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Transitions in the hierarchy of functional decline (our ability to carry out daily activities that are important to us)

Life expectancy continues to increase across the world. However, disability-free and healthy life expectancy are not experienced equally across the population.


We know that the ability to perform the activities of daily life (such as getting dressed, cooking and shopping) are lost in a predictable order, but we do not know how this happens over the course of time in an older person’s life.

By addressing this research gap, this project will lay the foundation for the development of a framework to track changes in the difficulties older people experience with daily activities over time. It will also take into account person-specific characteristics like health status, socioeconomic position, age and sex, so that we will have a better understanding of the factors that shape the timing and rate of changes and functional decline.

This project will shed light on the ways in which unequal ageing is experienced by older people. It will offer a clear understanding of the inequalities faced by different population sub-groups, providing evidence to support interventions to increase the number of years lived independently and reduce inequalities in ageing.

Aims and objectives

This project will aim to understand what the factors are that vary the onset age of disability, and the time spent at each stage in the hierarchy of functional decline.

It will also seek to understand how individual characteristics shape inequalities in pathways of progression through the hierarchy of functional decline.


We will use a number of methods for this project, including statistical methods, modelling, and looking at data sets.

Policy relevance

This will be relevant across many government departments. The findings will provide evidence to support policymakers in the design of equitable health programmes for prevention.

Delivery dates

April 2024 – April 2026


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