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Sleep problems and subjective cognitive complaints among middle-aged and older adults in 45 low- and middle-income countries

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Abstract

Background

Currently, a small body of evidence suggests that sleep problems are positively associated with subjective cognitive complaints (SCC). However, no studies on this topic exist from low- and middle-income countries (LMICs). Thus, we investigated the association between sleep problems and SCC in a large sample of middle-age and older adults from 45 LMICs.

Methods

Cross-sectional, predominantly nationally representative, community-based data were analyzed from the World Health Survey. Sleep problems (such as difficulties falling asleep, waking up frequently during the night or waking up too early in the morning) in the last 30 days were self-reported. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). Multivariable linear regression was conducted to explore the association between sleep problems (exposure) and SCC (outcome).

Results

Data on 60,228 adults aged ≥ 50 years were analyzed [mean (SD) age 61.4 (9.9) years; 53.9% females]. After adjustment for potential confounders, compared to those without sleep problems, the mean SCC score for the multivariable model was 13.32 (95% CI 12.01, 14.63), 19.46 (95% CI 17.95, 20.98), 24.17 (95% CI 22.02, 26.33), and 31.39 (95% CI 28.13, 34.65) points higher for mild, moderate, severe, and extreme sleep problems, respectively. Similar results were found for analyses stratified by age and country-income level.

Conclusion

Sleep problems were positively associated in a dose–response manner with SCC among middle-aged and older adults in multiple LMICs. Addressing sleep problems may aid in the prevention of SCC and ultimately dementia, pending future longitudinal research.

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Authors and Affiliations

  1. Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK

    Lee Smith, Laurie Butler & Yvonne Barnett

  2. Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA

    Hans Oh

  3. Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, 42, 08830, Sant Boi de Llobregat, Barcelona, Spain

    Louis Jacob & Ai Koyanagi

  4. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain

    Louis Jacob & Ai Koyanagi

  5. Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France

    Louis Jacob

  6. Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, 30100, Espinardo, Murcia, Spain

    Guillermo F. López-Sánchez

  7. Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy

    Nicola Veronese

  8. Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), Fatih, 34093, İstanbul, Turkey

    Pinar Soysal

  9. Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea

    Jae Il Shin

  10. Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil

    Felipe Schuch

  11. School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Newtownabbey, BT37 0QB, Northern Ireland, UK

    Mark A. Tully

  12. ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain

    Ai Koyanagi

Authors
  1. Lee Smith
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  2. Hans Oh
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  6. Pinar Soysal
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Corresponding author

Correspondence to Guillermo F. López-Sánchez.

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Ethical standards

The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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Ethical approval for the survey was provided by ethical boards at each study site.

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All human and animal studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Smith, L., Oh, H., Jacob, L. et al. Sleep problems and subjective cognitive complaints among middle-aged and older adults in 45 low- and middle-income countries. Aging Clin Exp Res 34, 1285–1293 (2022). https://doi.org/10.1007/s40520-021-02052-1

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  • DOI: https://doi.org/10.1007/s40520-021-02052-1

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