What Does It Mean to Die of Old Age or Natural Causes?

Besides superficial changes like laugh lines and gray hair, the natural aging process does cause some changes that make a person more vulnerable. Natural aging causes:

• Loss of muscle mass. A decline in muscle mass is linked to an increased risk of type 2 diabetes, difficulty managing weight, heart disease, and osteoporosis. People with lower muscle mass are more likely to become seriously injured after an accident.^[02]
• Senescent cell accumulation. This causes a constant state of low-level inflammation and prevents the body from regenerating new tissue cells.^[03]
• Shortened telomeres. Telomeres protect DNA from damage, and older people are more likely to have shorter telomeres. This means their DNA may experience more damage, which leads to general frailty.^[04]
• Hormonal changes. A decrease or increase in certain hormones as people age cause a host of issues. Among them are an increase in insulin resistance, a decrease in bone density, and a decline in metabolism.^[05]

These unavoidable changes in the body lower a person’s intrinsic capacity, which makes them more likely to have a serious problem if they get a disease.

For example, a 95-year-old woman experiences hormonal changes that lower her bone density and cause a loss of muscle mass. If she slips on an icy driveway, she’s more likely to break a hip than a 45-year-old with healthy bones and strong muscles. While in the hospital, she may catch a disease like pneumonia. Because she’s already in a weakened state, she’s less likely to survive.

Looking for signs that an elderly loved one needs more support can help prevent these accidents in the first place.

Old age, frailty, and intrinsic capacity

Aging causes a person’s body to undergo some serious changes, and any of these changes can contribute to a person’s eventual death. Scientists use the terms frailty and intrinsic capacity to describe these side effects of aging.^[05] A person’s intrinsic capacity is the reserve of physical and mental abilities to ward off infections, fight diseases, and take care of themselves.

As a person ages, their intrinsic capacity lowers and they become more frail. Intrinsic capacity and frailty aren’t necessarily correlated to age, either. A healthy 80-year-old is less frail than a 25-year-old with cancer. However, most elderly people are more frail than most younger people.

Read more:11 Signs It Might Be Time for Assisted Living

Saying a person “died of old age” can contribute to stigmas around caring for the elderly. Describing a cause of death is always complicated regardless of age, which is why most physicians and coroners often list more than one cause of death on a death certificate.

Problems like ageism, forced retirement, and a lack of geriatric medical care can be prevented with a better understanding of the aging process and how death fits into it. Quality of life in the senior years, too, is becoming more and more important as the number of people over 65 rises in the United States and people continue to live longer than they ever have.

It’s also outdated and inaccurate to say that a person “died of old age.”

People began officially classifying causes of death in the 18th century.^[06] In 1948, the World Health Organization began updating the International Classification of Diseases, which is now in its 11th edition.

In the American version (the ICD-10-CM), “old age” is not listed as a possible cause of death, but it was listed in the edition used in the United Kingdom — that is, until the death of Queen Elizabeth II in 2022, when “old age” was officially removed as a legitimate cause of death. It was replaced with “aging-associated biological decline in intrinsic capacity.”^[07]

The term “natural causes” is another commonly used phrase to describe an elderly person’s death when no obvious cause is identified. When an elderly person dies peacefully in their sleep, many people say “they died of natural causes.”

However, an older person dying in their sleep is likely due to a stroke, heart attack, or blood clot — all of which can be fatal, because elderly people have fewer physical reserves to survive.

The term “natural causes” comes from the five manners of death used by investigators, coroners, and law enforcement.^[08] The five manners of death include:

• Natural. A death is caused by disease or natural processes, such as cancer or a heart attack.
• Accidental. The most common example of an accidental death is a traffic accident.
• Suicide. A person takes their own life.
• Homicide. A person takes another person’s life.
• Undetermined. There not enough evidence to determine the cause of death.

Most deaths in people over 65 are indeed “natural deaths,” because they’re caused by natural factors like disease. But saying someone died of “natural causes” or “old age” isn’t specific and can mislead people into thinking that age itself will cause death.

Let our care assessment guide you

According to the Centers for Disease Control and Prevention, since 2002 the top causes of death for people over 65 are:^[09]

• Heart disease
• Cancer
• Stroke

These three conditions make up about 61% of the deaths of people over 65 in the United States.^[09] Cancer related to tobacco use remains the top preventable cause of death for people over 65. Influenza and pneumonia also continue to cause deaths in the elderly at a higher rate than any other age group, despite access to vaccines to prevent these diseases.

The top causes of death for the elderly have changed dramatically over the last century. In 1900, the leading causes of death for people over 65 were all bacterial or viral diseases:^[09]

• Influenza and pneumonia
• Tuberculosis
• Diarrhea and enteritis

Read more: What to Say to Someone Who Is Grieving

Unlike old age, Alzheimer’s disease or other dementias are listed as an official cause of death in the ICD-CM-10.^[10], and they’re now listed as the fifth most common cause of death in the United States.

You likely know someone who has died from dementia, and if so, you know these deaths are often slow and complex. Usually, a person with severe dementia dies from “self-care deficits.”^[11] This means that a person has stopped eating or drinking and eventually fades away.

Because these deaths are so slow, they can be very emotionally draining for caregivers and loved ones. If you’re caring for someone with late-stage dementia and need support, consider looking into memory care facilities with hospice.