Heli M. Bäckmand

Long-term consistency of diurnal-type preferences among men

Diurnal type (chronotype) differentiates individuals on an axis between the extremes of evening type to morning type. These diurnal-type preferences are thought to be relatively stable, but follow-up studies are sparse. The study aims were (1) to compare cross-sectional studies of diurnal type preferences between two decades and (2) to analyze the consistency of diurnal-type preferences using a longitudinal dataset. We analyzed a total of 18 087 adult males from four datasets with information on diurnal type and age. Of these, 2144 were available for survival analysis and 567 for analysis of longitudinal diurnal consistency. Diurnal type was assessed by asking the individual to what extent they would rate themselves a morning or an evening person, categorized into four groups. Statistical tests for stability of diurnal type were based on transition matrices and p values obtained using likelihood ratios. Cox regression was used to calculate the relative risk of all-cause mortality in each of the four diurnal type groups. After direct age standardization, 9.5% (95% CI: 9.0–10.1%) of participants in the four datasets were evening types. The cross-sectional data yielded that morning types were less common in the 2000s than two decades earlier. The longitudinal dataset revealed a significant shift from evening type to another type from 1985 to 2008 (p = 0.002). The relative risk of all-cause mortality was 1.3-fold (95% CI: 1.0–1.6; p = 0.05) higher for evening types compared to morning types. At the population level, eveningness appears to have become more prevalent over recent decades. However, on the individual level, the more morningness the chronotype, the more persistent it remains with aging.

Former athletes' health-related lifestyle behaviours and self-rated health in late adulthood.

The aim of this study was to examine the associations between self-rated health (SRH), physical activity and other lifestyle habits among former athletes and referents in late adulthood. Male athletes (N=514) who represented Finland from 1920 through 1965 and referents (N=368) who were classified healthy at the age of 20 years participated in this population-based cohort study. The present analysis was based on a questionnaire study in 2001. SRH was assessed by a single question. Univariate binary and multivariate logistic regression analyses were used to examine the associations of health-related behaviours with SRH. The majority of former athletes (64%) rated their health better than referents (48%). A higher percentage of the athletes (54%) compared to the referents (44%) belonged to the most physically active groups (MET quintiles IV-V). A high percentage of the athletes (77%) and referents (79%) were occasional or moderate alcohol users. The proportion of never smokers among athletes was 59% and among referents 37%. Among current smokers there were no differences in nicotine dependence between athletes and referents (p=0.07). In the univariate analysis the odds of reporting good SRH was 2 times higher for athletes (OR 2.01, 95% CI 1.53-2.64, p<0.001) than for referents. In multivariate logistic regression analysis, former participation in team and power athletic groups had significantly higher SRH than the referents even after adjusting for age, level of physical activity, alcohol and smoking habit, and occupation. People who participated in very active physical exercise in their youth, as indexed by participation in competitive sports by elite athletes, continue a physically active lifestyle, and maintained healthier lifestyle. They had significantly higher SRH than the referents in their senior years, which was not totally explained by their physically active and healthier lifestyles.

All-cause and disease-specific mortality among male, former elite athletes: an average 50-year follow-up

Aim To investigate life expectancy and mortality among former elite athletes and controls. Methods HR analysis of cause-specific deaths sourced from the national death registry for former Finnish male endurance, team and power sports athletes (N=2363) and controls (N=1657). The median follow-up time was 50 years. Results Median life expectancy was higher in the endurance (79.1 years, 95% CI 76.6 to 80.6) and team (78.8, 78.1 to 79.8) sports athletes than in controls (72.9, 71.8 to 74.3). Compared to controls, risk for total mortality adjusted for socioeconomic status and birth cohort was lower in the endurance ((HR 0.70, 95% CI 0.61 to 0.79)) and team (0.80, 0.72 to 0.89) sports athletes, and slightly lower in the power sports athletes (0.93, 0.85 to 1.03). HR for ischaemic heart disease mortality was lower in the endurance (0.68, 0.54 to 0.86) and team sports (0.73, 0.60 to 0.89) athletes. HR for stroke mortality was 0.52 (0.33 to 0.83) in the endurance and 0.59 (0.40 to 0.88) in the team sports athletes. Compared to controls, the risk for smoking-related cancer mortality was lower in the endurance (HR 0.20, 0.08 to 0.47) and power sports (0.40, 0.25 to 0.66) athletes. For dementia mortality, the power sports athletes, particularly boxers, had increased risk (HR 4.20, 2.30 to 7.81). Conclusions Elite athletes have 5–6 years additional life expectancy when compared to men who were healthy as young adults. Lower mortality for cardiovascular disease was in part due to lower rates of smoking, as tobacco-related cancer mortality was especially low.

