Mortality and causes of death among Croatian male Olympic medalists

Heads-Up: Risk-Specific Neurodegenerative Mortality and Years-Saved Analysis on the US Olympian Cohort

Purpose: This study aimed to identify the risk of neurodegenerative death (ND) that former Olympians endure due to their participation in sports grouped based on presumed repeated shocks to the head, and to understand the impact of their participation in such elite sports on their total longevity.

Materials and Methods: The cohort included all former US Olympians, who participated in the Olympic Games (OG) between 1948 and 1972, and whose vital status and causes of death were verified (n = 2,193). Olympic sports were classified into three categories of exposure: Collision (the highest presumed risk of repeated shocks to the head), Contact, and No-Contact. The Fine-Gray competing risk regression model was used to compare the risk of ND where the No-Contact category was a reference group. The years-saved analysis was performed to quantify the number of years saved or lost to ND and total longevity compared with the US general population.

Results: A total of 65 NDs were identified. Collision sports Olympians had a 3.11 (95% CI: 1.31–7.40) higher risk of ND while the Contact group showed a risk of 0.56 (95% CI: 0.21–1.48) compared with the No-Contact sports Olympians. Compared with the general population, the Collision group lost 0.61 (95% CI: -1.16—0.06) years of life from ND, while the Contact group saved 0.4 (95% CI: 0.26–0.54) and the No-Contact group saved 0.09 (-0.09–0.28) years of life up to the age of 90. Regarding the total longevity, Collision, Contact, and No-Contact groups saved 4.67 (95% CI: 3.13–6.22), 5.8 (95% CI: 4.93–6.67), and 6.24 (95% CI: 5.57–6.92) years of life, respectively, from all causes of death.

Conclusion: There is an elevated risk of ND among US Olympians, who engaged in sports with the highest presumed risk of repeated shocks to the head compared with those exposed to no such hazard. Such risk does not jeopardize the total longevity among Olympians in Collision sports.

Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes

INTRODUCTION

Exercise is widely accepted to improve health, reducing the risk of premature mortality, cardiovascular disease (CVD) and cancer. However, several epidemiological studies suggest that the exercise-longevity relationship may be 'J' shaped; with elite athlete's likely training above these intensity and volume thresholds. Therefore, the aim of this meta-analysis was to examine this relationship in former elite athletes.

METHODS

38,047 English language articles were retrieved from Web of Science, PubMed and SportDiscus databases published after 1970, of which 44 and 24 were included in the systematic review and meta-analysis, respectively. Athletes were split into three groups depending on primary sport: Endurance (END), Mixed/Team, or power (POW). Standard mortality ratio's (SMR) and standard proportionate mortality ratio (SPMR) were obtained, or calculated, and combined for the meta-analysis.

RESULTS

Athletes lived significantly longer than the general population (male SMR 0.69 [95% CI 0.61-0.78]; female SMR 0.51 [95% CI 0.40-0.65]; both p < 0.01). There was no survival benefit for male POW athletes compared to the general population (SMR 1.04 [95% CI 0.91-1.12]). Although male athlete's CVD (SMR 0.73 [95% CI 0.62-0.85]) and cancer mortality (SMR 0.75 [95% CI 0.63-0.89]), were significantly reduced compared to the general population, there was no risk-reduction for POW athletes CVD mortality (SMR 1.10 [0.86-1.40]) or END athletes cancer mortality (SMR 0.73 [0.50-1.07]). There was insufficient data to calculate female sport-specific SMR's.

DISCUSSION

Overall, athletes live longer and have a reduced incidence of both CVD and cancer mortality compared to the general population, refuting the 'J' shape hypothesis. However, different health risks may be apparent according to sports classification, and between sexes, warranting further investigation. Trial registration PROSPERO (registration number: CRD42019130688).

