Pro Athletes

Professional football players appear to have a somewhat elevated risk of death, including higher risk of succumbing to cardiac and neurodegenerative diseases, compared with professional baseball players of similar age, according to new research. The findings raise important questions about sport-specific differences in disease development and the mechanisms that drive the elevated risk. Such mechanisms mandate further research, the investigators said.

This particular study was not designed to elucidate the reasons for the elevate risk seen in NFL players, nor was it intended to examine the mechanisms that fuel disease development in these athletes, the investigators caution. The analysis—the first head to head comparison between elite professional athletes of similar ages is published May 24 in JAMA Network Open.

Retrospective analysis of death

The findings are based on a retrospective analysis of death rates and causes of death in 3,419 NFL (National Football League) and 2,708 MLB (Major League Baseball) players over more than 30 years. There were 517 deaths among NFL players and 431 deaths among MLB players between 1979 and 2013. The difference translates into a 26% higher mortality among football players compared with baseball players.

Extrapolating these differences into absolute numbers, the researchers said; so the elevated risk would translate into one additional death from a neurodegenerative disease per 1,000 NFL players by age 55 rising to 11 additional neurodegenerative deaths by age 75, compared with MLB players. Cardiovascular causes would account for 16 additional deaths per 1,000 NFL players by age 55 and rising to 77 additional deaths by age 75 in NFL players, compare with MLB players.

The number of excess deaths (77) stemming from cardiovascular illness was markedly higher; which may be due to several factors, including higher body-mass index among football players and the sheer prevalence of cardiovascular illness, the researchers said. Indeed, cardiovascular disease is the leading cause of death in the United States and worldwide.

Health status and mortality

Past research has compare health status and mortality outcomes; so between professional football players and the general population; but such comparisons are inherently flawed because football players are overall healthier than members of the general population. Past comparisons between NFL players and the general population; which have show a lower overall mortality rate among football players but an increased risk for death from neurologic disease.

In a somewhat more meaningful comparison; so a recent study analyzed death outcomes among NFL players and replacement football players who played during an NFL players’ strike. This research find a small; but statistically insignificant increase in death rates among NFL players.

A comparison between two groups of professional athletes with similar physical characteristics; so levels of conditioning and overall health status can tease out more meaningful differences; so in risk directly attributable to playing one sport versus the other, the investigators said.

Elucidating sports-specific aspects of disease development is critical; so for our ability to inform best strategies to maintain optimal player health and prevent disease, Zafonte added. This study illuminates the importance of former players taking an active step; so in seeking a comprehensive health evaluation from their doctor. They should ensure they are closely monitored for both cardiovascular and neurological issues, some of which may be treatable.