Health status and the end-of-life stage

Although numerous studies highlight the social, psychological, and physiological significance of life stages based on specific ages, little scholarly attention has been devoted to identifying factors that distinguish the stage prior to death. Instead of conceptualizing the life course as stages delineated by specific ages, our study explores the changes in self-rated health status and functional health limitations that occur when older adults pass from a vital stage of life into the end-of-life stage. Using data from the Longitudinal Study on Aging, we compare the health status of those at varying points near the end-of-life (died within 1-6 years from the initial interview) to vital survivors (survived beyond 6 years). Controlling for age, sex, race, education, and a host of diagnosed diseases and serious health conditions, those in the end-of-life stage have more lower and upper body limitations, greater difficulty with activities of daily living, and worse overall self-rated health than vital survivors. We conclude that the end-of-life stage should be considered a unique period in the life course that is irreducible to age.