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People with specific health profiles and diseases (such as diabetes, lung and heart conditions) have been classified as ‘clinically vulnerable’ (CV) to Covid-19, i.e. at higher risk of severe illness and mortality from Covid-19, and were targeted for shielding. However, there is as yet little evidence on how the pandemic and shielding impacted the health and social well-being of CV older people. Using data from Wave 9 (2018/19) and the first Covid-19 sub-study (June/July 2020) of the English Longitudinal Study of Ageing, we investigated changes in health and well-being during the pandemic by clinical vulnerability. We also explored the interactions between CV and age-group (50s, 60s, 70s, 80+), and between CV and shielding. Results suggest that CV older people (~39% of the sample) were more likely to report worse health and social well-being outcomes during the pandemic compared to non-CV participants, even considering pre-pandemic levels of health and well-being. However, changes in health were not uniform across age groups, with those in their 50s and 60s more likely to report greater deterioration in mental health than those in their 70s and over 80. Moreover, older adults who were shielding and were CV reported the most substantial rises in anxiety, depression, receipt of formal care as well as decreases in well-being and physical activity. While policies focussing on shielding CV older people reduce rates of hospitalisation and death from Covid-19, policymakers should address the wider needs of this group if their long-term health and social well-being are not to be compromised.

Both hearing and vision impairments are some of the most common deficits experienced by older adults. We examined the impact of self-reported vision and hearing impairments on disability-free life expectancy (DFLE). We used harmonized data from the Gateway to Global Aging Data from the US Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA). We used discrete-time multistate life table models to estimate disability-free life expectancy by sex, age and country. In both countries and at all ages either vision or hearing impairment was associated with shorter DFLE compared to those who reported no impairments. Reporting both vision and hearing impairments reduced DFLE. For example, at the age of 50, men and women with both vision and hearing impairments could expect to live up to 12 fewer years free from disability compared with men and women with no impairments, similar results were found in both countries.

Decreased walking speed can predict adverse health-related outcomes such as falls and admissions to hospital. Experiencing fast decline in walking speed has also been associated with increased risk of ‘all-cause’ mortality. In this study, we investigate the links between walking speed trajectories and specific causes of death. We used data from the English Longitudinal Study of Ageing, a large nationally representative survey which collects information biennially on people aged 50 and over in England since 2002. The sample consisted of 4,112 respondents eligible for a walking speed test at baseline who had not died before 2006. Rate of change in walking speed was derived from growth curve models and categorised in three trajectories (slow, moderate, and fast decline). We used competing risk analysis to explore the relationships between these trajectories and mortality, and their interactions with baseline wealth. During a mean of 9.5 years of follow-up, 1543 participants (37%) died (639 from cardiovascula disease -CVD, 311 from respiratory disease -RD, and 593 from cancer). Results suggest a significant difference in mortality across walking speed trajectories (with increased risk of death among those with fast declines) for CVD and RD deaths (P1.22 m/s). Strategies to maintain motor performances in later life have the potential to preserve life.