Many people view aging as something to be ashamed of, something to hide. There is a plethora of cosmetic treatments whose sole purpose is to help remove or reduce the signs of aging. Others may view aging as a gift that not all get to experience; either way you view it, aging isn’t always easy, on our brains or our bodies. Aging can introduce new problems and ailments that we didn’t previously have to deal with. Some issues people can develop include cognitive decline, trouble with mobility, and increased health issues.

Cognitive decline is often the most worrisome for families of seniors and seniors themselves. Decline is a common symptom for seniors, whether it be with their cognitive reserve, or their physical abilities. 

Functional decline is defined as a new loss of physical or cognitive functions that impacts the ability to participate in ADLs (activities of daily living) or IADLs (instrumental activities of daily living). Cognitive decline and functional decline are two separate, but often connected, ways to describe the change in the brain and body over time. Cognitive decline solely describes the loss or weakening of mental functions such as memory and attention. Functional decline happens when there is a decrease in a senior's ability to properly care for themselves and complete their ADLs (activities of daily living) such as using the restroom, bathing, and preparing meals for themselves. While these are two different types of decline, they are often intertwined. However, that doesn’t mean both will always be present at the same time; you can have one without the other.

In today’s blog post, we’ll be providing an overview of functional decline in seniors and how you can look for warning signs of it in your loved one, as well as ways to help reduce or cope with the symptoms.

What is Functional Decline?

Every person has a unique combination of cognitive, functional, psychological, and physical needs and abilities. These can change drastically as we age. According to an article on functional decline in older adults, functional decline and disability are relatively common in older adults. They explain that it is often episodic and is associated with a high risk of subsequent health decline. The severity of disability is determined by physical impairments caused by underlying medical conditions, and by external factors such as social support, financial support, and the environment. When multiple health conditions are present, they often result in greater disability than expected because the patient’s ability to compensate for one problem may be affected by multiple conditions. Evaluation of functional disability is most effective when a doctor is able to determine the course of the disability, associated symptoms, effects on specific activities, and coping mechanisms the patient uses to compensate for the functional problem. Underlying health conditions, impairments, and contextual factors (e.g., finances, social support) should be identified using validated screening tools. Interventions should focus on increasing the patient’s capacity to cope with task demands and reducing the demands of the task itself. Interventions for functional decline in older adults are almost always multifactorial because they must address multiple conditions, impairments, and contextual factors.

Functional decline can most often be seen in seniors following (or during) a hospitalization. Functional decline has been identified as the leading complication of hospitalization in the elderly and can result in undernutrition and dehydration, decreased mobility and loss of independence, accelerated bone loss, delirium and depression, pressure ulcers and skin tears, and incontinence.  These hazards can be prevented or minimized during an older person’s hospital admission by implementing effective strategies to minimize functional decline.

While a hospitalization can lead to functional decline, seniors can also experience it due to lesser reasons, including: falls, acute illnesses, arthritis, diabetes, and many other chronic and ongoing illnesses or conditions. 

Signs and Symptoms of Functional Decline:

According to the National Library of Medicine, the ability to perform activities of daily living is an essential measure of an individual's functional status. The inability to perform basic activities of daily living may lead to unsafe conditions and a poor quality of life. As we mentioned above, one of the biggest signs of functional decline is when older adults begin to struggle with ADLs (activities of daily living) including:

• Feeding themselves 
• Getting dressed
• Showering/bathing
• Walking (general mobility, transferring, etc.)
• Going to the bathroom
• Not maintaining personal hygiene

Seniors struggling with IADLs (instrumental activities of daily living) is another way to tell if your senior loved one might be experiencing functional decline. IADLs allow a person to live at home or maintain their independence, by completing tasks such as: 

• Managing finances 
• Using transportation 
• Shopping
• Housekeeping/cleaning
• Doing laundry
• Using the telephone 
• Managing medications
• Preparing meals

Functional decline affects an individual’s independence and makes them more vulnerable to injuries (and potential re-hospitalization) unless the causes are detected and addressed, or help is provided. Functional decline is typically easier for family members, medical personnel, or caregivers to spot because unlike cognitive decline, you can actually see it. If you’re around your senior loved one and you just take some time to watch them, see what they need help with, or are struggling to do, it will help give you an idea of their functional ability and whether or not they are experiencing any functional decline. Some signs of functional decline can present themselves in ways besides needing additional help and support with ADLs such as:

• Reduced mobility or changes/difficulty in body movements
• Posture changes
• Poor balance 
• Reduced body strength or lack of stamina
• Difficulty breathing
• Increased falls or injuries 
• Difficulty in carrying out personal tasks without assistance

How to Recognize Signs of Functional Decline:

As we mentioned above in the symptoms and signs section, one of the best ways to recognize signs of functional decline is to pay attention to your loved one, observe them as they go about their daily activities, and monitor whether or not they are having any trouble with ADLs or IADLs. 

These changes should be significant and consistent. Keep track of the signs and symptoms of any functional decline, and any significant physical or mental changes. Keeping a notebook to jot down any observations can help; be sure to include the date and accompanying details for future reference. Also pay attention to the things they are asking for help with. It’s a good idea to keep track of what they need support with, whether it be everyday tasks or minor and occasional things. This can help give you a better insight into their current level of functional ability.

It’s also recommended to have an evaluation done by a doctor, which is why making note of things you’ve witnessed firsthand can help give them a better insight into their daily functioning. This can result in a diagnosis, recommendations, and advice from a healthcare professional on how to reduce the symptoms or find methods of coping with them.

