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Objective This study examines the relationships between hearing impairment and cognitive function among older adults, and whether that association is mediated by loneliness and social isolation. Methods Data were drawn from English Longitudinal Study of Ageing (ELSA) wave two (2004/2005) until wave seven (2014/2015). The study sample consisted of 8,199 individuals aged 50 years or older. Cognitive function was measured using episodic memory. We performed analysis using a generalized structural equation modeling (GSEM) technique. Results GSEM analysis shows that the direct effect of hearing impairment on episodic memory was negative and significant (β = −0.29, p

Purpose The purpose of this paper is to understand the impact of religiosity on civic engagement in the health sector through giving advocacy for people with AIDs, mental health, cancer and disability. Design/methodology/approach The authors achieve this aim by proposing a structural equation model, which was derived based on literature. The data collection involved an on-line purposive sampling survey, which targeted young people who intend to work in the health sector. The survey asked about the experience and perception of 610 respondents in Indonesia. Findings The results indicate that the respondents with high religiosity were identified to be more caring towards those who suffer from mental health, AIDs, cancer and disability. However, the highly religious were less motivated by empathy in conducting civic engagement in the health sector. In this study, the impact of religiosity on civic engagement was found to be stronger for those who identified with low materialism. Originality/value The study contributes to the discussion on altruistic theory by challenging the widespread assumption that feelings of empathy drive civic engagement. The results extend the discussion on how to promote civic engagement in the health sector for young people with high materialism attitude.

ObjectiveThe levels of health enjoyed by individuals vary according to socio-economic status, and inflammation has been proposed as one pathway through which socio-economic status influences health in high-income countries. However, little is known regarding the social determinants of inflammation in low- and middle-income countries. This study investigated the association between socio-economic status and C-reactive protein (CRP) in England and Indonesia.MethodsThis study used data from 4923 respondents aged 50+ in the English Longitudinal Study of Ageing and from 1812 respondents from the Indonesian Family Life Survey at baseline. The sources of information on individuals’ education attainment, wealth, CRP and other covariates were ELSA Waves 2, 4 and 6, and IFLS Waves 4 and 5. Linear mixed models were performed to identify the longitudinal relationships between socio-economic status and CRP, and joint models were used to deal with bias in longitudinal ageing surveys due to attrition.ResultsRespondents with high school education (β = −0.036, p

This study aims to examine whether maternal smoking, birth weight, birth month and breastfeeding are associated with COVID-19 infection and hospitalisation. Maternal smoking was positively associated with COVID-19 infection. Breastfeeding was negatively associated with COVID-19 infection. The odds of being hospitalised due to COVID-19 were higher among those who had lower birthweight and mothers who were smoking during pregnancy.

Objectives Frequent social contact benefits cognition in later life although evidence is lacking on the potential relevance of the modes chosen by older adults, including those living with hearing loss, for interacting with others in their social network. Method 11,418 participants in the English Longitudinal Study of Ageing provided baseline information on hearing status and social contact mode and frequency of use. Multilevel growth curve models compared episodic memory (immediate and delayed recall) at baseline and longitudinally in participants who interacted frequently (offline only or offline and online combined), compared to infrequently, with others in their social network. Results Frequent offline (B = 0.23; SE = 0.09) and combined offline and online (B = 0.71; SE = 0.09) social interactions predicted better episodic memory after adjustment for multiple confounders. We observed positive, longitudinal associations between combined offline and online interactions and episodic memory in participants without hearing loss (B = 0.50, SE = 0.11) but not with strictly offline interactions (B = 0.01, SE = 0.11). In those with hearing loss, episodic memory was positively related to both modes of engagement (offline only: B = 0.79, SE = 0.20; combined online and offline: B = 1.27, SE = 0.20). Sensitivity analyses confirmed the robustness of these findings. Discussion Supplementing conventional social interactions with online communication modes may help older adults, especially those living with hearing loss, sustain, and benefit cognitively from, personal relationships.