Lifetime physical activity and cancer incidence-A cohort study of male former elite athletes in Finland

OBJECTIVES Physical activity has been shown to decrease the risk of certain cancers. Objective of this study was to assess the effect of physical activity on cancer incidence in former male athletes in older age. DESIGN A cohort of 2448 elite male athletes and 1712 referents was followed-up for cancer incidence during 1986-2010 through the Finnish Cancer Registry. METHODS Standardised incidence ratios were calculated with the general male population as the reference. Self-reported questionnaire-based data on covariates were used in Cox regression analyses comparing the risk of cancer in athletes and referents. RESULTS The overall cancer incidence was lower in athletes than in the general population, standardised incidence ratio 0.89 (95% confidence interval 0.81-0.97). It was lowest among middle-distance runners (standardised incidence ratio 0.51, 95% confidence interval 0.22-1.01), long-distance runners (standardised incidence ratio 0.57, 95% confidence interval 0.35-0.88) and jumpers (standardised incidence ratio 0.60, 95% confidence interval 0.37-0.92). The standardised incidence ratio of lung cancer among athletes was 0.40 (95% confidence interval 0.27-0.55) and that of kidney cancer 0.23 (95% confidence interval 0.06-0.57). The hazard ratio for lung cancer between athletes and referents increased from the unadjusted ratio of 0.29 (95% confidence interval: 0.18-0.48) to 0.61 (95% confidence interval: 0.30-1.26) after adjustment for smoking status and pack-years of smoking. CONCLUSIONS Former male elite athletes evidently have less cancer than men on the average. The lesser risk can be attributed to lifestyle factors, notably less frequent smoking among the athletes.

Physical and psychological functioning of daily living in relation to physical activity. A longitudinal study among former elite male athletes and controls

Background and aims: Physical exercise plays an important role in the prevention and reduction of disabilities in elderly people. The aim of this study was to determine the role of physical activity in the physical and psychological functioning of daily living in a cohort of former elite male athletes representing different sports, and controls of middle and old age. Methods: Subjects were 664 former elite male athletes (mean age 64.4 years) and 500 controls (62.0 years) in middle and old age. Subjects were mailed “Physical activity and health survey” questionnaires in 1985 and 1995. The primary outcomes — the physical and psychological functioning of daily living — were assessed in 1995 using items from the Mini-Finland Health Survey. Logistic regression was used for longitudinal as well as cross-sectional analyses to estimate odds ratios (OR) for poor physical and psychological functioning of daily living in relation to recreational physical activity adjusted for age, sport group, life-style, BMI, mood, chronic diseases, personality characteristics, life-events and socio-economic status. Results: In the longitudinal analysis, low levels of physical activity (lowest MET quintile vs highest quintile) in 1985 (OR 4.91, 95% confidence interval (CI) 2.02–11.9), older age (≥70 yrs vs under 60 yrs OR 9.93, 95% CI 4.90–20.2), depression (OR 2.03, 95% CI 1.01–4.09) and anxiety in 1995 (OR 2.67, 95% CI 1.34–5.32) increased the risk of poor physical functioning of daily living in 1995, whereas an increase in a physical activity between 1985–1995 (OR 0.89, 95% CI 0.83–0.95) protected against poor physical functioning of daily living. A history of participating in specific types of sports, especially among certain power sports (weight-lifting and track & field throwers) (OR 0.19, 95% CI 0.06–0.60) and team sports (OR 0.34, 95% CI 0.15–0.81) did reveal a significant protective effect against poor psychological functioning of daily living in the longitudinal analysis. Conclusions: This study suggests that an increase in physical exercise supports physical daily functionality. A specific history of sports participation promotes psychological well-being at an older age.

Former male elite athletes have better metabolic health in late life than their controls.

Elite‐class athletes have longer life expectancy and lower risk for chronic noncommunicable diseases possibly because of physically active and healthier lifestyle. In this study, we assessed former male Finnish elite‐class athletes’ (n = 392) and their matched controls’ (n = 207) body composition, and risk for the metabolic syndrome (MS) and nonalcoholic fatty liver disease (NAFLD) in later life. Compared with the controls, the former athletes had lower body fat percentage (24.8% vs 26.0%, P = 0.021), lower risk for MS [odds ratio (OR) 0.57, 95% confidence interval (CI) 0.40–0.81], and NAFLD (OR 0.61, 95% CI 0.42–0.88). High volume of current leisure‐time physical activity (LTPA) was associated with lower body fat percentage (P for trend < 0.001). When current volume of LTPA increased 1 MET h/week, the risk of MS and NAFLD decreased (OR 0.99, 95% CI 0.98–0.99 and OR 0.97, 95% CI 0.96–0.98, respectively). Although a career as an elite‐class athlete during young adulthood may help to protect from developing metabolic syndrome, present exercise levels and volume of LTPA seem equally important as well.

