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However, existing evidence has largely been derived from single\u2010country studies, limiting the understanding of whether predictors of poor sleep quality are consistent across different sociocultural contexts. Guided by the biopsychosocial framework, this study aimed to identify shared and context\u2010specific predictors of subsequent poor sleep quality among older adults using data from four nationally representative longitudinal cohorts (Health and Retirement Study [HRS], English Longitudinal Study of Ageing [ELSA], China Health and Retirement Longitudinal Study [CHARLS], and Mexican Health and Aging Study [MHAS]). Participants aged \u226560\u2009years with good baseline sleep quality were included, and harmonized predictors across demographic, biological, psychological, and social\u2010behavioral domains were examined using cross\u2010validated least absolute shrinkage and selection operator (LASSO) regression within each cohort. Depressive symptoms consistently emerged as the strongest predictor of subsequent poor sleep quality across all cohorts, whereas gender, cognitive function, educational attainment, self\u2010rated health, and comorbidity burden showed varying predictive contributions across populations. These findings highlight the multidimensional nature of sleep quality in later life and suggest that psychological health, particularly depressive symptoms, represents a potential target for early identification and intervention across diverse cultural settings.<\/jats:p>","DOI":"10.1111\/aphw.70207","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:44:25Z","timestamp":1786927465000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prospective multidimensional predictors of poor sleep quality in older adults: A cross\u2010national study"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1149-111X","authenticated-orcid":false,"given":"Jiale","family":"Xu","sequence":"first","affiliation":[{"name":"School of Psychology Nanjing Normal University  Nanjing 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