The quality of life in the year before death

Most Americans wish to live a long healthy life, but fear disease and dependency in their last years. Until recently, little has been known about the prevalence of opposite extremes of health in old age, particularly in the period leading up to death.

We used results from the 1986 National Mortality Follow-back Survey to estimate proportions of elderly decedents who were "fully functional" or "severely restricted" in the last year of life. Estimates were based on responses from proxies to questions regarding the decedent's functional status, mental awareness, and time spent in institutions.

Approximately 14% of all decedents aged 65 years and older were defined as fully functional in the last year of life; 10% were defined as severely restricted. Proportions varied with the decedent's age and sex, the underlying cause of death, and the presence of other preexisting conditions.

Results from this survey and future surveys can be used to learn more about "successful agers"--their medical histories, their life-styles, and whether their relative number is increasing or decreasing overtime.