(This story was updated to add new information)

Jason Shepherd appreciated being asked to take a picture of Pete Rose with some of his former Cincinnati Reds teammates Sunday after the Music City sports collectibles and autograph show in Franklin, Tennessee, near Nashville.

Rose, in a wheelchair, was surrounded by Dave Concepcion, George Foster, Tony Perez and Ken Griffey Sr. They left the building together after taking the picture.

It might have been the last picture taken of Rose, baseball's all-time hits leader as well as one of its most controversial figures. Rose died on Monday. He was 83.

On Tuesday, the Clark County Office of the Coroner said that Rose died of hypertension and atherosclerotic cardiovascular disease, with diabetes as a contributing factor.

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"Johnny (Bench) was there Saturday but some of Pete's other teammates were there Sunday and they said, 'Hey, let's get together for a picture,' and I was just standing there and was asked to take the picture," said Shepherd, who owns Shep's Cards & Collectibles and served as master of ceremonies at the event. "It was taken right before (Rose) left out the door."

Rose had shown up for every show at the Williamson County Ag Expo since it started in 2020, and Shepherd said Rose was in good spirits on Sunday.

"He said his back was hurting but he got to visit with all his Big Red Machine buddies . . . they were laughing and having a good time," Shepherd said. "Pete was great with the fans as he always is. It was always a highlight for him to be able to talk baseball with anybody at any time."

Rose signed about 200 autographs and posed for even more photos with fans.

One of those fans was Sean Root, who showed up early but still was about 50th in line to meet with Rose. It was the third straight year he asked Rose to sign for him, and he said he noticed a difference in Rose.

"In 2021 when we went, Pete was so much more talkative. He was sitting between Reggie (Jackson) and Wade (Boggs) and Pete looks over and was like, 'Reggie, who'd you hate to face?' and 'Wade, how'd you do against so-and-so?' Me and a friend were like, 'Oh my gosh, can we just sit here for the next hour and listen to them talk baseball?' " Root said.

"Last year I just went by and said hi and he and I talked for a second. In both of those interactions he was very sharp, very on-the-ball. Sunday he seemed somewhat calmer, more distant. I had watched 'Charlie Hustle,' which is a great documentary on HBO Max, and he obviously was not in the health he has been in or was in during his documentary. He was obviously going downhill."

Mark Austin noticed it, too. Austin, who was a Cincinnati fan during the Big Red Machine years in the 1970s, had met Rose a few years back in Las Vegas and they engaged in a lengthy conversation.

"Pete asked where I was from, and I said Nashville, and he said Larry Schmittou (former Nashville Sounds owner)," Austin said. "We sat and talked for about 30 minutes. Sunday was different. I had a coffee table book a friend and I talked about getting signed. I handed (Rose) the book and he signed it and I thanked him for staying engaged with his fans, and he just kind of nodded and raised his right hand."

Austin sent a photo of the autograph to his friend, who said something appeared off.

"I was like, 'Frankly, he did not look good. I think something's wrong,' " Austin said. "It's just age. My dad's getting old, people I know. We're not all what we used to be."