Disability Trajectories at the End of Life Among the Very Old (TH307-A)

Abstract

Objectives Assess functional trajectories as they differ by cause of death. Separate disability due to underlying chronic conditions from disability associated with end of life. Original Research Background: Investigators have identified varying trajectories of disability before death, but little is known about how decedent trajectories compare with those of matched survivors. Research Objectives: We examined self-reported disability at 6-month intervals before death among the 1,859 participants in the Health, Aging and Body Composition Study (Health ABC) who died before 2014 and made multiple comparisons with surviving participants. Methods: The original 3,075 study participants were recruited in 1997 from Medicare beneficiaries in Pittsburgh, PA, and Memphis, TN, who were at least 70 years of age and well functioning. Follow-up has continued for 17 years. Results: Disability trajectories among the decedents varied as expected. For example, difficulty dressing was reported 12 months before death by 27.5% of decedents with CHF or COPD compared with 8.1% who died from cancer (p<.0001). Compared to age-matched survivors, decedents with a history of stroke, dementia, pneumonia, or falls were more likely to report difficulty transferring at 6 months (46%-50% vs 22%, p<.0001) and also at 18 months before death (39%-45% vs 20%, p<.0001). Cancer decedents significantly differed from survivors only at 6 months before death. As expected, the proportion of study participants