Association Between Sleep Quality, Loneliness, and Mild Cognitive Impairment Among Elderly Individuals Attending a Tertiary Care Teaching Hospital: A Cross-Sectional Study

Introduction
Population aging has led to an increasing burden of cognitive decline and neuropsychiatric disorders among elderly individuals. Emerging evidence suggests that poor sleep quality and social loneliness may contribute to accelerated cognitive impairment; however, these factors remain underrecognized in routine geriatric evaluation, particularly in low- and middle-income countries. This study aimed to assess the association between sleep quality, loneliness, and mild cognitive impairment among elderly individuals attending a tertiary care teaching hospital.

Methods

A hospital-based cross-sectional study was conducted among 168 elderly participants aged ≥60 years attending geriatric and general medicine outpatient services at the tertiary care teaching hospital. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and loneliness using the UCLA Loneliness Scale. Sociodemographic and clinical variables were collected using a structured questionnaire. Statistical analysis included chi-square testing, Pearson correlation, and multivariate logistic regression analysis with significance established at p < 0.05.

Results
Poor sleep quality was observed in 61.3% of participants, while 38.7% demonstrated mild cognitive impairment. Participants with poor sleep quality had significantly lower MMSE scores compared with those reporting satisfactory sleep (23.4 ± 2.8 vs. 26.1 ± 1.9, p < 0.001). Higher loneliness scores demonstrated moderate negative correlation with cognitive performance (r = −0.49, p < 0.001). Multivariate analysis identified poor sleep quality (AOR: 2.9; 95% CI: 1.5–5.6) and severe loneliness (AOR: 3.4; 95% CI: 1.8–6.3) as independent predictors of mild cognitive impairment.

Conclusions

Poor sleep quality and loneliness demonstrated significant association with mild cognitive impairment among elderly individuals. Early screening and psychosocial interventions targeting sleep and social well-being may support cognitive health preservation in aging populations.