Format

Send to

Choose Destination
J Palliat Med. 2001 Winter;4(4):457-64.

Dying trajectory in the last year of life: does cancer trajectory fit other diseases?

Author information

1
Department of Community Health, Center for Gerontology and Health Care Research, Brown University School of Medicine, Providence, Rhode Island, USA. Joan_Teno@brown.edu

Abstract

PURPOSE:

To examine differences in the pattern of functional decline among persons dying of cancer and other leading noncancer causes of death.

DESIGN:

Mortality followback survey of next of kin listed on death certificate.

SETTING:

Probability sample of all deaths in the United States.

PARTICIPANTS:

Next of kin for 3,614 decedents that represented 914,335 deaths.

MEASUREMENTS:

Days of difficulty with activities of daily living and mobility in the last year of life.

RESULTS:

Relative to other decedents, patients with cancer experienced an increased rate of functional impairment beginning as late as 5 months prior to death. For example, only 13.9% of patients with cancer had difficulty getting out of bed or a chair 1-year prior to death. This increased from 22.2% to 63.0% in the last five months of life. In contrast, decedents from other diseases had higher rates of functional impairment 1 year prior to death (approximately 35% had difficulty getting out of bed or chair) and they manifested a more gradual increase in the level of functional decline (approximately 50% had difficulty getting out of bed). Precipitous functional decline was associated with hospice involvement and dying at home.

CONCLUSION:

Persons dying of cancer experienced sharp functional decline in the last months of life whereas other decedents' have a more gradual decline. The more precipitous functional decline was associated with hospice involvement and dying at home.

Comment in

PMID:
11798477
DOI:
10.1089/109662101753381593
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center