according to the terminal drop hypothesis

Theoretically, a curvilinear shape to change characterized by an abrupt drop before death may be attributable to an underlying disease or near-clinical status (e.g., engulfing presence of comorbidities, severe neurobiological compromise, impending death). Although the source of theoretical confusion and the subject of empirical debate, it is not yet settled whether the predominant shape and magnitude of cognitive decline trajectories preceding death follow a relatively steady linear decline function (i.e., “terminal decline”) or a more accelerated curvilinear function (i.e., “terminal drop” Palmore & Cleveland, 1976 Siegler, 1975).Īlthough terminal decline and terminal drop are often used as synonyms, observers (e.g., Berg, 1996) have cautioned that the different shapes implied by these terms may carry distinct theoretical and clinical implications. A plausible scenario is that, in the absence of neuropathogenic cognitive decline, most people may maintain stable or slightly declining functions into old age, with more marked decline indicating biological compromise (e.g., cardiovascular disease) associated with impending mortality. Arguably, just as the presence of identified cognitively impaired or dementia patients in a study sample can lead to overestimation of normative adult age differences, so can the undiagnosed presence of conditions associated with impending mortality ( Kleemeier, 1962). An association between cognitive functioning and impending mortality has critical implications for determining the shape and identifying the sources of normal cognitive decline with aging. Cognition, Death, Longitudinal, Terminal decline, Terminal dropĬONSISTENT with the early and conventional terminal decline hypotheses (e.g., Riegel & Riegel, 1972), subsequent research has indicated that accelerated cognitive decline in older adults is not only a function of neurodegenerative disease processes (e.g., leading to dementia) but also related to broader biological decline in proximity to death.

According to the terminal drop hypothesis