Investigating terminal decline

Results from a UK population-based study of aging

Graciela Muniz-Terrera, Ardo van den Hout, Andrea M. Piccinin, Fiona E. Matthews, Scott Hofer

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

The terminal decline hypothesis states that in the proximity of death, an individual's decline in cognitive abilities accelerates. We aimed at estimating the onset of faster rate of decline in global cognition using Mini Mental State Examination (MMSE) scores from participants of the Cambridge City over 75 Cohort Study (CC75C), a U.K. population-based longitudinal study of aging where almost all participants have died. The random change point model fitted to MMSE scores structured as a function of distance to death allowed us to identify a potentially different onset of change in rate of decline before death for each individual in the sample. Differences in rate of change before and after the onset of change in rate of decline by sociodemographic variables were investigated. On average, the onset of a faster rate of change occurred about 7.7 years before death and varied across individuals. Our results show that most individuals experience a period of slight decline followed by a much sharper decline. Education, age at death, and cognitive impairment at study entry were identified as modifiers of rate of change before and after change in rate of decline. Gender differences were found in rate of decline in the final stages of life. Our study suggests that terminal decline is a heterogeneous process, with its onset varying between individuals.

Original languageEnglish (US)
Pages (from-to)377-385
Number of pages9
JournalPsychology and Aging
Volume28
Issue number2
DOIs
StatePublished - 2013
Externally publishedYes

Fingerprint

Population
Aptitude
Cognition
Longitudinal Studies
Cohort Studies
Education
Cognitive Dysfunction

Keywords

  • Cognitive decline
  • MMSE
  • Old age
  • Random change point models
  • Terminal decline

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology
  • Social Psychology

Cite this

Muniz-Terrera, G., van den Hout, A., Piccinin, A. M., Matthews, F. E., & Hofer, S. (2013). Investigating terminal decline: Results from a UK population-based study of aging. Psychology and Aging, 28(2), 377-385. https://doi.org/10.1037/a0031000

Investigating terminal decline : Results from a UK population-based study of aging. / Muniz-Terrera, Graciela; van den Hout, Ardo; Piccinin, Andrea M.; Matthews, Fiona E.; Hofer, Scott.

In: Psychology and Aging, Vol. 28, No. 2, 2013, p. 377-385.

Research output: Contribution to journalArticle

Muniz-Terrera, G, van den Hout, A, Piccinin, AM, Matthews, FE & Hofer, S 2013, 'Investigating terminal decline: Results from a UK population-based study of aging', Psychology and Aging, vol. 28, no. 2, pp. 377-385. https://doi.org/10.1037/a0031000
Muniz-Terrera, Graciela ; van den Hout, Ardo ; Piccinin, Andrea M. ; Matthews, Fiona E. ; Hofer, Scott. / Investigating terminal decline : Results from a UK population-based study of aging. In: Psychology and Aging. 2013 ; Vol. 28, No. 2. pp. 377-385.
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