title: Mortality in former Olympic athletes: retrospective cohort analysis.
abstract: OBJECTIVE
  To assess the mortality risk in subsequent years (adjusted for year of birth, nationality, and sex) of former Olympic athletes from disciplines with different levels of exercise intensity.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Former Olympic athletes.
  
  
  METHODS
  9889 athletes (with a known age at death) who participated in the Olympic Games between 1896 and 1936, representing 43 types of disciplines with different levels of cardiovascular, static, and dynamic intensity exercise; high or low risk of bodily collision; and different levels of physical contact.
  
  
  METHODS
  All cause mortality.
  
  
  RESULTS
  Hazard ratios for mortality among athletes from disciplines with moderate cardiovascular intensity (1.01, 95% confidence interval 0.96 to 1.07) or high cardiovascular intensity (0.98, 0.92 to 1.04) were similar to those in athletes from disciplines with low cardiovascular intensity. The underlying static and dynamic components in exercise intensity showed similar non-significant results. Increased mortality was seen among athletes from disciplines with a high risk of bodily collision (hazard ratio 1.11, 1.06 to 1.15) and with high levels of physical contact (1.16, 1.11 to 1.22). In a multivariate analysis, the effect of high cardiovascular intensity remained similar (hazard ratio 1.05, 0.89 to 1.25); the increased mortality associated with high physical contact persisted (hazard ratio 1.13, 1.06 to 1.21), but that for bodily collision became non-significant (1.03, 0.98 to 1.09) as a consequence of its close relation with physical contact.
  
  
  CONCLUSIONS
  Among former Olympic athletes, engagement in disciplines with high intensity exercise did not bring a survival benefit compared with disciplines with low intensity exercise. Those who engaged in disciplines with high levels of physical contact had higher mortality than other Olympians later in life.
authors.affiliation: Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA Leiden, Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Zwiers
authors.forename: F W A
authors.initials: FW
authors.lastname: Zantvoord
authors.forename: F M
authors.initials: FM
authors.lastname: Engelaer
authors.forename: D
authors.initials: D
authors.lastname: van Bodegom
authors.forename: F J G
authors.initials: FJ
authors.lastname: van der Ouderaa
authors.forename: R G J
authors.initials: RG
authors.lastname: Westendorp
mesh_terms: D015444:Exercise; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013177:Sports / Q000706:statistics & numerical data*; D016019:Survival Analysis; D013997:Time Factors