Functional Decline Overview and Prevention

Functional decline is the loss of our physical and mental abilities. If functional decline is a result of aging or age-related problems (as it most often is), then it's referred to as "age-related functional decline."

Older man in a home environment looking into the distance
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There are many types of common age-related functional decline. These include:

This is just a short list of all the things that might change in a person's body due to aging that could lead to functional decline. You can give yourself your best chance of the least amount of functional decline through focusing on a healthy lifestyle.

How Functional Decline Progresses

Age-related functional decline can be subtle — you might need reading glasses for the first time, for example, or be diagnosed with osteopenia. However, it also can speed up suddenly and leave an older person unable to drive, live alone, or take care of the basics of daily life (like bathing, dressing, going to the bathroom and eating).

Family Caregiver Alliance reports that the "lifetime probability of becoming disabled in at least two activities of daily living or of being cognitively impaired is 68% for people age 65 and older." According to the National Institute on Aging, when a loved one becomes older than 65, even more assistance is needed to perform daily activities and life tasks, including money management.

Chronic illness can lead to gradual functional decline, but functional decline can occur swiftly when elderly people are hospitalized. In fact, a 2015 study of revealed up to 21.5% of older patients admitted to the hospital for an acute illness left the hospital with no improvement their daily living activities.

Preventing Functional Decline

It's possible to prevent functional decline, but it likely will take some work, and it may not succeed in every case. One study proves that keeping active is key in preventing functional decline, specifically with the Lifestyle-integrated Functional Exercise (LiFE) program. By integrating balancing and strength exercises into their daily life, seniors can prevent premature "age-related" functional decline.

Along with physical exercise, Harvard Health reports on further ways to protect against functional and cognitive decline. The main factors that contribute to cognitive health in seniors includes getting the right amount of sleep, eating a Mediterranean diet, mental stimulation, consuming one alcoholic beverage daily, and socialization.

Bottom Line

What can you do to prevent functional decline? This advice likely will sound familiar: eat a healthy diet, exercise regularly, manage any chronic diseases you might have, and stay active generally.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Colón-Emeric CS, Whitson HE, Pavon J, Hoenig H. Functional decline in older adults. American Family Physician. 2013;88(6):388-394. PMID: March, 2015.

  2. Schwenk M, Bergquist R, Boulton E, et al. The adapted lifestyle-integrated functional exercise program for preventing functional decline in young seniors: development and initial evaluation. Gerontology. 2019;65(4):362-374. doi. 10.1159/000499962.

  3. Mlinac ME, Feng MC. Assessment of activities of daily living, self-care, and independence. Archives of Clinical Neuropsychology. 2016;31(6):506-516. doi. 10.1093/arclin/acw049. Published, September, 2016.

  4. Kahlon S, Pederson J, Majumdar SR, et al. Association between frailty and 30-day outcomes after discharge from hospital. CMAJ. 2015;187(11):799-804. doi. Published August, 2015.

  5. Schwenk M, Bergquist R, Boulton E, et al. The adapted lifestyle-integrated functional exercise program for preventing functional decline in young seniors: development and initial evaluation. GER. 2019;65(4):362-374. doi. Published July, 2019.

Additional Reading
  • Gill TM et al. A program to prevent functional decline in physically frail, elderly persons who live at home. The New England Journal of Medicine. 2002 Oct 3;347(14):1068-74.
  • Hébert R et al. Factors associated with functional decline and improvement in a very elderly community-dwelling population. American Journal of Epidemiology. 1999 Sep 1;150(5):501-10.
  • Hirsch CH et al. The natural history of functional morbidity in hospitalized older patients. Journal of the American Geriatrics Society. 1990 Dec;38(12):1296-303.
  • Kleinpell RM et al. (2008) Patient Safety and Quality: An Evidence-Based Handbook for Nurses, Chapter 11: Reducing Functional Decline in Hospitalized Elderly. Rockville, MD: Agency for Healthcare Research and Quality.

By Mark Stibich, PhD
Mark Stibich, PhD, FIDSA, is a behavior change expert with experience helping individuals make lasting lifestyle improvements.