Table 1 Peer-reviewed elite athlete mortality literature (>1980; n = 54)
From: Do Elite Athletes Live Longer? A Systematic Review of Mortality and Longevity in Elite Athletes
Sport/Country | Authors | N | Key finding | LE vs. GP |
|---|---|---|---|---|
MLBa | Abel and Kruger [35] (2004) | 6038 | Significant differences in longevity related to handedness (F[2,6035] = 0.13) (death < 2001) | -- |
MLBa | Abel and Kruger [36] (2005) | 2604 | LE: ~4–5 years longer (f = 188.0, df = 1, 2,555, P < 0.001); (1900–1950 debut) | ↑ |
MLBa | Abel and Kruger [37] (2005) | 3573 | Median post-induction survival for HOFs was 5 years shorter than for non-inducted players, 18 years (CI 15.0–21.0) vs. 23 years (CI 22.1–23.9) for matched controls (OR = 1.37, CI 1.08–1.73); (death ≤ 2002) | -- |
MLBa | Abel and Kruger [38] (2006) | 4492 | LE: 4.8 years longer (SD = ±15.0); career length increased longevity (F = 3.4 df = 3,4379; P < 0.02); (1900–1939 debut) | ↑ |
MLBa | Abel and Kruger [39] (2007) | 3760 | Earlier career debut predicted earlier death (F[8,2898] = 7.78, P < 0.001); (death < 2006; 1900–1935 debut) | -- |
MLBa | Abel and Kruger [40] (2007) | 3835 | Players (n = 11) with positive initials (e.g., A.C.E.; 80.4 ± SE = 3.0) lived significantly longer (F[2904] = 3.7, P < 0.03, two-tailed) by 13 years than players (n = 30) with negative initials (e.g., D.E.D.; 67.0 ± SE = 3.1) or players (n = 864) with neutral initials (67.1 ± SE = 0.5); players with positive initials lived significantly longer than their matched controls and those with negative initials (P < 0.05); (died before 1950) | -- |
MLBa | Boren and Erickson [41] (1998) | 28 | The most common toxin that lead to death by poisoning was carbon monoxide; low overall risk (death 1889–1995) | -- |
MLBa | Fudin et al. [42] (1993) | 1686 | In response to Halpern and Coren’s [43] study: Left-handers (n = 235) had a M longevity of 64.46 years (SD = 15.34) right-handers (n = 1451), a difference of 38.57 days (t[1684] = 0.09, P > 0.05 for compared to 64.56 years (SD = 15.02) for years lived; Halpern and Coren [43] reported a difference of 244.72 days); (considered longevity data through 1978) | -- |
MLBa | Halpern and Coren [43] (1988) | 1708 | M age at death for right-handers was 64.64 years (n = 1472; SD = 15.5) and 63.97 years for left-handers (n = 236; SD = 15.4), a significant difference (Z = 6.63, P < 0.001) | -- |
MLBa | Hicks et al. [44] (1994) | 5441 | In response to Fudin et al.’s [42] study: Reliable data were confirmed for 3501 right-handers (64.3 %), 1199 mixed-handers (22.0 %) and 741 left-handers (13.6 %); the differences in M days of life were not significant in each group (F[2,5338] = .59, P = 0.55) and between just right- and left-handers (t[4240] = −1.08, P = 0.28; M longevity less for right-handers) | -- |
MLBa | Kalist and Peng [45] (2007) | 2641 | Greater longevity overall (SMR = 0.31); positive relationship between education and longevity (HR = 0.74, CI 0.56–0.977); black players had a HR 2.47 times greater than white players (1963–1996 debut) | ↑ |
MLBa | Reynolds and Day [15] (2012) | 14,360 | Greater longevity rates throughout the last century (1900–1999 debut); (SMR = 0.87, CI 0.85–0.89; 1930–1999) | ↑ |
MLBa | Saint Onge et al. [46] (2008) | 6772 | LE: ~5 years longer, compared to 20-year-old U.S. males; at 20 years, players from the Modern Era can expect to live 65.5 vs. 52.4 years and 58.3 years from the Early and Golden Eras, respectively (1902–2004 debut) | ↑ |