Do Former Elite Athletes Live Longer? New Evidence From German Olympic Athletes and a First Model Description

The positive effects of physical activity and recreational sports on health have been well-examined and are well-proven. In contrast, the consequences of extensive elite sports on life expectancy and mortality rates have been described in significantly less unique and comprehensive terms. There is a lack of models that systematically summarize the factors influencing the life span of elite athletes. Therefore, this study identifies the difference between all 6,066 German participants in Olympic Games between 1956 and 2016 and the total population, as well as between participants from the Federal Republic of Germany (FRG) and the German Democratic Republic (GDR), and between the genders. Currently, the survival rate of German Olympians is lower compared to the general population. On the contrary, it was found that Olympic success represents a linear risk for survival probability. While different types of sports do not exhibit any differences, gender and origin (FRG vs. GDR) do represent a significant risk factor. These results are combined with the current state of research to create an impact model of factors influencing the life span of elite athletes.

Female and male US Olympic athletes live 5 years longer than their general population counterparts: a study of 8124 former US Olympians

Objective

To quantify US female and male Olympic athletes’ longevity and the years of life lost or saved due to multiple causes of death as compared with the US general population.

Methods

Former US athletes who had participated in the summer or winter Olympic Games at least once between 1912 and 2012 were included. Olympians’ date of birth, death and the underlying causes of death were certified by the National Death Index. The Olympians’ overall and cause-specific mortality were compared with the US general population based on the US life tables, adjusted by sex, period and age. Mortality differences between the populations were quantified using the years lost/years saved (YS) method.

Results

8124 US Olympians (2301 women and 5823 men) lived 5.1 years longer (YS 95% CI 4.3 to 6.0) than the general population, based on 2309 deaths observed (225 women, 2084 men). Different causes of death contributed to longevity for Olympians as follows: 2.2 years were saved (1.9 to 2.5) from cardiovascular diseases (CVDs); cancer, 1.5 years (1.3 to 1.8); respiratory diseases (eg, influenza, pneumonia), 0.8 years (0.7 to 0.9); external causes (eg, accidents, homicides), 0.5 years (0.4 to 0.6); endocrine and metabolic diseases (eg, diabetes, hyperlipidaemia), 0.4 years (0.2 to 0.5) and digestive system diseases (eg, cirrhosis, hepatic failure), 0.3 years (0.2 to 0.4). Mortality rates due to nervous system disorders (eg, Alzheimer’s and Parkinsons’s diseases) and mental illness (eg, dementia, schizophrenia) were not different from the general population.

Conclusion

US Olympians lived longer than the general population, an advantage mainly conferred by lower risks of CVD and cancer. Nervous system disorders and mental illness did not differ between US Olympians and the general population.

Jung stirbt, wen die Götter lieben?

Während moderate sportliche Bewegung die Überlebenswahrscheinlichkeit einer Risikogruppe positiv beeinflusst, sind die Befunde im Leistungssport international gemischt. Für Deutschland liegt dazu nur eine Studie zu Fußball-Nationalspielern vor. Daher wurden mit Hilfe der Daten der Mitglieder der deutschen Olympiamannschaften 1956 bis 2016 (n = 6066) Hypothesen zu Effekten im Vergleich zur Gesamtbevölkerung, zum metabolischen Stoffwechsel, zu Einzel‑, Mix- und Mannschaftssportarten, zu Doping, zum olympischen Erfolg und zum Geschlecht getestet und dabei auch die Mitgliedschaft in den Olympiamannschaften der Bundesrepublik, der DDR sowie dem wiedervereinigten Deutschland berücksichtigt. Es zeigt sich, dass die Mitglieder der deutschen Olympiamannschaften bislang eine im Vergleich mit der Gesamtbevölkerung höhere Mortalitätsrate aufweisen, es keine höheren Überlebensraten für die Mitglieder der Olympiamannschaften der alten Bundesrepublik gibt, sich keine Differenzen zwischen Sportarten finden lassen, aber steigende olympische Erfolge zu höheren Mortalitätsraten führen.

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.