0230 Sleep Disturbances and Risk of Subsequent Disability Among Older Adults in India: Evidence from LASI-DAD

Abstract Introduction Sleep disturbances are common in older adults and may accelerate physical decline through disrupted restoration, inflammation, and cognitive impairment. Despite growing evidence linking sleep disturbances to functional deterioration, little is known about these associations in low- and middle-income countries undergoing rapid aging. India’s rising burden of multimorbidity and disability underscores the need to identify modifiable determinants of independence. This study examined prospective associations between sleep disturbances and ADL and IADL disabilities. Methods We analyzed longitudinal data from 2,469 participants aged ≥60 years in the LASI-DAD (2017–2018; 2022–2024), with baseline sleep disturbances assessed using four indicators (difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, and daytime restlessness). Functional status was measured using ADL and IADL performance. Logistic regression models were used to examine the association between sleep disturbance and disability over a five-year period. The models were adjusted for baseline functional status, age, sex, education, BMI, chronic conditions, and depressive symptoms. Results Participants reporting any sleep disturbances had significantly greater odds of subsequent ADL disability (odds ratio [OR] = 1.32, confidence interval [CI]: 1.11–1.57) and IADL disability (OR = 1.25, CI: 1.02–1.54). When examining individual disturbances, difficulty initiating sleep predicted higher odds of ADL (OR = 1.31, CI: 1.07–1.62) and IADL disabilities (OR = 1.29, CI: 1.00–1.66). Difficulty maintaining sleep was similarly associated with increased ADL (OR = 1.28, CI: 1.05–1.56) and IADL (OR = 1.29, CI: 1.02–1.64) disability. Early morning awakening showed the strongest association, predicting a higher ADL disability risk (OR = 1.36, CI: 1.11–1.66). Daytime restlessness was not associated with ADL or IADL outcomes. Conclusion Sleep disturbances, particularly difficulty in initiating or maintaining sleep and early morning awakening, predict a higher risk of functional disability among older Indian adults. As sleep disturbances are modifiable, screening and early intervention may help preserve the independence of older adults. These findings highlight the importance of identifying and addressing sleep disturbances to prevent functional decline in the aging population. Support (if any)