Background: The pattern of associations among aging, sleep complaints and health status have been described among older adults from high-income countries living in temperate climate. However, demographic and clinical correlates of sleep problems among the elderly in non-affluent countries have not been previously reported. Objectives: To describe the relationship between age and sleep problems among adults living in 5 middle income countries in Africa, Asia and North America, and evaluate the impact of clinical characteristics of study participants on the association between age and sleep problems. Design: Cross-sectional study. Setting: China, Ghana, India, Mexico and Russia. Participants: Community dwelling adults with ages ranging from 18 to 100 years. Measurements: Demographic and clinical characteristics which include age, gender, household income, selfreported sleep problems, pain, depression, breathing difficulty, memory problems, blood pressure, weight, height, gait speed, self-reported health status and quality of life. Results: Data was available for a total of 37,822 participants from the 5 countries. Sleep problems were more commonly reported among older adults, participants with symptoms of pain, depression, breathing difficulty, memory problems, and those with low walking speed. In multivariable logistic regression analysis, the association between age and sleep problems were considerably attenuated after adjusting for clinical characteristics of study participants. Conclusion: Results of this study suggest that the increased prevalence of sleep problems among older adults may be due to associated poor health status rather than the age of participants, regardless of ethnic origin and cultural background of study participants, or the geography of their place of residence. These findings would have important implications for the management of sleep problems as well as chronic diseases among older adults.