The Cognitive Triad in Iranian Older Adults: Emphasis on Sleep Quality and Physical Activity Levels
Keywords:
فعالیت بدنی, کیفیت خواب, مثلث شناختی, سالمندانAbstract
This study aimed to systematically investigate the simultaneous effects of physical activity level and sleep quality on cognitive-emotional functions in Iranian older adults. The research employed a cross-sectional descriptive design with multi-stage random cluster sampling. The statistical population consisted of 2,180 adults aged over 60 years from five geographical regions of Iran. Data collection tools included the Cognitive Triad Inventory (CTI), the Pittsburgh Sleep Quality Index (PSQI), and the CHAMPS Physical Activity Questionnaire for Older Adults. Results of the two-way multivariate analysis of variance (MANOVA) indicated that the main effects of physical activity level, sleep quality, and their interaction on the subscales of the cognitive triad in older adults were significant. Post hoc test results revealed that increased physical activity, regardless of sleep quality, was associated with improved self-perception among older adults (P = 0.001). Regarding worldview, the only significant difference was observed between sedentary and inactive groups with poor sleep quality (P = 0.05). More importantly, in older adults with poor sleep quality, higher physical activity was related to a more positive future outlook (P ≤ 0.05), whereas this relationship was not significant in the good sleep quality group. Findings showed that both physical activity (η² = 0.054) and sleep quality (η² = 0.058) had independent moderate effects on the subscales of the cognitive triad, while the interaction effect was stronger (η² = 0.1), accounting for a substantial proportion of the variance. This study suggests that physical activity can serve as a moderating factor in the relationship between sleep quality and cognitive attitudes in older adults. Specifically, in those with poor sleep quality, increased physical activity was associated with improved self-perception and future outlook, highlighting the importance of incorporating exercise programs into mental health interventions for this population. The findings support the development of targeted combined programs that address both sleep improvement and physical activity enhancement.
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