The Distribution and Determinants of End of Life Patterns to Death of Older Canadian Men: The Manitoba Follow-up Study

Objectives: To determine the patterns of end of life well-being, and the determinants of these patterns in older men. Subjects: A cohort study of older men. Measurements: We reviewed medical and questionnaire data to define end of life trajectories using the WHO Quality of Life Framework. Predictors of these patterns were measured in 2006: medical conditions, baseline quality of life, quality of life trajectory from 1996 to 2006, and self-ratings of well-being. Results: The most common pattern was a gradual decline in well-being prior to death; about 1/5 men experienced a rapid decline, and about 1/5 men experienced a terminal drop; while 13% survived and 5% could not be classified. Lower baseline physical functioning and more chronic diseases was associated with a gradual decline to death. Conclusions: End of life patterns are heterogeneous and clinical and social care must adjust to this heterogeneity.