All-cause and disease-specific mortality among male, former elite athletes: an average 50-year follow-up.
Kettunen JA, Kujala UM, Kaprio J, Backmand H, Peltonen M, Eriksson JG, and Sarna S. Br J Sports Med. 2015. 49:893-897.
Take Home Message: Former elite athletes have a longer life expectancy than demographically-matched control patients. Those athletes participating in soccer, basketball, ice hockey, jumping, short distance running, hurdling, cross-country skiing, middle and long distance runners suffer from heart disease less than control patients.
Observational studies can enhance a clinician’s understanding about the long-term outlook for a population including, quality of life, and mortality. For example, if clinicians better understand if participation in certain sports or level of competition compromised long-term health, then some type of early intervention program may be devised to limit the risk of chronic disease. Therefore, Kettunen and colleagues completed retrospective cohort study to investigate the life expectancy and mortality rates of former elite athletes. A total of 2675 former Norwegian elite athletes (track and field, cross-country skiing, soccer, ice hockey, basketball, boxing, wrestling, weightlifting and shooting) were included in the present study and were matched with 1712 control patients (identified through public archives). Causes of death were defined by International Classification of Disease (ICD) codes. Median time to follow-up was 50 years. Overall, 2,833 participated died including 2,293 (80%) participants who died from natural causes. Life expectancy was greater in endurance (cross-country skiing, middle- and long-distance running) and team sport (soccer, basketball, ice hockey, jumpers, short-distance running, and hurdlers) athletes than controls (see Figure). Natural-cause mortality was lower in all groups of former athletes compared with controls. The most commonly recorded cause of death was heart disease (479 athletes, 336 controls). Former endurance and team sport athletes had lower risk for death from ischemic heart disease and stroke. Compared with controls, former endurance and power sports had a reduced risk of death related to smoking-related cancer. Boxers may have a greater risk of dementia mortality compared with controls.
The data presented in the current study should be of interest not only to clinicians but to all active persons. The data here seems to suggest that participation in aerobic activity has a positive impact on overall life expectancy. Further, participation in these activities may delay the development of heart disease. While this is encouraging, more research should be done on the subject to detail if this increase in life expectancy and disease resistance is due to the activity in question or some other factor like genetics or other lifestyles. Something not researched in the current study that would be beneficial would be patients’ demographic data (BMI, past medical history, etc.) at the time of their deaths. In could be possible that exposure to these activities at a younger age helped the former athletes stay active for longer after discontinuation of the elite activity. This is realistic considering that many of the sports (soccer, basketball, ice hockey, jumping, short distance running, hurdling, cross-country skiing, middle and long distance running) are all sports that an athlete can decrease activity levels while still remaining active in the chosen sport. It is important to keep in mind that these athletes were all male and competing at an elite level. Hence, it will be helpful to see if female athletes and athletes at other competitive levels also benefit from longer life expectancy and delayed risk of heart disease. Until a definitive statement regarding participation in sports and increased life expectancy can be made, a more detailed analysis should be completed. Until this time, clinicians should encourage and educate their athletes to continue to participate in life-long physical activity regardless of the sport.
Questions for Discussion: Have you seen a similar trend in former athletes (do former athletes seem to experience less disease)? If so, do your observations align with the trends reported here?
Written by: Kyle Harris
Reviewed by: Jeffrey Driban