Mortality in Professional Athletes: Examining Incidence, Predictors and Causes of Death

Objective: The overarching purpose of this dissertation was to provide an evidence-based portrayal of i) incidence, ii) predictors and iii) causes of death in athletes from Major League Baseball, the National Basketball Association and American Basketball Association, the National Football League and the National Hockey League. More specifically, this investigation highlighted i) mortality outcome differences of athletes between and within professional sport(s), ii) potential statistical artifacts that may be empowering biases of risk of certain lifespan predictors and iii) the challenges of contextualizing historical data to answer questions with relevance in the present where socio-contextual factors may be different. Methods: Data on player lifespan and biological and occupational variables were collected from publically available sources. A majority of the data were collected from wikipedia.org and sports-reference.com, which is a recognized sports archive of aggregated athlete records, and were cross-verified through rigorous web-based and sport encyclopedia archival searches. Several methodological approaches were used across seven studies, including descriptive and Kaplan-Meier and Cox regression survival analyses. Results: The key findings of this dissertation suggest that elite athletes generally have favourable lifespan outcomes, although numerous characteristics need to be taken into consideration, such as occupational (e.g., required energy system needed for participation) and biological (e.g., height) differences. As well, the leading causes of death in players from the four major sports in North America are similar to the leading causes of death in the age- and sex-matched controls from the Canadian and United States general population. Conclusions: Statistical limitations and biased reporting may skew public perception of the relationship between participation in high performance sport and lifespan. As such, there is inherent value in scientists critically examining the health outcomes of athletes and to make these data known to a broader audience, particularly as preconceived notions of health risks from sport participation vocalized through media often distort reality and can adversely affect sport participation rates. In summary, a comprehensive understanding of the implications of involvement in elite sport informs our broader understanding of general athlete health and helps to form evidence-based models of athlete development and care

Retiring at 10 years of age: A discussion of the major trends in organized youth sports today and their association to relative-age-related dropout

A continued interest in investigating how annual age cohort groupings promote \u27relative age effects\u27 (RAEs), which create participation, attainment, and learning biases between relatively older and younger players within the same age cohort, has led to advances in our understanding of the magnitude of RAEs globally and what this important socially constructed phenomenon means for talent identification and development (e.g., Wattie, Schorer, & Baker, 2014). Srdjan\u27s talk will highlight some of the major trends in youth sports today, such as the emphasis on the performance ethic and the growth of specialized programs (Coakley, 2014), and their association to positive youth development and relative-age related sport discontinuation (e.g., Lemez, Baker, Wattie, Horton, & Weir, 2013). In a broader context, as physical inactivity remains a global health problem, and given that many psycho- and socio-ecological factors likely perpetuate RAEs, exploring practical avenues to reduce selection biases in youth sport remains a priority

ONTARIO ICE-HOCKEY PARTICIPATION FOR MALE YOUTH BETWEEN THE AGES OF 10 AND 15 YEARS: AN EXAMINATION OF THE RELATIONSHIP BETWEEN RELATIVE AGE AND DROPOUT RATES

Sport is one avenue through which positive youth development (PYD) can occur (Jones et al., 2011). While some aspects about sport participation are positive, structural issues and registration cut-off dates may detract from positive development. The relative age effect (RAE) suggests that athletes born in the first two quartiles of a given selection year experience a selection advantage and therefore a greater opportunity for success. The purpose of the present study was to examine the relationship between relative age and dropout rates of Ontario Minor Hockey Association male ice-hockey players from ages 10 to 15 years (n=14,325). From chi-square analyses, it appears that dropout was highest amongst players born in quartiles three and four [χ2(3) = 12.85, p \u3c .05; w = .03]. The over-representation of dropouts in the relatively younger players represents an important finding in youth ice-hockey research that has not previously been systemically examined by researchers

Developmental pathways of Para athletes: Examining the sporting backgrounds of elite Canadian wheelchair basketball players

This study examines developmental history data to identify common pathways for elite Para sport performance and contextualizes these findings using known models of athlete development (e.g., the Developmental Model of Sport Participation, Côté, 1999). Seventy-three Canadian wheelchair basketball players completed a modified version of the Developmental History of Athletes Questionnaire (Hopwood, 2013). Overall, the results emphasized considerable variability in measures related to ‘other’ organized sport participation regardless of disability status and competition level, including the proportion of participants that participated in at least one other sport, the number of other sports participated in, the age first participated in other sports, and the number of years spent participating in other sports. This variability suggests there may be multiple Para athlete development narratives and highlights a need for more evidence-based models that are sufficiently nuanced for this athlete cohort

Occupational Therapy Education and Entry-Level Practice: A Systematic Review

Occupational therapists can currently enter clinical practice with either a master’s or clinical doctorate-level degree, as mandated by the American Occupational Therapy Association (AOTA); however, the single vs. dual points of entry remains a topic of debate among practitioners and stakeholders. This systematic review addresses the question of whether existing knowledge around this topic provides defensible policy decision making. As such, the overarching objective was to expound on this current issue in education by aggregating existing literature and synthesizing data related to entry mandates to practice occupational therapy (OT). From 20 May to 20 June 2021, a systematic search of three electronic scientific databases (Web of Science, PubMed, and Sports Medicine and Education Index) and the Google Scholar database was performed. Following the 2020 PRSIMA guidelines, a total of 15 articles met our established inclusion criteria, which included: (1) publication date from 1 January 2008 or later; (2) North American OT programs only; (3) articles that specifically focused on OT and entry-level degree requirements; and (4) articles published in English. Bias was assessed using risk level categorizations recommended by Cochran Collaboration. Participants across the articles included in this review (N = 1749) ranged from OT practitioners and assistants, program directors, and supervisors, to current students, graduates, and faculty. Results were categorized into two central themes related to each side of the debate, and findings indicated that a majority of the participants support maintaining two entry points into the profession, despite compelling arguments having been made for both sides. The authors acknowledge the presence of several limitations in the included studies and advocate that more evidence-based research focusing on objective measures, rather than commentaries and opinions, of clinical performance outcomes between the two OT degree groups is needed to ensure that patient needs continue to be effectively addressed and policy decision making is justifiable