Cardiovascular diseases (CVD) are the leading cause of death in Indonesia, and there are large disparities in access to recommended preventative treatments across the country, particularly in rural areas. Technology-enabled screening and management led by community health workers have been shown to be effective in better managing those at high risk of CVD in a rural Indonesian population; however, the economic impacts of implementing such an intervention are unknown. We conducted a modelled cost-effectiveness analysis of the SMARThealth intervention in rural villages of Malang district, Indonesia from the payer perspective over a 10-year period. A Markov model was designed and populated with epidemiological and cost data collected in a recent quasi-randomized trial, with nine health states representing a differing risk for experiencing a major CVD event. Disability-Adjusted Life Years (DALYs) were estimated for the intervention and usual care using disability weights from the literature for major CVD events. Annual treatment costs for CVD treatment and prevention were $US83 under current care and $US144 for those receiving the intervention. The intervention had an incremental cost-effectiveness ratio of $4288 per DALY averted and $3681 per major CVD event avoided relative to usual care. One-way and probabilistic sensitivity analyses demonstrated that the results were robust to plausible variations in model parameters and that the intervention is highly likely to be considered cost-effective by decision-makers across a range of potentially acceptable willingness to pay levels. Relative to current care, the intervention was a cost-effective means to improve the management of CVD in this rural Indonesian population. Further scale-up of the intervention offers the prospect of significant gains in population health and sustainable progress toward universal health coverage for the Indonesian population.

Objectives Up to 90% of people with dementia in long term care (LTC) have hearing and/or vision impairment. Hearing/vision difficulties are frequently under‐recognised or incompletely managed. The impacts of hearing/vision impairment include more rapid cognitive decline, behavioural disturbances, reduced quality of life, and greater care burden. This research investigated LTC staff knowledge, attitudes and practice regarding hearing/vision care needs for residents with dementia. Methods A survey of staff in LTC facilities in England, South Korea, India, Greece, Indonesia and Australia. Respondents used a five‐point scale to indicate agreement or YES/NO response to questions regarding sensory‐cognitive care knowledge (what is known); attitudes (what is thought); practice (what is done). Results Respondents reported high awareness of hearing/vision care needs, although awareness of how to identify hearing/vison difficulties or refer for assessment was low. Most felt that residents were not able to use hearing/vision devices effectively due to poor fit, being poorly tolerated or lost or broken devices. A substantial minority of respondents reported low confidence in supporting use of assistive hearing/vision devices, with lack of training the main reason. Most staff did not undertake routine checking of hearing/vision devices, and it was rare for facilities to have designated staff responsible for sensory needs. Variation among countries was not significant after accounting for staff experience and having received dementia training. Conclusions There is a need to improve sensory support for people with dementia in LTC facilities internationally. Practice guidelines and training to enhance sensory‐cognitive knowledge, attitudes and practice in professional care teams is called for., Key points A survey of long term care (LTC) staff in six countries care revealed similar limitations in capacity to support residents with hearing/vision needsBetter capacity to support hearing/vision needs of people with dementia was associated with longer experience working in LTC and having received training in dementia awarenessPractice guidelines, training and fostering a long‐term professional work force could optimise support for hearing/vision needs for people living in LTC

Background Little attention has been paid to whether CBHIs improve awareness, treatment and control of hypertension in the contexts of low- and middle- income countries (LMICs). This study therefore aims to examine participation in CBHIs for non-communicable diseases (NCDs) and its association with awareness, treatment, and control of hypertension among Indonesians. Methods This study used data from the 2014 Indonesia Family Life Survey (IFLS), drawn from 30,351 respondents aged 18 years and older. Participation in CBHIs was measured by respondents’ participation in CBHIs for NCDs (Posbindu PTM and Posbindu Lansia) during the 12 months prior to the survey. Logistic regressions were used to identify the relationships between participation in CBHIs for NCDs and awareness, treatment, and control of blood pressure among respondents with hypertension. Results The age-adjusted prevalence of hypertension was 31.2% and 29.2% in urban and rural areas, respectively. The overall age-adjusted prevalence was 30.2%. Approximately 41.8% of respondents with hypertension were aware of their condition, and only 6.6% of respondents were receiving treatment. Participation in CBHIs for NCDs was associated with 50% higher odds of being aware and 118% higher odds of receiving treatment among adults with hypertension. There was no significant association between participation in CBHIs for NCDs and controlled hypertension. Conclusion Our data emphasise the importance of CBHIs for NCDs to improve the awareness and treatment of hypertension in the Indonesian population.