How to help reduce or cope with functional decline in seniors:

An article on functional decline, social support, and mental health in the elderly, found that

declining physical and cognitive function poses a major threat to independent living for older adults and their spouses. In particular, rapid functional declines can invoke uncertainties and, possibly, hopelessness about independent living, with little time for adjustment to the situation. Having somebody to rely on when in need is likely to reduce the effects of stress associated with declining function.

Functional decline isn’t always permanent and there can be improvements, especially following a hospitalization and improvement in health conditions and status. However, in some cases where functional decline is not showing any reduction, tools and aids can be implemented, such as:

• Use of assistive devices like a walker, cane, wheelchair, or hearing aids
• Installing handrails, elevated toilet seats, adequate lighting, or medical alert systems

These are ways to help reduce symptoms of functional decline or limit further decline:

• Regular mild to moderate physical activity and exercise
• Ensuring a healthy and balanced diet
• Increasing social engagement with friends, families, or community centers
• Regular health checkups 

All of these tools can be implemented to help reduce symptoms of functional decline or cope with lasting symptoms of functional decline. Some of these are also beneficial to use for safety and prevention of falls (like handrails, lighting, and changes in the home for increased safety). 

How is Functional Decline Alike and Different From Transitional Decline:

In a previous article on Senior Industry Services, we discussed transitional decline. We know we’ve thrown a lot of terms at you today, including cognitive decline, functional decline, and now transitional decline. But, they are all important to know and be able to differentiate between. 

Transitional decline describes a period of vulnerability during which an older adult experiences difficulty adapting to a major change in health, environment, routine, or life circumstances. This type of decline can occur alongside either, or both, functional decline and cognitive decline. This type of decline differs from functional decline because it is based on the mental state of a senior, rather than the physical and functional aspects. 

Similar to functional decline, transitional decline is also often temporary and can often occur after a hospitalization. Both are also aided by support from friends, family members, and/or caregivers. Having a strong support system can make a world of difference. 

How Senior Industry Services can help:

Senior Industry Services is here to help and support the families of seniors and those who care for them in the Central Texas region. Whether you need answers to a senior care question, want to explore local providers, or are trying to determine what support will help a loved one remain safe at home, SIS offers a safe place to start. 

Our website has everything you need, all in one place, expert insight, trusted resources, and information to help you wherever you are on your journey with your senior loved one. Start with one of our helpful resources such as Senior-AI to get some instant insight, and don’t hesitate to reach out to ask questions or get more information. 

If your loved one has recently been hospitalized and you are noticing signs of functional decline, check out our guide to navigating the Hospital-to-Home transition.

At Senior Industry Services (SIS) it is our goal to make Central Texas the best place for seniors to age. We do this by connecting seniors, families, caregivers, healthcare professionals, and senior care providers throughout Central Texas through education, technology, local resources, and professional collaboration. 

Remember, you are not alone! 

Written for Senior Industry Services by Lauren Hope Bartling

About Senior Industry Services

Senior Industry Services (SIS) is a Central Texas resource connecting seniors, families, caregivers, healthcare professionals, and local businesses through education, technology, and community collaboration.

SIS provides educational articles, Senior-AI tools, a searchable Senior Resource Directory, local service information, community resources, professional networking events, and educational opportunities. 

We explore and educate on topics such as healthy aging, caregiving, senior living, dementia, hospital-to-home transitions, Medicare, Medicaid, Veterans benefits, long-term care planning, and other issues affecting seniors and their families.

Senior Industry Services serves communities across Central Texas, including Austin, Round Rock, Georgetown, Cedar Park, Pflugerville, Lakeway, Buda, Kyle, Bastrop, Dripping Springs, Marble Falls, Burnet, Temple, Belton, Killeen, Harker Heights, Waco, San Marcos, New Braunfels, Canyon Lake, Bryan–College Station, and surrounding areas.

Whether you’re searching for reliable information, exploring local senior services, using Senior-AI, or looking to connect with trusted professionals, SIS is designed to be a central online resource for aging and senior care throughout Central Texas! Explore our website to learn more about all we have to offer to families, seniors, and senior care professionals in Central Texas!

About the Author

Lauren Hope Bartling is a content writer for Senior Industry Services & Oasis Senior Advisors of Austin and Central Texas. She searches and writes educational content focused on healthy aging, caregiving, healthcare, senior living, and community resources. Her goal is to help seniors, families, caregivers, and healthcare professionals better understand the challenges of aging through accurate, practical, and easy-to-understand information that supports informed decision-making.

References:

Activities of Daily Living. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK470404/

Colón-Emeric, C. S., Whitson, H. E., Pavon, J., & Hoenig, H. (2013). Functional decline in older adults. American Family Physician, 88(6), 388–394.

Fogel, A., Walsh, C., Fletcher-Lloyd, N. et al. Predicting rates of cognitive and functional decline in Alzheimer’s disease and mild cognitive impairment. Commun Med 6, 193 (2026). https://doi.org/10.1038/s43856-026-01432-w 

Muramatsu, N., Yin, H., & Hedeker, D. (2010). Functional declines, social support, and mental health in the elderly: does living in a state supportive of home and community-based services make a difference?. Social science & medicine (1982), 70(7), 1050–1058. https://doi.org/10.1016/j.socscimed.2009.12.005

Reviewed by Dr. Alice Pomidor, M. (2024, October 16). How to notice signs of functional decline in older adults: MedBox: Medications sorted by dose: Full-service pharmacy. MedBox. https://medbox.com/how-to-notice-signs-of-functional-decline-in-older-adults/ 

What is functional decline?. SA Health. (2022, April 3). https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/clinical+resources/clinical+programs+and+practice+guidelines/older+people/care+of+older+people+toolkit/what+is+functional+decline