High hopes: lower risk of death due to mental disorders and self-harm in a century-long US Olympian cohort compared with the general population

Abstract

ObjectiveTo determine the risk of death due to prominent mental disorders, substance abuse, and self-harm among US Olympians compared with the general population.MethodsAll female (n=2301) and male (n=5823) US Olympians who participated in the summer or winter Games between 1912 and 2012 were followed until 2016. The National Death Index certified their vital statuses and causes of death. We performed a Standard Mortality Ratio (SMR) analysis for all causes studied and applied the years-saved (YS) method to quantify differences in the risk of death for (1) anxiety, depression and self-harm and (2) substance abuse and eating disorders. Additionally, we examined the YS across sports with greater than 100 total deaths and between medalists and non-medalists.ResultsUS Olympians had a 32% (SMR=0.68, 95% CI 0.49 to 0.91) lower risk of death compared with the general population, resulting in a longevity advantage of 0.21 YS (95% CI 0.14 to 0.29) for deaths by depression, anxiety and self-harm and 0.12 years (95% CI 0.08 to 0.15) for substance abuse and eating disorders. There were no significant differences between medalists and non-medalists, but findings varied by sports. Most sports (eg, athletics, swimming, rowing) had significantly lower risks of deaths than the general population with the exceptions of fencing and shooting. Shooting showed a trend towards a higher risk through suicide by firearm.ConclusionOlympians have a lower risk of death, favouring an increased longevity compared with the general population for mental disorders, substance abuse and suicides.

Mental Health in Elite Student Athletes: Exploring the Link Between Training Volume and Mental Health Problems in Norwegian College and University Students

“…As such, the current study corroborates the findings from one of the largest register studies in this field, examining all US Olympians (n = 8124) who participated in the Summer or Winter Games between 1912 and 2012. That study found that elite athletes have significantly lower risk of both mental health problems and suicide when compared to the general population (Duncombe et al, 2020). Extending on these findings of reduced risk of mental health problems and suicidality, the current study also found elite athletes reported significantly higher quality of life, more positive affect, less loneliness and insomnia, as well as fewer alcohol problems, when compared to the general student population.…”

“…While some studies have reported prevalence rates of mental disorders and substance use disorder to be higher or comparable to the general population (Schaal et al, 2011;Rice et al, 2016;Gouttebarge et al, 2019;Akesdotter et al, 2020;Purcell et al, 2020), other studies have found lower suicide rates when compared to the general population (Maron et al, 2014;Rao et al, 2015;Lehman et al, 2016). Similarly, in one of the largest studies in this field, a recent study of US Olympians found a lower risk of mental health problems and suicide for this group, compared to the general population (Duncombe et al, 2020). In a consensus statement from IOC, it was concluded than more studies with large reference groups were needed to address specific domains of mental health outcomes in elite athletes, and also to examine whether there may by gender-specific patterns in the associations between the amount of exercise and mental health indicators (Reardon et al, 2019).…”

Mortality from mental disorders and suicide in male professional American football and soccer players: A meta‐analysis

“…10 In addition to the benefits of exercise on mental health, athletes might have a lower risk of death from mental disorders than the general population. Duncombe et al 11 recently analyzed a cohort of former athletes who had participated in the Olympics between 1912 and 2012. Although there were some exceptions (notably shooters, who actually showed a trend toward a higher risk), this study found a 32% lower risk of death attributable to mental and eating disorders or to suicide in former athletes than in the general population.…”

“…The finding of a lower risk of death from these conditions or from suicide in athletes was corroborated in subgroup analyses for individual sports such as athletics, rowing, or swimming (as well as for "all other sports" combined as a single category). 11 Whether the abovementioned benefits on mental health are generalizable to top-level sports, particularly those associated with repeated head impacts (eg, boxing, American football) is, however, less clear. In fact, individuals with a previous history of repeated head impacts have more depression symptoms and an impaired cognitive function compared with people without this history.…”

Heads-Up: Risk-Specific Neurodegenerative Mortality and Years-Saved Analysis on the US Olympian Cohort

“…This function was then compared with the one based on the general population of the same age and sex, living in the same calendar period obtained through the national life tables. Then, we calculated the difference between the areas below both functions to estimate the number of years lost or saved due to ND or all causes of death altogether (Antero et al, 2018;Duncombe et al, 2020).…”