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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 Sarna et al. [5, 6] (1993, 1997) 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) --
  1. Studies with no subscript analyzed multiple countries, or other sports were used as controls. Full citations provided in reference list; all LE and MR data were compared to age-matched controls from the GP and all studies were on male participants, unless stated otherwise; descriptions reflect only the key findings
  2. AD Alzheimer’s disease, ALS amyotrophic lateral sclerosis, BMI body mass index, CI confidence interval, CVD cardiovascular disease, GP general population, HOF hall of fame, HR hazard rate/ratio of death, LE life expectancy, M mean, MLB Major League Baseball, MR mortality rate, NBA National Basketball Association, NFL National Football League; OR odds ratio for mortality, PL powerlifting, explained variation/total variation (coefficient of determination), RCS relative conditional survival, RSR relative survival ratio, SD standard deviation, SMR standardized mortality ratio, SPMR standardized proportionate mortality ratio, SW sumo wrestling, T and F track and field
  3. aUSA
  4. bReviews met inclusion criteria
  5. cUnited Kingdom
  6. dFrance
  7. eItaly
  8. fBelgium
  9. gNorway
  10. hSweden
  11. iFinland
  12. jNew Zealand
  13. kNetherlands
  14. lGermany
  15. mJapan
  16. nPoland