Former male elite athletes have better metabolic health in late life than their controls

Elite‐class athletes have longer life expectancy and lower risk for chronic noncommunicable diseases possibly because of physically active and healthier lifestyle. In this study, we assessed former male Finnish elite‐class athletes’ (n = 392) and their matched controls’ (n = 207) body composition, and risk for the metabolic syndrome (MS) and nonalcoholic fatty liver disease (NAFLD) in later life. Compared with the controls, the former athletes had lower body fat percentage (24.8% vs 26.0%, P = 0.021), lower risk for MS [odds ratio (OR) 0.57, 95% confidence interval (CI) 0.40–0.81], and NAFLD (OR 0.61, 95% CI 0.42–0.88). High volume of current leisure‐time physical activity (LTPA) was associated with lower body fat percentage (P for trend < 0.001). When current volume of LTPA increased 1 MET h/week, the risk of MS and NAFLD decreased (OR 0.99, 95% CI 0.98–0.99 and OR 0.97, 95% CI 0.96–0.98, respectively). Although a career as an elite‐class athlete during young adulthood may help to protect from developing metabolic syndrome, present exercise levels and volume of LTPA seem equally important as well.

Former male elite athletes and risk of hypertension in later life

Objective: The aim of this study was to assess whether a former career as an elite athlete protects from hypertension in later life. We hypothesized that vigorous physical activity during young adulthood protects against hypertension later in life. Methods: The study population (n = 3440) consists of 2037 former male elite athletes and 1403 matched controls. Of those, 599 (392 former athletes, 207 controls) participated in a clinical study in 2008. The athletes were divided into three groups: endurance, mixed and power sports. Assessment of hypertension was based on athletes’ entitlement to reimbursable antihypertensive medication from the Finnish Social Insurance Institution; among the clinical study participants, this was also based on self-reported current use of antihypertensive drugs or measured hypertension. The current volume of leisure-time physical activity (LTPA) was determined by questionnaires. Results: Among the participants, the former athletes had lower age-adjusted prevalence of hypertension than the controls [odds ratio (OR) 0.69, 95% confidence interval (CI) 0.49–0.98] and the endurance athletes had the lowest OR (OR 0.43, 95% CI 0.23–0.80). OR for the prevalence of hypertension decreased (OR 0.90, 95% CI 0.84–0.96 per 10 metabolic equivalent hours/week) when there was an increase in the volume of LTPA. The former athletes without blood pressure-lowering medication had significantly lower SBP than the controls [139.2 mmHg (SD 18.7) vs. 144.2 mmHg (SD 19.5)] (P = 0.027). Conclusion: A former career as an elite athlete seems to be associated with a lower prevalence of hypertension in later life. The volume of current LTPA was inversely related to prevalence of hypertension.

Mobility and muscle strength in male former elite endurance and power athletes aged 66−91 years

The aim of this cross‐sectional study was to compare mobility and muscle strength in male former elite endurance and power athletes aged 66−91 years (n = 150; 50 men in both former elite athlete groups and in their control group). Agility, dynamic balance, walking speed, chair stand, self‐rated balance confidence (ABC‐scale), jumping height, and handgrip strength were assessed. Former elite power athletes had better agility performance time than the controls (age‐ and body mass index, BMI‐adjusted mean difference −3.6 s; 95% CI −6.3, −0.8). Adjustment for current leisure time physical activity (LTPA) and prevalence of diseases made this difference non‐significant (P = 0.214). The subjects in the power sports group jumped higher than the men in the control group (age‐ and BMI‐adjusted mean differences for vertical squat jump, VSJ 4.4 cm; 95% CI 2.0, 6.8; for countermovement jump, CMJ 4.0 cm; 95% CI 1.7, 6.4). Taking current LTPA and chronic diseases for adjusting process did not improve explorative power of the model. No significant differences between the groups were found in the performances evaluating dynamic balance, walking speed, chair stand, ABC‐scale, or handgrip strength. In conclusion, power athletes among the aged former elite sportsmen had greater explosive force production in their lower extremities than the men in the control group.