly recognized as the most suitable pattern, regardless of the complexity of the true underlying mortality.

Are We Approaching a Biological Limit to Human Longevity?

Until recently human longevity records continued to grow in history, with no indication of approaching a hypothetical longevity limit. Also, earlier studies found that age-specific death rates cease to increase at advanced ages (mortality plateau) suggesting the absence of fixed limit to longevity too. In this study, we reexamine both claims with more recent and reliable data on supercentenarians (persons aged 110 years and older). We found that despite a dramatic historical increase in the number of supercentenarians, further growth of human longevity records in subsequent birth cohorts slowed down significantly and almost stopped for those born after 1879. We also found an exponential acceleration of age-specific death rates for persons older than 113 years in more recent data. Slowing down the historical progress in maximum reported age at death and accelerated growth of age-specific death rates after age 113 years in recent birth cohorts may indicate the need for more conservative estimates for future longevity records unless a scientific breakthrough in delaying aging would happen. The hypothesis of approaching a biological limit to human longevity has received some empirical support and it deserves further study and testing.

Covid-19 Mortality: A Matter of Vulnerability Among Nations Facing Limited Margins of Adaptation

Context: The human development territories have been severely constrained under the Covid-19 pandemic. A common dynamics has been observed, but its propagation has not been homogeneous over each continent. We aimed at characterizing the non-viral parameters that were most associated with death rate.

Methods: We tested major indices from five domains (demography, public health, economy, politics, environment) and their potential associations with Covid-19 mortality during the first 8 months of 2020, through a Principal Component Analysis and a correlation matrix with a Pearson correlation test. Data of all countries, or states in federal countries, showing at least 10 fatality cases, were retrieved from official public sites. For countries that have not yet finished the first epidemic phase, a prospective model has been computed to provide options of death rates evolution.

Results: Higher Covid death rates are observed in the [25/65°] latitude and in the [−35/−125°] longitude ranges. The national criteria most associated with death rate are life expectancy and its slowdown, public health context (metabolic and non-communicable diseases (NCD) burden vs. infectious diseases prevalence), economy (growth national product, financial support), and environment (temperature, ultra-violet index). Stringency of the measures settled to fight pandemia, including lockdown, did not appear to be linked with death rate.

Conclusion: Countries that already experienced a stagnation or regression of life expectancy, with high income and NCD rates, had the highest price to pay. This burden was not alleviated by more stringent public decisions. Inherent factors have predetermined the Covid-19 mortality: understanding them may improve prevention strategies by increasing population resilience through better physical fitness and immunity.

Do Centenarians Die Healthier than Younger Elders? A Comparative Epidemiological Study in Spain

This study aims to describe the clinical course, drug use, and health services use characteristics during the last year of life of elders who die being centenarians and to identify key aspects differentiating them from elders who die at an earlier age, with a particular focus on sex differences. We conducted an observational, population-based study in the EpiChron Cohort (Aragón, Spain). The population was stratified by sex and into three age sub-populations (80-89, 90-99, and ≥100 years), and their characteristics were described and compared. Multimorbidity was the rule in our elders, affecting up to 3 in 4 centenarians and 9 in 10 octogenarians and nonagenarians. Polypharmacy was also observed in half of the centenarian population and in most of the younger elders. Risk factors for cardiovascular disease (i.e., hypertension, dyslipidaemia, diabetes), cerebrovascular disease and dementia were amongst the most common chronic conditions in all age groups, whereas the gastroprotective drugs and antithrombotic agents were the most dispensed drugs. Centenarians presented in general lower morbidity and treatment burden and lower use of both primary and hospital healthcare services than octogenarians and nonagenarians, suggesting a better health status. Sex-differences in their clinical characteristics were more striking in octogenarians and tended to decrease with age.

Mortality of Japanese Olympic athletes: 1952-2017 cohort study

Aim

To evaluate mortality among Japanese Olympic athletes compared with the general population and also evaluate their mortality based on total number of Olympics participation and intensity of sports disciplines.

