Gender-specific associations between sleep quality, sleep duration and cognitive functioning among older Indians: findings from WHO-SAGE study

Abstract

Background Sleep is an essential component of human health and well-being, playing a crucial role in several cognitive processes, including attention, memory, and executive function. In this study, we aimed to examine the association between sleep quality, sleep duration and cognitive functioning among older men and women in India. Methods Data come from the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE), India wave-2, which was conducted in 2015 in six selected states of India, representing different country regions. The sample included 6,396 older adults aged 50 years and above. We used multivariable linear regression models to examine the associations between sleep quality, sleep duration and cognitive function, separately among older men and women. Results Older men and women with poor sleep and short duration sleep had lower mean scores of cognition than their peers with good sleep and age-appropriate sleep duration. Poor sleep (aCoef: -5.09, CI: -8.66, -1.51) and short duration sleep (aCoef: -5.43, CI: -7.77, -3.10) were negatively associated with cognitive functioning among older men and the associations remained significant among older men with poor sleep (aCoef: -2.39, CI: -3.78, -1.00) and short duration sleep (aCoef: -4.39, CI: -6.46, -2.31) after adjusting for a large number of socio-demographic, health and behavioral factors. Similarly, poor sleep (aCoef: -3.15, CI: -5.79, -0.52) and short duration sleep (aCoef: -2.72, CI: -4.64, -0.81) were associated with cognitive functioning among older women, however, the associations were insignificant when the potential confounders were adjusted. Conclusions This study provides evidence for the significant association between sleep health and cognitive functioning in older Indian adults, especially older men, with poor sleep quality and insufficient sleep duration being detrimental to their cognitive health. Healthcare providers should routinely screen for sleep quality and age-appropriate sleep duration in their older adult patients and consider sex/gender-tailored sleep interventions as part of cognitive health management strategies.