Prevalence of and Factors Associated with Poor Sleep Quality Among Community-Dwelling Older Adults: A Population-Based Cross-Sectional Study

This study aimed to investigate the prevalence of and factors associated with poor sleep quality among community-dwelling older adults. This population-based cross-sectional study was conducted in Matutina, Minas Gerais, Brazil, and included 294 older adults with a mean age of 74.4 ± 7.9 years, of whom 63.9% were women. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Functional capacity was evaluated through basic, instrumental, and advanced activities of daily living, depressive symptoms were assessed using the Geriatric Depression Scale (GDS), and physical activity level and sedentary behavior were evaluated using the long version of the International Physical Activity Questionnaire (IPAQ). Statistical analyses included the Wald chi-square test for bivariate analysis and Poisson regression with robust variance, including variables with p ≤ 0.20 in the multivariable model. The final model was adjusted for sex and age. The prevalence of poor sleep quality was 49.7%. Older adults who were sufficiently physically active had a higher prevalence of good sleep quality (67.6%; p = 0.009), whereas polypharmacy was associated with a higher prevalence of poor sleep quality ( p = 0.002). In the adjusted analysis, depressive symptoms remained independently associated with poor sleep quality (PR: 1.44; 95% CI: 1.14–1.81; p = 0.002), even after adjustment for sex and age. Poor sleep quality was highly prevalent among community-dwelling older adults and was mainly associated with depressive symptoms, female sex, insufficient physical activity, and polypharmacy. These findings highlight the importance of integrated prevention strategies focused on promoting physical activity, monitoring mental health, and optimizing medication use to improve sleep health among older adults.