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

Lee Smith, Hans Oh, Louis Jacob, Guillermo F. López-Sánchez, Nicola Veronese, Pinar Soysal, Jae Il Shin, Felipe Schuch, Mark A. Tully, Laurie Butler, Yvonne Barnett, Ai Koyanagi

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)1285-1293
Number of pages9
JournalAging Clinical and Experimental Research
Issue number6
Publication statusPublished - 2022 Jun

Bibliographical note

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Switzerland AG.

All Science Journal Classification (ASJC) codes

  • Ageing
  • Geriatrics and Gerontology


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