Sleep Quality, Physical Activity, and Social Engagement Among Older Adults in Sulaimani, Iraq: A Cross-Sectional Study

Abstract

Background: Sleep quality, physical activity, and social interaction are crucial for the health and well-being of older adults. These factors are interconnected; however, their cumulative impact remains inadequately examined, particularly in developing country contexts. Aim: This study aimed to investigate the interrelationship between sleep quality, physical activity, and social engagement among older adults in Sulaimani, Iraq, and to assess their combined impact on health. Methods: A cross-sectional descriptive study was conducted involving 200 community adults aged 60 years and older, selected through purposive sampling. From October 2025 to February 2026, structured questionnaires were used to gather data. These included the Pittsburgh Sleep Quality Index (PSQI), the Physical Activity Scale for the Elderly (PASE), and the Social Activities Participation (SAP) questionnaire. The data were analysed using SPSS version 22. The Mann–Whitney U test, chi-square test, and Spearman’s correlation were used for the non-parametric data, establishing a statistical significance threshold at p < 0.05. Results: The majority (81.5%) of participants were classified as having poor sleep quality, with a mean PSQI score of 8.77 ± 3.44. while the mean PASE and SAP scores were 274.95 ± 209.75 and 9.27 ± 3.18, respectively, showing moderate levels of physical activity and social participation. Sleep quality was negatively correlated with physical activity (ρ = –0.471, p < 0.001) and social engagement (ρ = –0.320, p < 0.001); indicating that higher levels of physical activity and social engagement were associated with better sleep quality. In contrast, physical activity was positively correlated with social participation (ρ = 0.477, p < 0.001), suggesting that more physically active individuals were also more socially engaged.  Conclusion: In older adults, sleep quality, level of physical activity, and social engagement are all closely related. Implementing broad interventions that target these domains concurrently may improve well-being and assist them in a healthy way. Additional longitudinal studies are recommended to clarify the causal relationships.