Early-life endurance sports lowers frailty and falls in former male athletes

The long-term impact of professional endurance sports on frailty and fall risk in older age remains underexplored. This study examined frailty, physical activity (PA), and health outcomes in older men with and without a history of professional endurance sports. We assessed 200 men aged 60-85 years, 100 former professional endurance athletes (For-A) with ≥ 5 years of competitive experience and 100 age-matched non-athletes (Non-A). Frailty was evaluated using the Frailty Assessment Screening Tool (FAST), PA with the International PA Questionnaire-Short Form, quality of life (QoL) perception via self-report, and falls/hospitalizations via examination. Group differences were tested with Independent t-tests, Mann-Whitney U, and chi-square, while ANCOVA and logistic regression were employed to adjust for current PA. For-A showed lower frailty prevalence (24% vs. 68%, p = 0.001), higher PA (2385 vs. 299 MET-min/week, p = 0.001), better QoL (median 7 vs. 5, p = 0.001), fewer falls (OR = 0.023, 95% CI [0.004, 0.127], p < 0.001), and a non-significant reduction in hospitalizations (OR = 0.414, 95% CI [0.142, 1.202], p = 0.105) in the past year compared to Non-A. Frailty (p = 0.003) and falls (p < 0.001) remained significantly lower in For-A after adjustment for current PA (p = 0.003), but hospitalization differences attenuated. Early-life endurance training is associated with reduced frailty and potentially lower fall risk. While psychological health and hospitalization outcomes appear more dependent on current activity, the potential benefits for mobility, physical performance, continence, and memory suggest the importance of structured youth sports in supporting healthy and resilient aging. Longitudinal studies with diverse populations and objective measures are needed to confirm causality.