Social status and mortality with activity of daily living disability in later life.

OBJECTIVES The aim of this study was to assess which social status factors predispose a person to dying with activity of daily living (ADL) disability in later life. METHODS We followed 243 deceased members of the Swiss Interdisciplinary Longitudinal Study on the Oldest Old annually up to 8 years before their deaths. Using a multilevel regression, we analyzed age at death, gender, occupational category, and geographic area as potential factors predisposing a person to ending life with ADL disability. RESULTS Disability scores showed a substantial increase as death approached. Individuals from a lower occupational category were at higher risk of ADL disability and experienced a greater functional decline prior to death compared to those from higher occupational categories. DISCUSSION Consistent with the cumulative disadvantage theoretical framework, the health differential between the occupational categories seems to be exacerbated prior to death.