Relationship between Perceived Social Support and Sleep Quality among Older Men in Guangdong Province, China: The Mediating Role of Rumination and the Moderating Role of Physical Activity

Abstract

Background: The mental health status of older men is affected by several factors. Perceived social support, rumination, sleep quality, and physical activity are key factors that affect the mental health status of men over 60 years old. The mechanisms of their interactions have not been fully elucidated. The purpose of this research was to explore the relationship and interaction mechanisms among perceived social support, rumination, physical activity and sleep quality. The differences in physical activity levels of individuals in different characteristics groups were also investigated. Methods: A total of 296 valid questionnaires were collected and the participants had a mean age of 69.94 ± 7.97. The Perceived Social Support (PSS), Ruminative Responses Scale (RRS), Pittsburgh Sleep Quality Index (PSQI), and the International Physical Activity Questionnaire (IPAQ) were administered to older men in Guangdong Province over 60 years old to collect data on perceived social support, rumination, physical activity and sleep quality. The established hypotheses were tested using mediation model and moderation model. The mediating effect of rumination between perceived social support and sleep quality and the moderating effect of physical activity between perceived social support and sleep quality were examined. Results: (1) The findings showed that the levels of physical activity varied significantly based on characteristics variables such as age, perceived age, residence, and amount of housework undertaken. (2) Perceived social support was negatively correlated with rumination and poor sleep quality, and rumination was positively correlated with poor sleep quality. (3) Rumination partially mediated the relationship between perceived social support and sleep quality, with a mediating effect of 36.9%. (4) Physical activity moderated the relationship between perceived social support and sleep quality, with a significant moderating effect observed for moderate-high intensity physical activity compared with low intensity physical activity. Conclusions: Older men who perceived social support reduced rumination level and improved sleep quality. Moderate-high physical activity positively modulated the relationship between perceived social support and sleep quality more effectively than low physical activity level. The present findings can be used to establish recommendations and measures to improve the mental health of older men.