Tobacco is well known as a risk factor for early morbidity and mortality worldwide. However, the relative risk of mortality and the effects of smoking vary among the countries. Indonesia, as one of the world’s largest market for smoking tobacco, is significantly affected by tobacco-related illness. Previous research has shown that smoking causes several diseases, including stroke, neoplasm and coronary heart disease. There has to date been no research on the hazard risk of smoking for all-cause mortality in Indonesia. This study aimed to identify the association between smoking and all-cause mortality rates in Indonesia. Information from a total of 3,353 respondents aged 40 years and older was collected in this study. The data were taken from the Indonesian Family Life Survey (IFLS) Wave 4 (2007) to collect personal information and determine smoking status and from Wave 5 (2015) to collect information about deaths. Current smokers make up 40.3% of Indonesia’s population. Current smokers were more likely to have a higher risk of all-cause death (hazard ratio = 1.48, 95% confidence interval = 1.11 to 1.98) than non-current smokers. The number of smokers in Indonesia remains high and is expected to increase gradually every year. A firm government policy is needed to reduce the number of smokers in Indonesia which would automatically reduce the health problem of smoking-related illness in the future.

Although 91% of 12&ndash, 23-month-old children in Indonesia received at least one immunization in 2013, only 76% completed DTP3 immunization. This percentage is below the UNICEF and WHO recommended standards. Thus, this study aims to investigate trends, spatial disparities, and social determinants related to low coverage of DTP3 immunization in Indonesia. Using a multilevel approach, we analyzed data from 305,090 12&ndash, 23-month-old children living across approximately 500 districts in Indonesia to study demand and supply factors determining DTP3 immunization status. We examined unique, nationally representative data from the National Socioeconomic Survey (Survei Sosial Ekonomi Nasional or Susenas) and Village Potential Census (Potensi Desa or Podes) from 2004 to 2016. The percentage of children receiving complete DTP3 immunization increased from 37.8% in 2004 to 75.9% in 2016. Primarily income, parity status, and education, showed influence on DTP3 coverage. Among individual-level factors, the presence of a professional birth attendant was the most influential factor. At the district level, the factors varied. Low progress in DTP3 immunization status in Indonesia is due to huge disparities across the country&rsquo, s islands, in the density of health services, and in household socioeconomic status.

Objective: This article aims to examine community long-term care (LTC) in Indonesia by drawing upon the five principles of human right provision: availability, accessibility, acceptability, quality, and universality. Method: We used a qualitative approach with exploratory multiple case studies in three different areas in East Java Province, Indonesia. This study gathered the initial evidence using a report card approach with self-report questionnaires. In-depth interviews and focus group discussions were carried out to understand factors that affect the efficacy of LTC services. Results: The Indonesia Government imposed a regulation that required each local community to make community health services available for the elderly. By managing the integrated post, the community provided LTC service for the elderly. Community leadership played a pivotal role to make LTC services available. Improving the services with religious activities was essential to improving the acceptability, but it also needed to take into consideration universality and nondiscrimination principles. Results show that LTC services are difficult to expand and quality standards are difficult to raise, due to challenges such as few community members volunteering their services, lack of support from religious leaders, limited resources, and inadequate volunteer training. Discussion: This study highlights the role of community engagement in LTC services and shows that it is difficult to succeed without adequate government support. Improving services with creative and culturally acceptable activities is necessary.

Objectives: To test whether hearing aid use alters cognitive trajectories in older adults. Design: US population-based longitudinal cohort study. Setting: Data were drawn from the Health and Retirement Study (HRS), which measured cognitive performance repeatedly every 2 years over 18 years (1996–2014). Participants: Adults aged 50 and older who who took part in a minimum of 3 waves of the HRS and used hearing aids for the first time between Waves 4 and 11 (N=2,040). Measurements: Cognitive outcomes were based on episodic memory scores determined according to the sum of immediate and delayed recall of 10 words. Results: Hearing aid use was positively associated with episodic memory scores (β=1.53, p

Highlights • We investigated the implications of heterogeneous cohort composition on depression trajectories of older adults in the United States and England, using the growth curve model to draw trajectories over a decade. The findings showed for the first time that the trajectories of depression in later life are radically different for different cohorts living at the same time in the early 21st century. • The trajectories of depression of older cohorts, particularly those of the prewar cohorts in both countries and the war cohort in England, followed a U-shape. Conversely, the trajectories of depression of the younger cohort, particularly those of the postwar cohorts in both countries and the war cohort in the United States, took an inverted U-shape., Objective This study aims to investigate the implications of the heterogeneous cohort composition on depression trajectories of older adults in the United States and England. Methods Using growth curve models to identify depressive symptom trajectories and data spanning six waves over 10 years (2002–2012) from the U.S. Health Retirement Study and the English Longitudinal Study of Ageing, community-dwelling Americans and Britons aged 50 years and older were studied. Depressive symptoms were measured using the eight-item Center for Epidemiologic Studies Depression Scale. Results The sample included 11,919 respondents (7,095 women [59.53%]) in the United States and 10,606 respondents (5,802 women [54.7%]) in England aged 50 and older. Older cohorts were shown to have higher depressive symptoms than younger cohorts in the United States and England. The trajectories of depression of older cohorts, particularly those of the prewar cohorts in both countries and the war cohort in England, followed a U-shape. Conversely, the trajectories of depression of the younger cohort, particularly those of the postwar cohorts in both countries and the war cohort in the United States, took an inverted U-shape. Conclusion The trajectories of depression in later life between cohorts took different shapes. This finding may lead to the development of more cost-effective policies for treating depression in later life.