Relative age effects in women's rugby union from developmental leagues to world cup tournaments

Annual age cohort groupings promote relative age effects (RAEs), which often, inadvertently, create participation and attainment biases between relatively older and younger players within the same age cohort. In a globally evolving sport, women's rugby team selection practices may potentially bypass qualified players as a result of maturational differences. Purpose: Our study examined the prevalence of RAEs in women's rugby union. Method: Player data (age range = 4–21+ years) were gathered from the 2006 and 2010 Rugby World Cups (n = 498) and from Canadian (n = 1,497) and New Zealand (NZ; n = 13,899) developmental rugby leagues. Results: Although no evidence of an RAE was found in the World Cup samples, chi-square analyses identified some typical and atypical patterns of RAEs at the developmental levels (w ≥  .3). Younger developmental groups displayed a typical RAE patterning with a greater representation of older players (Canadian 13-year-olds, w = .58; NZ 4-year-olds, w = .35), whereas older developmental groups displayed an atypical RAE patterning with a greater representation of younger players (Canadian 19-year-olds, w = .58; NZ 17-year-olds, w = .32). Further, a traditional RAE emerged in the Canadian 11- to 15-year-old age group, χ2(3) = 10.92, p <  .05, w = .30. Conclusion: The lack of homogeneity of traditional RAEs across the sample questions the existence of a single, clear RAE in women's rugby. Some evidence of participation inequalities at the developmental levels suggests that further RAE research in more varied sociocultural contexts may be necessary

Do "big guys" really die younger? An examination of height and lifespan in former professional basketball players.

While factors such as genetics may mediate the relationship between height and mortality, evidence suggests that larger body size may be an important risk indicator of reduced lifespan longevity in particular. This study critically examined this relationship in professional basketball players. We examined living and deceased players who have played in the National Basketball Association (debut between 1946-2010) and/or the American Basketball Association (1967-1976) using descriptive and Kaplan-Meier and Cox regression analyses. The cut-off date for death data collection was December 11, 2015. Overall, 3,901 living and deceased players were identified and had a mean height of 197.78 cm (± 9.29, Range: 160.02-231.14), and of those, 787 former players were identified as deceased with a mean height of 193.88 cm (± 8.83, Range: 167.6-228.6). Descriptive findings indicated that the tallest players (top 5%) died younger than the shortest players (bottom 5%) in all but one birth decade (1941-1950). Similarly, survival analyses showed a significant relationship between height and lifespan longevity when both dichotomizing [χ2 (1) = 13.04, p < .05] and trichotomizing [χ2 (2) = 18.05, p < .05] the predictor variable height per birth decade, where taller players had a significantly higher mortality risk compared to shorter players through median (HR: 1.30, 95% CI: 1.13-1.50, p < .05) and trichotomized tertile split (HR: 1.40, 95% CI: 1.18-1.68, p <. 05; tallest 33.3% compared to shortest 33.3%) analyses. The uniqueness of examining the height-longevity hypothesis in this relatively homogeneous sub-population should be considered when interpreting these results. Further understanding of the potential risks of early mortality can help generate discourse regarding potential at-risk cohorts of the athlete population

Height and lifespan in professional basketball players

This dataset examines living and deceased players who have played in the National Basketball Association (debut between 1946 – 2010) and/or the American Basketball Association (1967–1976) using descriptive and Kaplan-Meier and Cox regression analyses. The cut-off date for death data collection was December 11, 2015

Mean (<i>M</i>) ages of death per birth decade, by percentile height.

<p>Mean (<i>M</i>) ages of death per birth decade, by percentile height.</p

Does Early Career Achievement Lead to Earlier Death? Assessment of the Precocity-Longevity Effect in Professional Basketball Players

Objectives: To examine the precocity-longevity (P-L) effect in North American professional basketball players who debuted between 1946 and 1979, and to determine whether playing position and decade of play influenced the relationship between age of career achievements and lifespan. Methods: 1852 players were evaluated from a recognized sports archive (i.e., sports-reference.com), which provided information on date of birth, death, and career debut, playing position, and indicators of achievement (i.e., All-Star team and/or All-League team selection). Athletes were categorized as above or below the median age of professional debut, and median age of selection to first All-Star team and/or All-League team. Analyses of deceased players (n = 598) were comprised of bivariate correlations between age of achievement (age of debut, age of first All-Star game and age of first All-League team selection) and age of death, and t-tests to compared the average age of death of early and late achievers (p < .05). Survival analyses, using the entire sample (living and deceased players), compared the lifespans between those who debuted above and below the median age of achievement for each indicator of achievement. Results: Only the correlation between age of professional debut and age of death (r = .33, p < .001) and age of first all-star game and age of death (r = .29, p < .05) and the t-test comparing the average death age of early (66.4 y) and later (69.3 y) debut age groups (p =.01), reached statistical significance. However, survival analyses demonstrated a trend for lower risk of death for early achievers, with one exception (i.e., age of debut) this trend was not statistically significant. Conclusions: Results did not support the P-L hypothesis, suggesting that sample characteristics (i.e., physical fitness of high performance athletes), and measurement methodologies, may influence support for the proposed hypothesis in sport. However, future research would benefit form larger sample sizes and cause of death data