Sleep Problems and Cognitive Aging: Quantifying Years of Life

Written By Dr Chi-Tsun Chiu

Millions worldwide suffer from sleep problems and dementia, yet effective treatments and predictions remain elusive. As populations age, these issues become increasingly critical for public health. While strong associations among sleep quality, cognitive functioning, and mortality are well documented, the role of sleep in cognitive status and life expectancy across different cognitive states remains unclear. Using 18 years of Health and Retirement Study data and multistate life table methods, we estimated how sleep quality translates into years of different levels of cognitive functioning for Americans aged 65+.

Our life expectancy results indicated that sleep problems show a stronger association with longevity and cognitive life expectancy in older men than in older women. Men are more vulnerable to sleep problems because their life expectancy decreases more due to poor sleep quality. The results based on initial cognitive status indicate that sleep, as a modifiable factor, mainly benefits individuals with normal cognition, while those with CIND still have potential for improvement. However, the intervention effect is limited for people with dementia. Therefore, sleep intervention may be most effective in the early stages of cognitive decline among older adults.

Overall, our findings highlight the complex interplay between sleep problems, cognitive aging, and gender and underscore the importance of addressing sleep issues to promote healthy cognitive aging. The findings have important implications for public health policies and interventions targeting cognitive decline and dementia. Sleep quality is a significant risk factor for cognitive aging and life expectancy, but the association varies by gender and cognitive status. Therefore, gender-specific approaches to interventions to improve sleep quality based on an individual’s cognitive status should be considered to promote cognitive health among older adults. Healthcare professionals should also consider the potential impact of sleep problems on cognitive health and provide appropriate treatment and interventions to mitigate the effects of sleep problems on cognitive function. Our finding also raises questions about the underlying mechanisms of gender differences in the association between sleep quality and cognitive life expectancy. Future research should focus on understanding the mechanisms behind the observed gender differences and the complex association between sleep quality and cognitive states.

 

Further Reading

Chiu, C. T., Chen, C. A., Wang, J., & Ofstedal, M. B. (2025). Sleep Quality and Cognitive Life Expectancy in the United States. Research on aging, 1640275251394993. Advance online publication. https://doi.org/10.1177/01640275251394993

Dr Chi-Tsun Chiu

Dr Chi-Tsun Chiu is an Associate Research Fellow (with tenure) at the Institute of European and American Studies, Academia Sinica in Taiwan. He received his Ph.D. in Sociology with a Demography specialization at the University of Texas at Austin in 2013. Prior to his move back to Taiwan, he spent one year at Duke-NUS Medical School, Singapore. His main fields of work are demography and gerontology in general, and aging and health and health expectancy in particular. His research focuses on using life table techniques and large survey data to gain insight into the social determinants of health and mortality for older people. He is particularly interested in conditions in the environments that people can do something about in order to improve health and longevity for a population. His current research involves living arrangements and health expectancy, sleep quality and cognitive life expectancy, education and health inequality, and racial/ethnic disparities in health.

https://www.ea.sinica.edu.tw/people/Chi-Tsun-Chiu.aspx?lang=e
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