The concept of routinization in the elderly is defined as the performance of environmental, behavioral, and social activities, in the same manner over time. First, routines are described from a developmental point of view and a multidisciplinary approach. Second, the development of this concept in recent studies is analyzed. Different functions of routinization are discussed as a general model of disability. Based on the results of the PAQUID epidemiological investigation, routinization of behaviors and activities in older persons appears as a complex phenomenon that cannot only be understood in terms of adaptive functioning. Various relationships were found between preference for routines and vulnerability factors in psychological, functional or cognitive domains. Finally, the theoretical issues and clinical implications are discussed with regard to distinct dimensions of the routinization concept, including its relevance for identifying the vulnerability markers in the elderly, and improving early detection, prevention and management of adaptation difficulties in this population.