Relationship between Multidimensional Sleep Health and Cognitive Function in Older Adults in Nursing Homes: A Cross-Sectional Study

Abstract Background As an increasingly prevalent geriatric health issue, mild cognitive impairment (MCI) is a critical transitional stage preceding dementia, with a high risk of progression to dementia but also substantial plasticity for intervention. Sleep problems are prevalent among elderly people in nursing homes and can increase the risk of cognitive impairment in the elderly. Although existing studies have explored the association between sleep problems and cognitive function.However, most previous studies have focused on single sleep characteristics rather than comprehensive sleep health. Methods A cross-sectional study was conducted among 416 older adults aged ≥ 60 years from 3 nursing homes in Wuhan. The Sleep Health Composite Score (Sleep HCS) based on the SATED model (Satisfaction/quality, Alertness, Timing, Efficiency, Duration) was used to assess multidimensional sleep health, while cognitive function was evaluated by using the Montreal Cognitive Assessment Basic Version (MoCA-B). Correlation analysis and binary logistic regression were performed to explore the associations between sleep health and MCI. Results Among participants, 47.35% were diagnosed with MCI, and 70.7% had sleep problems in at least two domains. Sleep HCS was positively correlated with MoCA-B scores (r = 0.141, P < 0.01) and served as an independent protective factor for MCI (adjusted OR = 0.493, 95% CI: 0.366–0.665, P < 0.001). Specifically, poor sleep efficiency (adjusted OR = 1.969, 95% CI: 1.102–3.521, P = 0.022) and abnormal sleep midpoint (adjusted OR = 1.955, 95% CI: 1.142–3.349, P = 0.015) were significantly associated with an elevated risk of MCI. Conclusion Multidimensional sleep health, particularly sleep efficiency and sleep midpoint, is closely associated with the risk of MCI in nursing home-dwelling older adults. The findings highlight the importance of comprehensive sleep health assessment and targeted sleep interventions to delay cognitive decline in this population.