Introduction:Social and economic conditions in childhood have been found to predict cognitive ability in midlife and old age in high-income countries. This study examines the long-term effect of childhood conditions on cognition among a nationally representative sample of older adults in a low- and middle-income country.Materials and Methods:Data were obtained from the 2014 to 2015 Indonesia Family Life Survey Wave 5 (6676 respondents, aged 50 years and older). Cognitive function was assessed based on total score on a series of tests adapted from the Telephone Interview for Cognitive Status. Retrospective information was collected on childhood poverty, with questions including whether respondents ever experienced hunger before age 15, whether basic facilities were available, and the number of books in the childhood home. We used linear regression to examine the association between childhood conditions and cognitive function in later life.Results:The findings show that the numbers of facilities and books available in childhood homes are substantially associated with cognition in later life after taking adulthood characteristics into account. Childhood hunger has no significant association with cognitive ability in later life. Belonging to an older birth cohort and living in a rural area were shown to have negative associations with cognitive ability in Indonesia.Conclusions:Our findings suggest that childhood poverty, birth cohort, and living in a rural area may contribute to cognitive aging in Indonesia. Policies and interventions that target childhood poverty in developing countries may also recognize the rural–urban divide in access to educational and other socioeconomic resources.

Importance Cardiovascular diseases (CVDs) are the leading cause of disease burden in Indonesia. Implementation of effective interventions for CVD prevention is limited. Objective To evaluate whether a mobile technology–supported primary health care intervention, compared with usual care, would improve the use of preventive drug treatment among people in rural Indonesia with a high risk of CVD. Design, Setting, and Participants A quasi-experimental study involving 6579 high-risk individuals in 4 intervention and 4 control villages in Malang district, Indonesia, was conducted between August 16, 2016, and March 31, 2018. Median duration of follow-up was 12.2 months. Residents 40 years or older were invited to participate. Those with high estimated 10-year risk of CVD risk (previously diagnosed CVD, systolic blood pressure [BP] >160 mm Hg or diastolic BP >100 mm Hg, 10-year estimated CVD risk of 30% or more, or 10-year estimated CVD risk of 20%-29% and a systolic BP >140 mm Hg) were followed up. Interventions A multifaceted mobile technology–supported intervention facilitating community-based CVD risk screening with referral, tailored clinical decision support for drug prescription, and patient follow-up. Main Outcomes and Measures The primary outcome was the proportion of individuals taking appropriate preventive CVD medications, defined as at least 1 BP-lowering drug and a statin for all high-risk individuals, and an antiplatelet drug for those with prior diagnosed CVD. Secondary outcomes included mean change in BP from baseline. Results Among 22 635 adults, 3494 of 11 647 in the intervention villages (30.0%; 2166 women and 1328 men; mean [SD] age, 58.3 [10.9] years) and 3085 of 10 988 in the control villages (28.1%; 1838 women and 1247 men; mean [SD] age, 59.0 [11.5] years) had high estimated risk of CVD. Of these, follow-up was completed in 2632 individuals (75.3%) from intervention villages and 2429 individuals (78.7%) from control villages. At follow-up, 409 high-risk individuals in intervention villages (15.5%) were taking appropriate preventive CVD medications, compared with 25 (1.0%) in control villages (adjusted risk difference, 14.1%; 95% CI, 12.7%-15.6%). This difference was driven by higher use of BP-lowering medication in those in the intervention villages (1495 [56.8%] vs 382 [15.7%]; adjusted risk difference, 39.4%; 95% CI, 37.0%-41.7%). The adjusted mean difference in change in systolic BP from baseline was −8.3 mm Hg (95% CI, −10.1 to −6.6 mm Hg). Conclusions and Relevance This study found that a multifaceted mobile technology–supported primary health care intervention was associated with greater use of preventive CVD medication and lower BP levels among high-risk individuals in a rural Indonesian population.