MLBa | Smith [29] (2011) | -- | In response to Abel and Kruger’s [40] study: No relationship between name initials and longevity (P > 0.05) | -- |
MLBa | Smith [30] (2011) | 102 | In response to Abel and Kruger’s [37] study: Corrected data shows that there is no statistically significant difference in the LE of HOF players (Z = 0.06, two-sided P = 0.952) | -- |
MLBa | Waterbor et al. [47] (1988) | 985 | Greater longevity overall (SMR = 0.94); longevity was correlated with position and in-game achievement (1911–1925 debut) | -- |
NBAa | Fafian Jr. [48] (1997) | 2810 | Greater longevity overall, particularly in guards (active 1946–1994) | ↑ |
NBAa | Lawler and Lawler [25] (2011) | 3647 | Handedness was not significantly related to LE (HR = 0.92, CI 0.54–1.60; P = 0.76); (active 1946–2009) | -- |
NBAa | Lawler et al. [10] (2012) | 3366 | White players lived longer (~1.5 years) than black players (HR = 1.77, CI 1.35–2.32); LE: ~4 year longer overall (active 1946–2005) | ↑ |
NFLa | Abel and Kruger [49] (2006) | 1512 | LE: 6.1 years longer (SD = ±11.9); career length (F = 4.7, df = 2,1504; P < 0.01) and BMI (R² = 0.01, P < 0.01) increased longevity (debut < 1940) | ↑ |
NFLa | Baron et al. [19] (2012) | 3439 | Greater longevity overall (SMR = 0.53, CI 0.48–0.59); BMI, race, and position were associated with longevity (active 1959–1988) | ↑ |
NFLa | Lehman et al. [12] (2012) | 3439 | Greater longevity overall (SMR = 0.53, CI 0.48–0.59); increased overall risk of neurodegenerative MR (SMR = 2.83–3.26, CI 1.36–5.21); elevated ALS (SMR = 4.31, CI 1.73–8.87) and AD (SMR = 3.86, CI 1.55–7.95) subcategories (active 1959–1988) | ↑ |
NFLa | Selden et al. [50] (2009)b | -- | Review of recent data suggests ↑ CVD risk factors in players, particularly linemen | -- |
Boxing | Baird et al. [18] (2010) | 339 | Decline in premature MR after 1983 (rounds reduced from 15 to 12); (death 1950–2007) | -- |
Cricketc | Aggleton et al. [51] (1993) | 3165 | There was a significant lifespan longevity difference (t[3163] = 2.77, P = 0.006, two-tailed) between right-handers (n = 2580; 65.62 years) and left-handers (n = 585; 63.52 years); left-handers were more likely to die prematurely in accidents or in warfare (players in the British Isles from 1864–1983) | -- |
Cricketc | Aggleton et al. [52] (1994) | 5960 | No significant relation between mortality and handedness (P = 0.3); left-handers were more likely to die from unnatural causes (P = 0.03, log hazard 0.37, CI 0.04–0.70), particularly warfare (P = 0.009, log hazard 0.53, CI 0.13–0.92); (born between 1840–1960; players in the British Isles from 1864–1992) | -- |
Cyclistsd | Marijon et al. [27] (2013) | 786 | Greater longevity overall in Tour de France participants (SMR = 0.59, CI 0.51–0.68, P < 0.0001); reduction in neoplasms (SMR = 0.56, CI 0.42–0.72, P < 0.0001) and CVD (SMR = 0.67, CI 0.50–0.88, P = 0.004); (1947–2012 participants) | ↑ |
Cyclistsd | Morcet et al. [13] (2012) | 514 | Greater longevity overall (SMR = 0.50, CI 0.34–0.71); although higher MR in younger cyclists (active 1960–1990) | ↑ |
Cyclistsd,e,f | Sanchis-Gomar et al. [28] (2011) | 834 | LE: ~8 years longer for Tour de France participants (P < 0.05); (active 1930–1964) | ↑ |
