Sleep disturbance and cognitive impairment: a mediation analysis of frailty among older adults in the Philippines
Date
2026-06-08
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Abstract
This study examines the role of frailty as a mediator in the association between sleep disturbance and cognitive impairment among older adults in the Philippines. Using the data from the 2018 Longitudinal Study of Ageing and Health in the Philippines (LSAHP), a causal mediation analysis is applied to estimate the direct, indirect, and total effects of sleep disturbance on cognitive impairment, with frailty as mediator. A total of 5,177 older adults were included. Results show that sleep disturbance is significantly associated with cognitive impairment, and frailty mediates this relationship, explaining a small but statistically significant portion, accounting for 15.43% of the total effect. The findings underscore that interventions for the management or delaying cognitive impairment of older adults can be geared towards addressing frailty. Early screening for both sleep disturbance and frailty may be a good strategy in maintaining the cognitive health of older adults.
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Keywords
Sleep disturbance, Frailty, Cognitive impairment, LSAHP, Causal mediation analysis