BackgroundThe brunt of cardiovascular disease (CVD) burden globally now resides within low- and middle-income countries, including Indonesia. However, little is known regarding cardiovascular health in Indonesia. This study aimed to estimate the prevalence of elevated CVD risk in a specific region of Indonesia.MethodsWe conducted full household screening for cardiovascular risk factors among adults aged 40 years and older in 8 villages in Malang District, East Java Province, Indonesia, in 2016-2017. 10-year cardiovascular risk scores were calculated based on the World Health Organization/International Society of Hypertension's region-specific charts that use age, sex, blood pressure, diabetes status and smoking behaviour.ResultsAmong 22,093 participants, 6,455 (29.2%) had high cardiovascular risk, defined as the presence of coronary heart disease, stroke or other atherosclerotic disease; estimated 10-year CVD risk of ≥ 30%; or estimated 10-year CVD risk between 10% to 29% combined with a systolic blood pressure of > 140 mmHg. The prevalence of high CVD risk was greater in urban (31.6%, CI 30.7-32.5%) than in semi-urban (28.7%, CI 27.3-30.1%) and rural areas (26.2%, CI 25.2-27.2%). Only 11% and 1% of all the respondents with high CVD risk were on blood pressure lowering and statins treatment, respectively.ConclusionsHigh cardiovascular risk is common among Indonesian adults aged ≥40 years, and rates of preventive treatment are low. Population-based and clinical approaches to preventing CVD should be a priority in both urban and rural areas.

The relationships between older age and sleep efficiency have traditionally been assessed using cross-sectional studies that ignore changes within individuals as they age. This research examines the determinants of sleep efficiency, the heterogeneity in an individual's sleep efficiency trajectory across a period of up to 27 years in later life and its associations with health. The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age cohort (n = 6,375; age 42-94 years) was used in this study. Depression and health data were collected using self-report validated instruments (Cornell Medical Index, Beck Depression Inventory and Geriatric Depression Scale). Longitudinal sleep and sociodemographic data were collected using a study-specific self-report questionnaire. A mixed-effect model was performed for sleep efficiency with adjustments for time-invariant and time-variant predictors. Latent class analysis was used to demonstrate subgroups of sleep efficiency trajectories and associations between sleep efficiency clusters and health history of the participants were investigated. Older adults have decreased sleep efficiency over time, with 18.6% decline between 40 and 100 years of age. Three sleep efficiency trajectory clusters were identified: high (32%), medium (50%) and low sleep efficiency (18%). Belonging to the high sleep efficiency cluster was associated with having lower prevalence of hypertension, circulatory problems, general arthritis, breathing problems and recurrent episodes of depression compared to the low efficiency cluster. Overall, ageing decreases sleep efficiency. However, there are detectable subgroups of sleep efficiency that are related to prevalence of different diseases.

Evening-oriented sleep timing preferences have been associated with risk of diabetes, cardiovascular diseases, obesity, psychiatric disorders, and increased mortality. This research aims to explore the relationship between diurnal preferences (chronotype), daily habits, metabolic health, and mortality, using longitudinal data from The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age (6375 participants at inception, recruited in the North of England) with a long follow-up period (up to 35.5 years). Mixed models were used to investigate the influence of aging, socio-demographic, and seasonal factors on sleep timing. Results show that sleep timing shifted towards earlier time with aging. Test seasons influence chronotype of older adults but working schedules challenge seasonality of sleep timing. Moreover, the season of birth may set chronotype in adulthood. Individual chronotype trajectories were clustered using latent class analysis and analyzed against metabolic health and mortality. We observed a higher risk of hypertension in the evening-type cluster compared to morning-type individuals (Odds ratio = 1.88, 95%CI = 1.02/3.47, p = .04). Evening-type cluster was also associated with traits related to lower health such as reduced sport participation, increased risk of depression and psychoticism personality, late eating, and increased smoking and alcohol usage. Finally, Cox regression of proportional hazards was used to study the effects of chronotype on longevity after adjusting for sleep duration, age, gender, smoking, alcohol usage, general health, and social class. The survival analysis (82.6% censored by death) revealed that evening-type chronotype increased the likelihood of mortality (Hazard ratio = 1.15, 95%CI = 1.04/1.26, p = .005). Taken together, chronotype is influenced by aging and seasonal effects. Evening-type preference may have detrimental outcomes for human well-being and longevity.

