Getting Older: Aging in D&D 5E
Some time back I began a D&D 5E campaign based in part on the Kalder campaign setting, and just this past week it took an interesting turn. While battling the vengeful spirit of a long-dead werewolf-slaying knight the party's barbarian fell prey to the Ghost's Horrifying Visage ability and aged 40 years, bringing her right up against her life expectancy. The party cleric being unable to cast Greater Restoration, the aging was permanent.
Flipping through the Dungeon Master's Guide after the session to deal with the aftermath of the adventure, I discovered that 5e flat out has no rules for aging. Talking it over with the barbarian's player, we both agreed that aging 40 years in a matter of seconds should have some mechanical effect, but were dissatisfied with how D&D, Pathfinder, and similar games usually handle aging. So I did the only thing that's ever made sense and wrote up my own rules to handle the situation.
The rules below are meant to apply to characters aging for any reason, be it the normal progression of time, the abnormal progression of time in another plane, or accelerated aging caused by a curse of other supernatural effect. Under normal circumstances aging cannot be reversed except by divine intervention or potent magic such as a Wish spell. However, if the aging is caused by an effect that allows a save, such as the Horrifying Visage ability above, it can be reversed with greater restoration or similar magic at the DM's discretion.
Aging
For every 10 years a character ages roll a d4 twice on the Aging Effects Table, once to determine the effect on the character’s mental attributes and once to determine the effect on the character’s physical attributes. If the character exceeds the maximum lifespan for their race, they must make a Constitution saving throw (DC of 15 + 1 per year in excess of their lifespan). On a failed save the creature dies of natural causes in 1d20x days. A character tending to the aging character’s needs with proficiency in the Medicine skill can use their skill in place of the aging character’s Constitution save. Repeat this check every time the character ages 1 year, preferably on their birthday.
Aging Effects Table
1d4
1 - Increase Charisma by 1/Decrease Constitution by 1
2 - Inctrease Intelligence by 1/Decrease Dexterity by 1
3 - Increase Wisdom by 1/Decrease Strength by 1
4 - Attribute unnafected.