The Journals of Gerontology, Series ANov 1, 2026, 20:44 GMT

Three disability patterns emerged before death in older adults

In six Swedish cohorts, 53% had consistently low disability, compared with 36% with sharp late increases and 11% with higher, increasing disability.

Paper by Saila M Kyrönlahti, Halonen Pauliina, Rizzuto Debora, +5Enroth Linda · Tampere University

Figure 1. Disability trajectories in relation to impending death.Disability trajectories in relation to impending death.Saila et al.

Our read

Populations

Studied:: Cohort study of 2,294 adults who died aged 70 or older, up to 12 years
What changed:: Disability stayed low in 53%, increased sharply in 36%, and was high and increasing in 11% before death
The catch:: Cognitive impairment could bias participants’ self-reported disability
Why it’s aging research:: It measures an outcome that worsens with age.

Editor of record: Boris Djordjevic · AgingResearch.News

Paper

An observational study analyzed disability records for 2,294 people in Sweden who died at age 70 or older. Their average age at death was 89.8 years, and 62% were women. Researchers combined six aging studies from 1997–2016 and examined assessments made up to 12 years before death. They counted difficulties with five self-care activities, including dressing, bathing and eating.

Statistical modeling identified three patterns: consistently low disability, low disability that rose sharply near death, and higher disability that kept increasing. For most participants, limitations remained low until the final two years of life. Women, people with less education and those who died at older ages were more likely to follow increasing or persistently high disability patterns. The higher, increasing pattern was also associated with cognitive impairment—problems with memory and thinking.

Why it matters

Late-life functional decline raises questions about when people may need help with daily life. The authors suggest that identifying associated factors may help anticipate care needs and inform targeted interventions.

Caveats

The observational design cannot establish what caused disability. Most participants contributed only two assessments, and people excluded for insufficient data were older at death and less educated, potentially limiting how representative the findings are.

From the paper

Participants

The final analytic sample consisted of 2294 individuals drawn from the six studies (Figure S1).

Methods, Study design and population

Result

… prevalence was also higher in the high-increasing than in low-sharply increasing trajectory [0.80 (95% CI 0.72-0.88) vs 0.46 (95% CI 0.42-0.51)] …

Results, Prevalence of cognitive impairment and chronic conditions across disability trajectories

Limitation

Although harmonization improved comparability, differences in study design, sampling, and measurement protocols may have introduced residual heterogeneity that could not fully be eliminated.

Strengths and limitations

Quoted word for word from the full text on academic.oup.com.