Dying Trajectory in the Last Year of Life: Does Cancer Trajectory Fit Other Diseases?
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.
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A literature review on bereavement and bereavement care
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- Authors
- Teno, J. M., Weitzen, S., Fennell, M. L., & Mor, V.
- Affiliations
- Brown University (US)
- Venue
- Journal of Palliative Medicine
- Publisher
- SAGE Publications
- Published
- 2001-12
- Volume
- 4
- Issue
- 4
- Pages
- 457-464
- ISSN
- 1096-6218 (ISSN-L)
- 1557-7740
- OpenAlex
- W2046867396
- Cited by
- 290
- References
- 22
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 5 · 2023: 11 · 2022: 9 · 2021: 11 · 2020: 7 · 2019: 18 · 2018: 14 · 2017: 14 · 2016: 16 · 2015: 10 · 2014: 12 · 2013: 10 · 2012: 18
- FWCI
- 8.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Palliative Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Robert Wood Johnson Foundation
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- functional decline, last year of life, cancer mortality, activities of daily living, mobility impairment, hospice care, home death, next of kin
- MeSH terms
- Activities of Daily Living, Data Collection, Death, Death Certificates, Diabetes Mellitus, Heart Failure, Humans, Neoplasms, Prognosis, United States, Hospice Care, Disease Progression, Stroke, Pulmonary Disease, Chronic Obstructive
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