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BMJ 2010; 340 doi: (Published 07 April 2010) Cite this as: BMJ 2010;340:c1887

Course of disability in the last year of life is hard to predict

Although most older people experience disability before they die, little information on the trajectories of disability is available to elderly people, their families, and doctors, as well as planners of services at the end of life. In a longitudinal study, 754 people aged 70 years or more were followed up for 10 years by monthly telephone interviews and more comprehensive home based assessments every 18 months. Disability was assessed across four activities of daily living: bathing, dressing, walking, and standing up from a chair.

On the basis of data from 383 participants who died during follow-up, the researchers performed trajectory modelling to identify five distinct courses of disability in the year before death. They then looked at the distribution of the trajectories according to the condition leading to death and …

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