Methods

Information on biography, vital status, date of birth, date of death and latest follow-up date on Japanese Olympians was retrieved from six online databases and compared. Standardised mortality ratio (SMR) was estimated according to observation periods and years from last participation in the Olympics. To further evaluate the association between mortality and total number of Olympics participation/intensity of sports disciplines within the study population, rate ratios (RRs) adjusted by sex, observation period and attained age group were estimated by a Poisson regression model.

Results

A total of 3381 Olympians were included in the analysis. The total person years was 94 076.82. The deaths of 153 (4.53%) Olympians were confirmed, and the overall SMR was 0.29 (95% CI, 0.25 to 0.34). SMRs categorised by years from last participation did not differ significantly. Higher mortality was observed among those who participated in the Olympics twice (RR: 1.52; 95% CI, 1.04 to 2.23) and three times or more (RR: 1.87; 95% CI, 1.08 to 3.25) compared with those who participated just once. Compared with combination of low static and low dynamic intensity category, higher mortality was observed in most combinations of middle-intensity or high-intensity categories.

Conclusion

Japanese Olympians lived longer than the general population. More frequent participation in the Olympics and higher intensity of sports disciplines were associated with higher mortality.

A Medal in the Olympics Runs in the Family: A Cohort Study of Performance Heritability in the Games History

Introduction: Elite performance in sports is known to be influenced by heritable components, but the magnitude of such an influence has never been quantified.

Hypothesis/Objectives: We hypothesized that having a former world-class champion in the family increases the chances of an athlete to repeat the achievement of her or his kinship. We aimed to measure the heritability of a medal in the Olympic Games (OG) among Olympians and to estimate the percentage of the genetic contribution to such a heritance.

Study Design: Twin-family study of a retrospective cohort.

Methods: All the 125,051 worldwide athletes that have participated in the OG between 1896 and 2012 were included. The expected probability to win a medal in the OG was defined as the frequency of medallists among Olympians without any blood kinship in the OG. This expected probability was compared with the probability to win a medal for Olympians having a kinship (grandparent, aunt/uncle, parent, or siblings) with a former Olympian that was a (1) non-medallist or (2) medallist. The heritability of the genetically determined phenotype (h²) was assessed by probandwise concordance rates among dizygotic (DZ) and monozygotic (MZ) twins (n = 90).

Results: The expected probability to win a medal in the OG was 20.4%. No significant difference of medal probability was found in the subgroups of Olympians with a Non-medallist kinship, except among siblings for whom this probability was lower: 13.3% (95% CI 11.2–14.8). The medal probability was significantly greater among Olympians having a kinship with a former Olympic Medallist: 44.4% for niece/nephew (33.7–54.2); 43.4% for offspring (37.4–48.6); 64.8% for siblings (61.2–68.8); 75.5% for DZ twins (63.3–86.6); and 85.7% for MZ twins (63.6–96.9); with significantly greater concordance between MZ than DZ (p = 0.01) and h² estimated at 20.5%.

Conclusion: Having a kinship with a former Olympic medallist is associated with a greater probability for an Olympian to also become a medallist, the closer an athlete is genetically to such kinship the greater this probability. Once in the OG, the genetic contribution to win a medal is estimated to be 20.5%.

Are We Reaching the Limits of Homo sapiens?

Echoing scientific and industrial progress, the Twentieth century was an unprecedented period of improvement for human capabilities and performances, with a significant increase in lifespan, adult height, and maximal physiological performance. Analyses of historical data show a major slow down occurring in the most recent years. This triggered large and passionate debates in the academic scene within multiple disciplines; as such an observation could be interpreted as our upper biological limits. Such a new phase of human history may be related to structural and functional limits determined by long term evolutionary constraints, and the interaction between complex systems and their environment. In this interdisciplinary approach, we call into question the validity of subsequent forecasts and projections through innovative and related biomarkers such as sport, lifespan, and height indicators. We set a theoretical framework based on biological and environmental relevance rather than using a typical single-variable forecasting approach. As demonstrated within the article, these new views will have major social, economical, and political implications.