Divingg | Irgens et al. [8] (2013) | 3130 | Greater longevity overall (HR = 0.79, CI 0.63–0.997), although increased violent deaths (born 1950–1999) | ↑ |
Golfa | Coate and Schwenkenberg [21] (2012) | 313 | LE: 5.4 years longer (won prize money 1980–2009) | ↑ |
Golfh | Farahmand et al. [11] (2009) | 300,818 | Greater longevity overall (SMR = 0.60, CI 0.57–0.64); greatest longevity in most skilled players (SMR = 0.53, CI 0.41–0.67); (born >1920, registered < 2001) | ↑ |
PLi | Pärssinen et al. [53] (2000) | 62 | Increased premature MR (SMR = 4.6, CI 2.04–10.45; P = 0.0002), suspected from prior anabolic steroid use (placed first–fifth in Finnish championships, 1977–1982) | ↓ |
Rugbyj | Beaglehole and Stewart [54] (1983) | 822 | LE of All Blacks is the same as GP, although LE (73.0 years) for non-Māori All Blacks was ~10 years longer (CI 71.8–74.5) relative to the Māori All Blacks (1884–1981) | = |
Skiingg | Grimsmo et al. [22] (2011) | 122 | Total MR was 9 % lower after a 30-year follow-up (P = 0.04); (study participants, 1976–1981) | ↑ |
Soccere | Belli and Vanacore [55] (2005) | 350 | Similar observed and expected MR, although a ten-fold increase of ALS MR (SPMR = 1158, CI 672–1998) was present (active 1960–1996) | = |
Soccerk | Koning and Amelink [23] (2012) | 371 | Greater longevity overall (P = 0.003); (active 1970–1973) | ↑ |
Soccerl | Kuss et al. [24] (2011) | 812 | Cumulative observed survival was smaller than cumulative expected survival; therefore, male and female players had reduced longevity (RSR ≤ 1); (active 1908–2006) | ↓ |
Soccere | Taioli [56] (2007) | 5389 | Greater longevity overall (SMR = 0.68, CI 0.52–0.86), although increased risk for car accident (SMR = 2.23, CI 1.46–3.27) and ALS (SMR = 18.18, CI 5.00–46.55) death (active 1975–2003) | ↑ |
SWm | Kanda et al. [57] (2009) | 73 | Deceased wrestlers had higher BMIs (OR = 1.08, CI 1.01–1.15) and winning percentages (OR = 1.29, CI 0.86–1.93); (active 1926–1989) | -- |
T and Fc | Menotti et al. [58] (1990) | 983 | Greater longevity in males (SMR = 0.73; n = 700) and females (SMR = 0.48; n = 283); significant when analyzed together (P = 0.0296); (active > 1940) | ↑ |
Mixeda | Abel and Kruger [17] (2010) | 10,216 | Decrease in longevity associated with names beginning with A–D; linear decrease for baseball and hockey players, but non-linear in football and basketball players; for each sport, A names lived longer than E–Z names, and D names had decreased longevities compared to E–Z names F(4,10,193) = 4.16, P = 0.002); football players lived the longest (72.3 ± 12.7) and baseball players lived the least years (70.8 ± 14.7); significant letter differences occurred between A and E–Z (HR = 0.80, CI 0.71–0.91, P < 0.001) and D and E–Z (HR = 1.16, CI 1.04–1.30, P < 0.01); (born 1875–1930) | -- |
Mixed | Bianco et al. [59] (2007) | 715 | Baseball (LE: 76; n = 154), basketball (LE: 78; n = 58), boxing (LE: 73; n = 81),football (LE: 77; n = 81), ice hockey (LE: 74.5; n = 130), swimming (LE: 74; n = 37), tennis (LE: 79; n = 83), track and field (LE: 75; n = 59), and wrestling (LE: 77; n = 32) HOFs had greater overall longevity (P < 0.05); (M = 76 years); (born 1860–1930) | ↑ |
Mixed | Clarke et al. [20] (2012) | 15,174 | 11,619 (76.6 %) male and 3555 (23.4 %) female Olympic Game medalists’ (1896–2010) LE was 2.8 years longer (RCS = 1.08, CI 1.07–1.10); endurance (RCS = 1.13, CI 1.09–1.17) and mixed (RCS = 1.11, CI 1.09–1.13) sport athletes had a more favorable survival advantage relative to power sport athletes (RCS = 1.05, CI 1.01–1.08) | ↑ |
