'Do Top Athletes Live Better and Longer Lives?'

 Just under a month before the Olympic Games in Paris, the National Academy of Medicine devoted an entire day to a series of conferences on medicine and the Olympic and Paralympic Games. Topics included "high-level sports and cardiac function," athletes' mental health, and the life expectancy and "healthy aging" of high-level athletes. The conference was moderated by Dr Jean-Philippe Hager, a sports physician in Lyon, France. "The subject is complex," he asserted at the outset.

Defining Terms

"First, we must define the terms." What is an athlete? An athlete practices high-level sports, sometimes outside of competition. Aging is the set of changes that occur with advancing age aside from any illness. What is healthy aging? There is no physiologic definition. For the World Health Organization, "healthy aging involves improving the quality of life of aging individuals." 

Based on these definitions, the next question to address is the life expectancy of high-level athletes. To answer this question, Hager relied on a systematic review of the literature on the subject from 2015 onward. The review included 57 articles. "High-level sports lengthen the lifespan, but the physiologic mechanism at play remains uncertain. These athletes live on average 5 years longer and have a lower risk of cardiovascular or cancer pathologies. However, they exhibit the same risks as the general population regarding neurologic or psychiatric pathologies," said Hager.

Better Aging?

Do these exceptional athletes have a higher chance of aging well? To answer this challenging question, Hager relied on, among other sources, a systematic review conducted by Filippo Migliorini. "There are arthrogenic sports, like soccer and American football, contrasting with endurance sports that are not arthrogenic. Contact sports (like boxing, rugby, and martial arts) are traumatogenic, but it must be added that prevention and early medical management related to intensive sports should allow for normal joint aging. Nevertheless, continuing high-level sports despite nonhealed injuries reinforces the arthrogenic risk."

Quality of Life

Sports, regardless of whether they are arthrogenic or traumatogenic, do not seem to affect these athletes' quality of life. "According to a study on professional cricket, professional players experience more pain during and after their careers but report a very satisfactory quality of life. In rugby, it is known that front-line players present cervical arthritis but have little functional impact other than neck stiffness. Rugby is traumatogenic, but former rugby players report having a good quality of life," said Hager.

Addiction Issues

Nevertheless, he added, many retired athletes face addiction problems, particularly with alcohol. "I also add that even when the athlete practices traumatogenic or arthrogenic sports, their participation is valued by society. Sports create social connections that contribute to good quality of life." In conclusion, Hager suggested that "we must teach our athletes to take care of themselves. We must also improve medical support, prevent traumatic injuries, screen for psychologic disorders... Athletes must also play an active role in sports health."

https://www.medscape.com/viewarticle/do-top-athletes-live-better-and-longer-lives-2024a1000cou