When an Elder Sim overexerts, they will get a strong uncomfortable moodlet that lasts four hours. This death only affects Elder Sims who perform frequent strenuous activities, such as lifting weights, running, or woohooing. But, for those who want to play the game with all the default choices intact and without cheats, players are likely to see the Grim Reaper eventually.
Players can also make their Sims entirely immortal through cheats. Players have the option to extend a Sim's lifespan in the game options menu or by purchasing the Potion of Youth for 1500 Satisfaction Points from completing levels of an Aspiration or fulfilling whims.
Sims, like people, grow old and eventually will die of old age. Players have the best chance of encountering one of these during their playthroughs. The base game for The Sims 4 comes with ten possible avenues for death, ranging from the mundane and expected Old Age (the most likely death players will experience in the game), to the significantly stranger Death by Cow Plant.