Abstract
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.
Highlights
Evidence suggests an association between the risk of the development of neurodegenerative disorders and repeated traumatic brain injury as a result of significant shocks on the head while playing sports (Peskind et al, 2013; Faden and Loane, 2015; Crane et al, 2016)
The mean age of neurodegenerative death (ND) was at 84.1 years, and the death in the oldest occurred at 98.2 years
Total longevity from the extended cohort showed a great survival advantage compared with the 1948 cohort; Collision and Contact sports Olympians saved 6.78 years and 6.73 years, respectively
Summary
Evidence suggests an association between the risk of the development of neurodegenerative disorders and repeated traumatic brain injury as a result of significant shocks on the head while playing sports (Peskind et al, 2013; Faden and Loane, 2015; Crane et al, 2016). Previous studies have found that the risk of neurodegenerative death (ND; deaths caused by degenerative nerve diseases such as Alzheimer’s disease and dementia) among American football players and Finnish boxers to be higher than that of the general population (Sahler and Greenwald, 2012; Kettunen et al, 2015; Simmons et al, 2017). Such studies have set the general population as the control group when it would be more appropriate to compare with elite athletes to account for the cohort effect. We hypothesized that Olympians who were engaged in sports where players purposely and frequently hit or collide with each other and with inanimate objects may be subjected to a higher risk of ND, which could lead to a negative impact on their total longevity
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