The Mediating Effects of Social Networks and Wisdom on the Relationship between Lifestyle Habits and Healthy Aging in Older Adults with Chronic Diseases
Round 1
Reviewer 1 Report
The authors touched upon a very important topic, and testing the mediating effect of social networks and wisdom brings inspiration to the current knowledge. Overall the research has merits, although several issues need to e addressed before it can be published.
1. The definitions of lifestyle habits and wisdom are a bit arbitrary/contingent now. It would be appreciated if the authors could give very clear definitions of them upfront in the introduction/literature review. I waited till the method section to get a sense of what they meant by looking at the survey questions.
2. The survey questions. I still don't quite fully understand what you mean by a healthy lifestyle and wisdom. It would be great to show example survey questions in the appendix to give more details. Furthermore, the wisdom measurements are developed in the Korean context thus it is very context and culture-specific. The oriental wisdom is different from Western wisdom. That is something you may want to highlight for international readers.
3. Research using cross-sectional data like this one are usually subject to reverse causality. It is unclear in your research how you address/acknowledge it. For example, I am not convinced that wisdom is something that can be developed from a healthy lifestyle. Isn't it the other way around that, as you stated 443-445, wise people incline to adopt healthier lifestyles? The same goes for social networks. If you check Colman's work and its following studies on social capital, you will find that social networks disseminate good and bad habits which cause people to adopt healthy or unhealthy behaviors, not the other way around. So, I suspect that healthy lifestyles should be the mediating variable. Wisdom and social networks have impacts on healthy habits, which influence healthy aging while both wisdom and social networks can have impacts on healthy aging as well. I think this logic chain is what you should really work on and justify.
Author Response
|
Reviewer 1 |
|
|
The authors touched upon a very important topic, and testing the mediating effect of social networks and wisdom brings inspiration to the current knowledge. Overall the research has merits, although several issues need to e addressed before it can be published. 1. The definitions of lifestyle habits and wisdom are a bit arbitrary/contingent now. It would be appreciated if the authors could give very clear definitions of them upfront in the ntroduction/literature review. I waited till the method section to get a sense of what they meant by looking at the survey questions.
|
Thank you very much for your careful and sincere review and comment. Your review was very helpful in completing my paper. I revised it as you pointed out. I look forward to your kind cooperation. I hope for your kindness.
I revised it in introduction as below. First of all, when it comes to healthy aging in the elderly, daily lifestyle habits are very important. Lifestyles are decisions made by individuals that affect health and refer to things that can be controlled to some extent [10]. Healthy lifestyles among the elderly reduce the occurrence of chronic diseases and depression, as well as extend life expectancy [11]. Wisdom is an attitude of pursuing truth throughout life, cherishing artistic endeavors, and embodying morality and humanity. It emphasizes the value of the present moment [15]. This disposition contributes to resolving problems, conflicts, crises, and challenges faced in old age, subsequently influencing life satisfaction [16]. In a study involving middle-aged men, a positive correlation was found between lifestyle and wisdom. Wisdom also exhibited a complete mediating effect in the relationship between the health habits and health preservation of middle-aged men. This suggests the need for strategies to enhance wisdom [17]. Therefore, it becomes imperative to cultivate healthy lifestyles among the elderly, which in turn fosters wisdom and ultimately facilitates healthy aging. |
Reviewer 2 Report
Thank you for your paper. Introducing wisdom added to the value of it. It would be necessary to have more references related to the topic of wisdom and the elderly.
Please check the lines 241-244 for coherence.
Add more information about the subscales for wisdom and your findings related to them and their implications in all phases of your study.
Please add the limitations and detail applicability.
Author Response
|
|
Thank you for your paper. Introducing wisdom added to the value of it. It would be necessary to have more references related to the topic of wisdom and the elderly.
|
Thank you very much for your careful and sincere review and comment. Your review was very helpful in completing my paper. I revised it as you pointed out. I look forward to your kind cooperation. I hope for your kindness.
I added references to old people and wisdom. Reference 11,15,16,17,55,56,58 Branch, L. G.; Jette, A. M. Personal health practices and mortality among the elderly. Am J Public Health, 1984, 74(10), 1126 –1129. DOI: 10.2105/ajph.74.10.1126 Kim, M. J. Wisdom about 'aging' in Confucianism. Philosophy, 2011, 106, 1-23. Ardelt, M. Antecedents and effects of wisdom in old age: A longitudinal perspective on aging well. Research on Aging 2000, 22(4), 360-336. https://doi.org/10.1177/016402750022400 Kim, H. K. Mediating Effects of Wisdom in the relation between Lifestyle Habits (LH) and Health Conservation (HC) of Middle-aged Men. Indian Journal of Public Health Research & Development 2018, 9(12), 478-483. Kim, H. K. The influence Factors on Health Conservation of Middle-aged Adults. International Journal of Applied Engineering Research 2015, 10(23), 43538-43544. Kim, H. K. Mediating Effect of Wisdom on the Relationship between Health Promoting Behavior and Health Conservation among the Korean Middle-aged Adults. International Journal of Applied Engineering Research 2016, 11(6), 3923-3929. Lyster T. A nomination approach to the study of wisdom in old age (Unpublished doctoral dissertation). Concordia University, Montreal, Quebec, Canada, 1996. |
|
|
Please check the lines 241-244 for coherence.
|
Changed The elderly with one disease had a higher degree of health aging than the elderly with four or more diseases. The elderly who perceived that the economic level was high had a higher degree of health aging than the elderly who perceived that the economic level was low or moderate. |
|
|
|
Add more information about the subscales for wisdom and your findings related to them and their implications in all phases of your study. Please add the limitations and detail applicability.
