Do Elite Athletes Live Longer? A Systematic Review of Mortality and Longevity in Elite Athletes

BACKGROUND Understanding of an athlete's lifespan is limited with a much more sophisticated knowledge of their competitive careers and little knowledge of post-career outcomes. In this review, we consider the relationship between participation at elite levels of sport and mortality risk relative to other athletes and age- and sex-matched controls from the general population. Our objective was to identify, collate, and disseminate a comprehensive list of risk factors associated with longevity and trends and causes of mortality among elite athletes. METHODS English language articles were searched using the Web of Science database. Keywords athletes, death, elite, "high performance" life expect*, longevity, mortality, players, professional, and sport were used to locate research articles. Seventeen additional articles were retrieved from reference lists found in these papers and a general web search. The inclusion criteria were the following: (1) publication year 1980 or later; (2) the study examined elite-level athletes; and (3) outcome data measured mortality/longevity trends and/or causes. RESULTS Fifty-four peer-reviewed publications and three articles from online sources met the criteria for inclusion. Baseball, football, soccer, basketball, and cycling had the most reported data on elite athletes' lifespan longevities. A variety of mechanisms have attempted to explain mortality risk (e.g., handedness, playing position, achievement, etc.). Considerable support was found for superior longevity outcomes for elite athletes, particularly those in endurance and mixed sports. CONCLUSIONS Future research into the mechanisms that may affect mortality risk is important for a better understanding of life expectancies in both eminent and non-eminent populations. Participation in elite sport is generally favorable to lifespan longevity. KEY POINTS A majority of studies included in this review reported superior lifespan longevity outcomes for elite athletes compared to age- and sex-matched controls from the general population and other athletes.Several mechanisms within and between sports may have powerful effects on the overall lifespan longevities of players (e.g., type of sport, playing position, race, and energy system).Future research on mortality in elite athletes would benefit from more comprehensive statistical measures and reliable databases to determine potential mechanisms that may influence mortality trends and causes in both athlete and non-athlete samples.