Aging Successfully until Death in Old Age: Opportunities for Increasing Active Life Expectancy

The purpose of this study was to estimate the prevalence of having no disability in the year prior to death in very old age and to examine factors associated with this outcome. Participants were men and women aged 65 years and older who were followed prospectively between 1981 and 1991 from three communities: New Haven, Connecticut; lowa and Washington counties, lowa; and East Boston, Massachusetts. Persons who died in late old age with known disability status within 15 months of death (n = 1,097) were studied for predictors of dying without disability at the last follow-up interview prior to death. The probability of a nondisabled 65-year-old man's surviving to age 80 and then being nondisabled prior to death was 26% and, for a 65-year-old woman, the probability of surviving to age 85 and being nondisabled before death was 18%. Physical activity was a key factor predicting nondisability before death. There was nearly a twofold increased likelihood of dying without disability among the most physically active group compared with sedentary adults (adjusted odds ratio = 1.86, 95% confidence interval 1.24–2.79). These findings provide encouraging evidence that disability prior to death is not an inevitable part of a long life but may be prevented by moderate physical activity. Am J Epidemiol 1999; 149:654–64.