Trajectories of End of Life: A Systematic Review

Jiska Cohen-Mansfield*, Michal Skornick-Bouchbinder, Shai Brill

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

85 Scopus citations


Objectives Because End of life (EOL) is becoming an increasingly long life stage, this paper aims to describe the delineation of EOL by reviewing studies which examine (a) terminal decline (TD), the timing of change in slope of decline in specific abilities; and (b) trajectories of decline in areas such as function, health care expenditures, and well-being according to cause of death. Methods Studies were identified through Google Scholar, PsycNET, and PubMed. Results TD was identified in diverse domains. Most findings focused on decline of cognitive abilities, and they reported this to occur 3-7 years prior to death. TD in wellbeing was found to begin 3-5 years prior to death. Trajectories by cause of death generally examined sudden death, terminal illness, organ failure, and frailty, and findings described differences in costs, function, and wellbeing, though examining a shorter predeath period than the TD literature. Discussion Further research is needed to combine methods of investigation in order to assist the health care system in personalizing services to the trajectories of decline, and in enabling caregivers to prepare for the EOL experience.

Original languageEnglish
Pages (from-to)564-572
Number of pages9
JournalJournals of Gerontology - Series B Psychological Sciences and Social Sciences
Issue number4
StatePublished - 16 Apr 2018


FundersFunder number
Minerva Foundation3158329500


    • Cause of Death
    • End of Life
    • Terminal Decline
    • Trajectories


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