Mortality and causes of death among Croatian male Olympic medalists

Aim

To compare the overall and disease-specific mortality of Croatian male athletes who won one or more Olympic medals representing Yugoslavia from 1948 to 1988 or Croatia from 1992 to 2016, and the general Croatian male population standardized by age and time period.

Methods

All 233 Croatian male Olympic medalists were included in the study. Information on life duration and cause of death for the Olympic medalists who died before January 1, 2017, was acquired from their families and acquaintances. We asked the families and acquaintances to present medical documentation for the deceased. Data about the overall and disease-specific mortality of the Croatian male population standardized by age and time period were obtained from the Croatian Bureau of Statistics (CBS). Overall and disease-specific standard mortality ratios (SMR) with 95% confidence intervals (CI) were calculated to compare the mortality rates of athletes and general population.

Results

Among 233 Olympic medalists, 57 died before the study endpoint. The main causes of death were cardiovascular diseases (33.3%), neoplasms (26.3%), and external causes (17.6%). The overall mortality of the Olympic medalists was significantly lower than that of general population (SMR 0.73, 95% CI 0.56-0.94, P = 0.013). Regarding specific causes of death, athletes’ mortality from cardiovascular diseases was significantly reduced (SMR 0.61, 95% CI 0.38-0.93, P = 0.021).

Conclusions

Croatian male Olympic medalists benefit from lower overall and cardiovascular mortality rates in comparison to the general Croatian male population.

Debate on human aging and lifespan

The issue of human lifespan has long been a matter of controversy among scientists. In spite of the recent claim by Dong et al that human lifespan is limited to 115 years, with the mounting improvements in biotechnology and scientific understanding of aging, we may be confident that aging will slow down over the course of the current century extending human longevity much longer than 115 years.

Mortality in female and male French Olympians: a 1948-2013 cohort study

BACKGROUND

Whereas intense physical activity has been associated with deleterious effects on elite athletes' health, in particular due to cardiovascular anomalies, long-term follow-ups have suggested lower mortality rates among elite athletes. Causes of death for French Olympic athletes and female elite athletes have not been studied.

HYPOTHESIS/PURPOSE

We aimed to measure overall and disease-specific mortality of French female and male Olympians compared with the French general population. We hypothesize that Olympians, both women and men, have lower mortality rates.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

French elite athletes (601 women and 1802 men) participating in summer or winter Olympic Games from 1948 to 2010 had their vital status verified by national sources and were followed until 2013. Causes of death were obtained via the National Death registry from 1968 to 2012. Overall and disease-specific mortalities of Olympians were compared with those of the French general population through standardized mortality ratios (SMRs) and 95% CIs. Olympians' observed and expected survivals were illustrated by Kaplan-Meier curves.

RESULTS

At the endpoint of the study, 13 women and 222 men had died. Overall mortality in Olympians compared with that of their compatriots was 51% lower (SMR, 0.49; 95% CI, 0.26-0.85) among women and 49% lower (SMR, 0.51; 95% CI, 0.45-0.59) among men. Olympic athletes' survival is significantly superior to that of the French general population (women, P = .03; men, P < .001). According to the total deaths occurring from 1968 to 2012 (12 among women, 202 among men), female Olympians died from neoplasm (50.0%), external causes (33.3%), and cardiovascular diseases (16.6%). The main causes of death among men were related to neoplasms (36.1%), cardiovascular diseases (24.3%), and external causes (14.4%). Regarding the main causes of mortality among male Olympic athletes, the SMRs were as follows: 0.55 for neoplasms (95% CI, 0.43-0.69), 0.55 for cardiovascular diseases (95% CI, 0.41-0.73), and 0.66 for external causes (95% CI, 0.44-0.94).

CONCLUSION

French Olympians live longer than their compatriots: A lower overall mortality of similar magnitude is observed among male and female athletes compared with the general population. The main causes of death in French Olympians are neoplasms, cardiovascular diseases, and external causes.