This study aims to investigate the consequences of corporatisation on organisational commitment and to explain the relationship between work values, job satisfaction and organisational commitment. The research was carried out in 54 public hospitals in East Java, Indonesia, applying a multilevel structural equation model to survey data on 1282 workers in those hospitals. Analysis suggests that the longer a hospital has been corporatised, the greater the organisational commitment of its employees. Incentives have positive and substantive association with organisational commitment, while training and resource availability do not. We found that employees in larger hospitals are more committed than those in smaller hospitals and that work values and job satisfaction have a positive and significant relationship with organisational commitment. Our findings shed light on the debate on corporatisation as a lever for improving organisational commitment in public hospitals in developing countries.

Background Visual impairment has been associated with lower cognitive ability among older adults, yet little is known about whether improving visual function with cataract surgery would be associated with slower cognitive decline. This study aimed to assess whether trajectories of cognitive decline differed before and after cataract surgery and compare those trajectories between older adults with cataract surgery and without cataract. Methods and findings Data were drawn from the English Longitudinal Study of Ageing (ELSA) Wave 1 (2002/03) until Wave 7 (2014/15). The study population consisted of 2,068 individuals who underwent cataract surgery between Wave 2 and Wave 6 as the treatment group and 3,636 individuals with no cataract as the control group. We included only respondents who took part in a minimum three waves. Propensity score matching method was used to match the individuals in the treatment group with those in the control group. After we put an “artificial” intervention point for the individuals in the control group at the point that the matched person has cataract surgery, spline method was used to identify differences in cognitive trajectories pre- and post-cataract surgery. In the treatment group, we found that cataract surgery was positively associated with episodic memory scores after controlling for the potential covariates (β = 4.23, p

BackgroundImmunization is one of the most cost-effective public health interventions to prevent children from contracting vaccine-preventable diseases. Indonesia launched the Expanded Program for Immunization (EPI) in 1977. However, immunization coverage remains far below the United Nations International Children’s Emergency Fund (UNICEF) and World Health Organization (WHO) target of 80%. This study aims to investigate the determinants of complete immunization status among children aged 12–23 months in Indonesia.MethodsWe used three waves of the Indonesian National Socioeconomic Survey (2008, 2011, and 2013) and national village censuses from the same years. Multilevel logistic regression was used to conduct the analysis.ResultsThe number of immunized children increased from 47.48% in 2008 to 61.83% in 2013. The presence of health professionals, having an older mother, and having more educated mothers were associated with a higher probability of a child’s receiving full immunization. Increasing the numbers of hospitals, village health posts, and health workers was positively associated with children receiving full immunization. The MOR (median odds ratio) showed that children’s likelihood of receiving complete immunization varied significantly among districts.ConclusionsBoth household- and district-level determinants were found to be associated with childhood immunization status. Policy makers may take these determinants into account to increase immunization coverage in Indonesia.

Introduction: highly prevalagent hearing and vision sensory impairments among older people may contribute to the risk of cognitive decline and pathological impairments including dementia. This study aims to determine whether single and dual sensory impairment (hearing and/or vision) are independently associated with cognitive decline among older adults and to describe cognitive trajectories according to their impairment pattern.Material and methods: we used data from totals of 13,123, 11,417 and 21,265 respondents aged 50+ at baseline from the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA) and the Survey of Health, Ageing and Retirement in Europe (SHARE), respectively. We performed growth curve analysis to identify cognitive trajectories, and a joint model was used to deal with attrition problems in longitudinal ageing surveys.Results: respondents with a single sensory impairment had lower episodic memory score than those without sensory impairment in HRS (β = -0.15, P < 0.001), ELSA (β= -0.14, P< 0.001) and SHARE (β= -0.26, P < 0.001). The analysis further shows that older adults with dual sensory impairment in HRS (β= -0.25, P < 0.001), ELSA (β= -0.35, P< 0.001) and SHARE (β= -0.68, P < 0.001) remembered fewer words compared with those with no sensory impairment. The stronger associations between sensory impairment and lower episodic memory levels were found in the joint model which accounted for attrition.Conclusions: hearing and/or vision impairments are a marker for the risk of cognitive decline that could inform preventative interventions to maximise cognitive health and longevity. Further studies are needed to investigate how sensory markers could inform strategies to improve cognitive ageing.