Elite Athletes: Is Survival Shortened in Boxers?

Abstract

Moderate exercise and intense physical training are associated with increased life expectancy (LE). Boxing is characterized by intentional and repetitive head blows, sometimes causing brain injury, possibly reducing LE. We examined a sample of male athletes born between 1860 and 1930 selected from the international “hall of fame” inductees in baseball (n = 154), ice hockey (n = 130), tennis (n = 83), football (n = 81), boxing (n = 81), track and field (n = 59), basketball (n = 58), swimming (n = 37) and wrestling (n = 32). In boxing, we analyzed the number of disputed bouts/rounds and career records. Sports were also analyzed according to physiological demand and occurrence and kind of contact (intentional, unintentional). The Kaplan-Meier product limit method was used to compare survival curves (significance: p ≤ 0.05). Median LE of the samples was 76.0 yrs and no differences were observed in different sports, although it was lower in boxers (73.0 yrs) and higher in tennis players (79.0 yrs). Sports of different physiological demand were similar in respect to LE. No differences in LE were found related to occurrence and kind of impact. Similar LE was found in boxers of different weight or career records. In conclusion, this study indicates that LE in top-level athletes is unaffected by the type of discipline, and not related to physiological demand and intentional contact.

Key words

exercise - fight - survival - age - dementia pugilistica - contact

References

• 1 Alevizos A, Lentzas J, Kokkoris S, Mariolis A, Korantzopoulos P. Physical activity and stroke risk.  Int J Clin Pract. 2005;  59 922-930
• 2 Betti C O, Ottino C A. Pugilistic encephalopathy.  Acta Neurol Latinoam. 1969;  15 47-51
• 3 Casson I R, Siegel O, Sham R, Cambell E, Tarlau M, Di Domenico A. Brain damage in modern boxers.  JAMA. 1984;  251 2663-2667
• 4 Critchley M. Medical aspects of boxing, particularly from a neurological standpoint.  Br Med J. 1957;  1 357-362
• 5 Dal Monte A, Faina M. Metodi di valutazione funzionale: applicazioni pratiche. Pugilato. Dal Monte A, Faina M Valutazione dell'atleta. Analisi funzionale e biomeccanica della capacità di prestazione. Turin; UTET 1999: 413-416
• 6 Erikssen G, Liestol K, Bjornholt J, Thaulow E, Sandvik L, Erikssen J. Changes in physical fitness and changes in mortality.  Lancet. 1998;  352 759-762
• 7 Fang J, Wylie-Rosett J, Cohen H W, Kaplan R C, Alderman M H. Exercise, body mass index, caloric intake, and cardiovascular mortality.  Am J Prev Med. 2003;  25 283-289
• 8 Gotay C C. Behaviour and cancer prevention.  J Clin Oncol. 2005;  23 301-310
• 9 Humphries B, Newton R, Bronks R, Marshall S, McBride J, Triplett-McBride T, Hakkinen K, Kraemer W J, Humphries N. Effect of exercise intensity on bone density, strength, and calcium turnover in older women.  Med Sci Sports Exerc. 2002;  32 1043-1050
• 10 Kohort W. Osteoprotective benefits of exercise: more pain, less gain?.  J Am Geriatr Soc. 2001;  49 1565-1567
• 11 Kujala U M, Kaprio J, Taimela S, Sarna S. Prevalence of diabetes, hypertension, and ischemic heart disease in former elite athletes.  Metabolism. 1994;  43 1255-1260
• 12 Kujala U M, Viljanen T, Taimela S, Viitasalo J T. Physical activity, V·O_2max, and jumping height in an urban population.  Med Sci Sports Exerc. 1994;  26 889-895
• 13 La Monte M J, Blair S N, Church T S. Physical activity and diabetes prevention.  J Appl Physiol. 2005;  99 1205-1213
• 14 Lakka T A, Venalainen J M, Rauramaa R, Salonen R, Tuomilehto J, Salonen J T. Relation of leisure-time physical activity and cardiorespiratory fitness to the risk of acute myocardial infarction in men.  N Engl J Med. 1994;  330 1549-1554
• 15 Larson E B, Shadlen M F, Wang L, McCormick W C, Bowen J D, Teri L, Kukull W A. Survival after initial diagnosis of Alzheimer disease.  Ann Intern Med. 2004;  140 501-509
• 16 Layne J, Nelson M. The effects of progressive resistance training on bone density: a review.  Med Sci Sports Exerc. 1999;  31 25-30
• 17 Martland S. Punch drunk.  JAMA. 1928;  91 1103-1107
• 18 McCrory P, Johnston K, Meeuwisse W, Aubry M, Cantu R, Dvorak J, Graf-Baumann T, Kelly J, Lovell M, Schamasch P. Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004.  Br J Sports Med. 2005;  39 196-204
• 19 Paffenbarger R S, Hyde R T, Wing A L, Lee I M, Jung D L, Kampert J B. The association of changes in physical activity level and other lifestyle characteristics with mortality among men.  N Engl J Med. 1993;  324 538-545
• 20 Paffenbarger R S, Hyde R T, Wing A L, Hsieh C C. Physical activity, all-cause mortality and longevity of college alumni.  N Engl J Med. 1986;  314 605-613
• 21 Pekkanen J B, Marti B, Nissinen A, Tuomilehto J, Punsar S, Karvonen M J. Reduction of premature mortality by high physical activity: a 20-year follow-up of middle-aged Finnish men.  Lancet. 1987;  1 1473-1477
• 22 Philonenko A. Storia della boxe. Riflessioni preliminari. Philonenko A Storia della boxe. Genova; Il Melangolo 1997: 13-36
• 23 Rana J, Nasir K, Santos R D, Roguin A, Orakzai S H, Carvalho J A, Meneghello R, Blumenthal R S. Increased level of cardiorespiratory fitness blunts the inflammatory response in metabolic syndrome.  Int J Cardiol. 2006;  11 224-230
• 24 Ross R J, Casson I R, Siegel O, Cole M. Boxing injuries: neurologic, radiologic, and neuropsycologic evaluation.  Clin Sports Med. 1987;  6 41-51
• 25 Sarna S, Sahi T, Koskenvuo M, Kaprio J. Increased life expectancy of world class male athletes.  Med Sci Sports Exerc. 1993;  25 237-244
• 26 Tanasescu M, Leitzmann M F, Rimm E B, Willett W C, Stampfer M J, Hu F B. Exercise type and intensity in relation to coronary heart disease in men.  JAMA. 2002;  288 1994-2000
• 27 Tardon A, Lee W J, Delgado-Rodriguez M, Dosemeci M, Albanes D, Hoover R, Blair A. Leisure-time physical activity and lung cancer: a meta-analysis.  Cancer Causes Control. 2005;  16 389-397
• 28 Unterharnscheidt F. About boxing: review of historical and medical aspects.  Texas Reports on Biol Med. 1970;  28 421-495
• 29 Wolfson C, Wolfson D B, Asgharian M, M'Lan C E, Ostbye T, Rockwood K, Hogan D B. Clinical Progression of Dementia Study Group . A reevaluation of the duration of survival after the onset of dementia.  N Engl J Med. 2001;  15 1111-1116