Association between Nutritional Status and Sleep Quality among Community Dwelling Older Adults in Selected Rural and Peri-Urban Areas of Dhaka District, Bangladesh: A Cross-Sectional Study

Abstract Background: Poor Sleep Quality and nutritional vulnerability are prevalent among older adults, yet evidence on their interrelationship in Bangladesh remains overlooked. This study therefore aimed to assess the association between nutritional status and sleep quality among community dwelling older adults in selected rural and peri-urban areas of Dhaka, Bangladesh. Methods: We conducted a community-based cross-sectional study among 500 adults aged 60 years or older in Savar and Dhamrai between August and September 2023. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and nutritional status was evaluated using the Mini Nutritional Assessment–Short Form (MNA-SF). Multivariable linear and quantile regression models were used to examine the association between continuous MNA-SF and PSQI scores. Binary logistic regression estimated associations between nutritional-status categories and poor sleep quality. Results: Overall, 60.8% of participants had poor sleep quality, 53.8% were at risk of malnutrition, and 37.4% were malnourished. In the adjusted linear model, each one-point increment in MNA-SF score was associated with a 0.405-point lower PSQI score ( β = -0.405; 95% CI: -0.584–0.226). Significant inverse associations were also evident at the 10th, 25th, 50th and 75th PSQI quantiles. In adjusted logistic regression model, compared with well-nourished participants, malnourished participants had higher adjusted odds of poor sleep quality (aOR = 3.75; 95% CI = 1.77–7.95), as did those at risk of malnutrition (aOR = 2.33; 95% CI = 1.14–4.76). Conclusion: Poor sleep quality and nutritional vulnerability were pervasive among the community-dwelling older adults of Savar and Dhamrai. Poorer nutritional status was independently associated with poor-sleep quality after adjusting all the relevant covariates. Longitudinal studies are needed to establish temporality and elucidate the potential causal pathways.