|
I added a reference to old people and wisdom. -> Therefore, it is necessary to develop interventions to enable the elderly with chronic diseases to have a healthy lifestyle, increase their social network, and have wise life experiences in order to maintain a healthy old age. The results of this study have helped us recognize the significance of wisdom and social networks. Consequently, these findings can serve as fundamental data for guiding future studies that utilize these variables to enhance the lifestyles of the elderly and promote healthy retirement. As a limitation of the study, the participants of this study were elderly people in a selected area, so caution should be taken in interpreting the results. Research focused on lifestyle, wisdom, and the underlying social networks is currently inadequate for promoting healthy aging among the elderly. Specifically, there exists a need for a more comprehensive exploration of wisdom. Furthermore, qualitative research concerning the parameters of this study, namely wisdom and social networks, is also essential. It is advisable to conduct iterative research by expanding both the study's participant pool and geographical coverage. |
|
|
Reviewer 3 Report
The authors propose a study aimed at verifying results essentially already obtained in other research. The instruments used are validated, the theoretical frame of reference is broad and articulate, the statistical analyses conducted are well illustrated and the conclusions reached by the authors are supported by the data. However, beyond the consideration that these are results already known and reported in the literature, some doubt arises with respect to the alleged relationships between the variables examined. That a good lifestyle positively influences health has long been known; that the presence of a good social network and a good level of wisdom are associated with good health are equally well known. But it is difficult to think that the variables used as mediators in the regression model are not in fact, at least partially influenced, by the dependent variable. Those with good health status are more likely to have social relationships, and airing an excellent social network counteracts isolation by promoting health status. As for wisdom, the increase in which, it is not known in what way, the authors suggest in the conclusions it is easier to imagine it as a prerequisite of a good lifestyle with consequent influence on health rather than as an outcome of a good lifestyle where wisdom is assumed to be acquired through experience and the ageing.
Overall, the paper appears to be well organized although of little impact on the general knowledge of problems related to old age. It is recommended that lines 423 to 425 be revised because the text appears obviously flawed by a tautology ("and elderly people with higher levels of wisdom had higher levels of wisdom than those with lower levels of wisdom, indicating that the better the lifestyle, the higher the level of wisdom.")
Author Response
|
The authors propose a study aimed at verifying results essentially already obtained in other research. The instruments used are validated, the theoretical frame of reference is broad and articulate, the statistical analyses conducted are well illustrated and the conclusions reached by the authors are supported by the data. However, beyond the consideration that these are results already known and reported in the literature, some doubt arises with respect to the alleged relationships between the variables examined. That a good lifestyle positively influences health has long been known; that the presence of a good social network and a good level of wisdom are associated with good health are equally well known. But it is difficult to think that the variables used as mediators in the regression model are not in fact, at least partially influenced, by the dependent variable. Those with good health status are more likely to have social relationships, and airing an excellent social network counteracts isolation by promoting health status. As for wisdom, the increase in which, it is not known in what way, the authors suggest in the conclusions it is easier to imagine it as a prerequisite of a good lifestyle with consequent influence on health rather than as an outcome of a good lifestyle where wisdom is assumed to be acquired through experience and the ageing.
|
Thank you very much for your careful and sincere review and comment. Your review was very helpful in completing my paper. I revised it as you pointed out. I look forward to your kind cooperation. I hope for your kindness.
The lifestyle of the elderly during their lifetime is closely related to health and has a significant impact on health aging. |
|
Overall, the paper appears to be well organized although of little impact on the general knowledge of problems related to old age. It is recommended that lines 423 to 425 be revised because the text appears obviously flawed by a tautology ("and elderly people with higher levels of wisdom had higher levels of wisdom than those with lower levels of wisdom, indicating that the better the lifestyle, the higher the level of wisdom.")
|
I believe this study examined key concepts related to the lifestyles of the elderly, healthy aging, wisdom, and social networks, yielding significant findings for the enhancement and promotion of the elderly's well-being during their retirement years. Particularly, I consider training aimed at enhancing lifestyles, expanding wisdom, and maintaining robust social networks to be crucial foundational data. This data offers insights into how effectively the health and well-being of the elderly can be ensured in their later years. I greatly appreciate your consideration ->Therefore, it is necessary to develop interventions to enable the elderly with chronic diseases to have a healthy lifestyle, increase their social network, and have wise life experiences in order to maintain a healthy old age. The results of this study have helped us recognize the significance of wisdom and social networks. Consequently, these findings can serve as fundamental data for guiding future studies that utilize these variables to enhance the lifestyles of the elderly and promote healthy retirement. As a limitation of the study, the participants of this study were elderly people in a selected area, so caution should be taken in interpreting the results. Research focused on lifestyle, wisdom, and the underlying social networks is currently inadequate for promoting healthy aging among the elderly. Specifically, there exists a need for a more comprehensive exploration of wisdom and sub region. Research on ways to develop wisdom for the elderly is needed. Furthermore, qualitative research concerning the parameters of this study, namely wisdom and social networks, is also essential. It is advisable to conduct iterative research by expanding both the study's participant pool and geographical coverage. I modified the contents of line 423-425. Thank you so much. -> In the study of the elderly, wisdom was related to lifestyle behaviors such as practicing exercise, not drinking alcohol, eating a regular diet. |
Round 2
Reviewer 1 Report
The authors have addressed my concerns.
Reviewer 2 Report
no further comments
