The details vary a lot in each case. You often have a cascading failure where one issue triggers another issue. In older people you almost always find cancer and pneumonia as part of the reason they die. So you may for example have cancer which reduces the immune system which allows pneumonia to get a hold which fills the lungs with liquid which reduces the amount of oxygen in the blood which can lead to oxygen starvation in the heart muscles which reduces the capacity of the heart which further reduces the amount of oxygen in the blood until the heart stops and all cells in the body is now left without oxygen. The last part of this is true for every death, if the heart stops you can not get oxygen to your cells and unless you can restore blood flow with things like chest compressions you are dead.
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