Multidimensional sleep health is associated with mild cognitive impairment in older adults: a cross-sectional study

Abstract

Mild cognitive impairment (MCI) is a transitional stage preceding dementia and may be amenable to early intervention. Although sleep problems are common among older adults and related to cognitive function, most studies have focused on single sleep characteristics rather than multidimensional sleep health. This cross-sectional study included 416 adults aged ≥ 60 years from three nursing homes and two communities in Wuhan, China. Sleep health was assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) to measure the five SATED sleep dimensions. Cognitive function was evaluated using the Montreal Cognitive Assessment Basic Version. Group comparisons and binary logistic regression analyses were used to examine associations between sleep health indicators and prevalent MCI. Overall, 197 participants (47.35%) had MCI, and 294 (70.7%) had unfavorable sleep health in at least two SATED-based dimensions. The non-MCI group had a higher composite sleep health score than the MCI group (Z = −5.051, p  < 0.001). In the fully adjusted model, each one-point increase in the composite sleep health score was associated with lower odds of prevalent MCI (OR = 0.692, 95% CI: 0.553–0.867, p  = 0.001), and grouped analyses showed a significant decreasing trend in the odds of MCI across increasing sleep health score groups (P for trend = 0.004). Among individual sleep dimensions, sleep efficiency showed the most consistent association with MCI after full adjustment (OR = 0.510, 95% CI: 0.301–0.866, p  = 0.013). Better multidimensional sleep health was associated with lower odds of prevalent MCI among older adults. Longitudinal studies are needed to confirm these findings.