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Invited Commentary
Occupational Health
May 24, 2019

Considerations for Present and Future Research on Former Athlete Health and Well-being

Author Affiliations
  • 1Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill
  • 2Center for the Study of Retired Athletes, The University of North Carolina at Chapel Hill
JAMA Netw Open. 2019;2(5):e194222. doi:10.1001/jamanetworkopen.2019.4222

Using previously collected data from a 1990 National Football League pension fund database, the Lahman Baseball Database, and the National Death Index, Nguyen et al1 examined former National Football League and Major League Baseball players who had played at least 5 seasons between 1959 and 1988 and had died between 1979 and 2013 in the United States. Using Cox proportional hazards regression models, the authors1 observed that rates of all-cause, cardiovascular disease, and neurodegenerative disease mortality were higher among former American-style football players than among former professional baseball players.

The ongoing research on this unique population is important because these findings can help drive the discussion on how best to support athlete retirement transitions. We commend Nguyen et al1 for their study, their careful consideration of the 2 data sources, and particularly their efforts to ensure comparability between 2 distinct data sets. As noted by the authors,1 previous research has compared various control groups ranging from the general US population2,3 to replacement players during a strike4 to cohorts of former professional football players. Yet, each control group is uniquely limited in comparability to the exposure group of interest, former American-style football players. Nguyen et al1 carefully note that they “did not have information on other factors that may contribute to neurological and other conditions, such as genetics, family history, or lifestyle and environmental risk factors.”1 As a result, despite the growing body of literature, there are still gaps in the literature that need to be addressed. We strongly echo the call by Nguyen et al1 for “the need for cohort studies of football players with more detailed information on specific aspects of players’ football experience to isolate what specific factors are associated with increased cardiovascular and neurodegenerative risk.”1 Future research must aim to also consider additional risk factors extraneous to participation in professional American-style football.

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