Prevalence and associated factors of cognitive impairment among older adults in long-term care facilities in Sri Lanka: A descriptive cross-sectional study

Background Cognitive impairment is a major health concern among older adults, particularly those residing in long-term care facilities. This study aimed to assess the prevalence and associated factors of cognitive impairment among older adults residing in long-term care facilities in Colombo district, Sri Lanka. Methods A descriptive cross-sectional study was conducted among 465 older adults aged ≥60 years residing in twelve long-term care facilities. Participants were selected using a two-stage cluster sampling technique. A pre-tested interviewer-administered questionnaire was used to collect socio-demographic and health-related information, and a validated Sinhala version of the Montreal Cognitive Assessment (MoCA) was used to assess cognitive function. A total score <26 indicated cognitive impairment. Pearson’s chi-square test was used to assess associations among categorical variables, and variables that were significantly associated were entered into a multivariate binary logistic regression model. Statistical Package for the Social Sciences (SPSS) Version 27 was used for data analysis. Statistical significance was kept at 0.05. Results The mean (SD) age of the study sample was 72.93(6.72) years, and 270(58.1%) were females. The prevalence of cognitive impairment was 79.8% (371) . After adjustment of potential confounders, lower educational status (AOR=2.20; 95% CI:1.36-3.55), absence of previous employment (AOR=1.85; 95% CI:1.01-3.37), and non-engagement in leisure activities (AOR=1.89; 95% CI:1.02-3.51) were independently associated with cognitive impairment. Conclusions A high prevalence of cognitive impairment was observed among institutionalized older adults. Social and lifestyle-related factors were significantly associated with cognitive impairment, highlighting the need for routine cognitive screening and targeted psychosocial interventions in long-term care facilities.