Predictors of Disability in the Final Year of Life

Disability among deceased subjects in the Duke Established Population for Epidemiologic Studies of the Elderly (EPESE) survey was analyzed to determine the risk of becoming disabled before or during the final year of life and the predictors of this disability. The method was a comparison of the baseline characteristics of decedents who became disabled with the characteristics of decedents who were not disabled. It was found that 63% of the initially nondisabled who survived to the next interview remained able to do the basic activities of daily living without help, at least until a few months before death. Multivariate analysis showed that initial age, income, depression, and self-rated health were strong and independent predictors of becoming disabled. The findings suggest that reducing poverty, depression, and illness may reduce the risk of disability in the final year.