Mixeda | Coate and Sun [9] (2013) | 2690 | Females (n = 1348; HR = 0.61, CI 0.51–0.72) had a ~6 year LE advantage over males (n = 1342), even though they competed in the same Olympic events (1900–2008) and tennis championships (HR = 0.65, CI 0.47–0.91; >1880); Olympic medalists’ LE: 2–3 years longer if born <1920, but smaller advantage overall; tennis players’ LE: 5–6 years longer if born <1920, and 2–3 years overall; M LE was 82 years for females and 76 years for males | ↑ |
Mixedn | Gajewski and Poznańska [60] (2008) | 2113 | Greater longevity overall in male (n = 1689; SMR = 0.50, CI 0.44–0.56) and female (n = 424; SMR = 0.73, CI 0.48–1.05) Olympians (1924–2000) | ↑ |
Mixedi | Kettunen et al. [3] (2014) | 2363 | LE: ~5–6 years longer overall; endurance (79.1 years; CI 76.6–80.6), team (78.8 years; CI 78.1–79.8) and power (75.6 years; CI 74.0–76.5) sport athletes who represented Finland in international competitions (active 1920–1965) had higher LE than controls (72.9 years, CI 71.8–74.3), even after adjusting for socio economic status, birth cohort, and disease-specific mortality (HR ≤ 1); boxers had increased risk of dementia mortality (HR = 4.20, CI 2.30–7.81) | ↑ |
Mixedi | Kujala et al. [4] (2001) | 2009 | Greater longevity overall (SMR = 0.74, CI 0.69–0.79); all-cause mortality was lower for endurance (SMR = 0.57, CI 0.47–0.68), mixed (SMR = 0.68, CI 0.61–0.76), and power (SMR = 0.90, CI 0.81–1.00) sport athletes who represented Finland in international competitions (active 1920–1965); increased risk of hypertension in power sport athletes (SMR = 2.63, CI 1.06–5.42); (SMRs calculated 1971–1995) | ↑ |
Mixedh | Lindqvist et al. [26] (2013) | 1199 | MR was not increased overall in former power sport athletes, except a slight increase at 45 years (CI 2.1–4.2); between 20 and 50 years, estimated HR = 1.44–1.46; 2.1–3.9 times increased MR from suicide between 30 and 50 years (overall, HR = 1.74, CI 1.08–2.66; P = 0.025); however, there was a lower malignancy MR (HR = 0.71, CI 0.50–0.98; P = 0.036); (active 1960–1979) | -- |
Mixedn | Poznańska and Gajewski [14] (2001) | -- | Greater overall longevity (SMR = 0.42, CI 0.35–0.49), particularly between 1992 and 1998 (Olympians 1981–1998) | ↑ |
Mixedb | Samaras et al. [61] (2002) | 1505 | Modest correlation coefficients indicated that weight is only one risk factor that affected the longevities of baseball players (n = 1278; r = −0.22, P < 0.025) [58], football players (n = 199; r = −0.33, P < 0.005) [59], and Finnish elite athletes (r = −0.51, non-significant) [5] | -- |
Mixedi | 2613 | LE for endurance (5.7; M = 75.6, CI 73.6–77.5), team (4.0; M = 73.9, CI 72.7–75.1), and in power (1.6; M = 71.5, CI 70.4–72.2) sport athletes was greater than the referents (69.9); decreased CVD in endurance (OR = 0.49, CI 0.26–0.93) and team (OR = 0.61, CI 0.41–0.92) sport athletes (active 1920–1965) | ↑ | |
Mixed | Zwiers et al. [31] (2012) | 9889 | High-intensity sport athletes had lower longevity compared to low-intensity sport athletes (high risk of bodily collision, HR = 1.11, CI 1.06–1.15, and high levels of physical contact, HR = 1.16, CI 1.11–1.22 (Olympians 1896–1936; sex breakdown unknown) | -- |