F1000Research F1000Research 2046-1402 F1000 Research Limited London, UK 10.12688/f1000research.149132.4 Brief Report Articles Negative perceptions toward older adults and life satisfaction among community-dwelling older citizens in Japan

[version 4; peer review: 4 approved, 1 approved with reservations]

 Shimizu Yuho Conceptualization Data Curation Formal Analysis Investigation Methodology Validation Visualization Writing – Original Draft Preparation https://orcid.org/0000-0002-0841-1205 a 1 2 3 Sato Kenichiro Conceptualization Data Curation Investigation Methodology Writing – Review & Editing 3 Ogawa Susumu Data Curation Writing – Review & Editing 3 Cho Daisuke Data Curation Writing – Review & Editing 4 Takahashi Yoshifumi Data Curation Writing – Review & Editing 3 Yamashiro Daichi Data Curation Writing – Review & Editing 3 Li Yan Data Curation Writing – Review & Editing 3 Takahashi Tomoya Data Curation Writing – Review & Editing 3 Hinakura Keigo Data Curation Writing – Review & Editing 3 Iizuka Ai Data Curation Writing – Review & Editing 3 Furuya Tomoki Data Curation Writing – Review & Editing 3 Suzuki Hiroyuki Data Curation Funding Acquisition Project Administration Supervision Writing – Review & Editing 3 Japan Society for the Promotion of Science, Tokyo, Japan The University of Tokyo, Tokyo, Japan Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan Aoyama Gakuin University, Tokyo, Japan yuhos1120mizu@gmail.com

No competing interests were disclosed.

 11 3 2025 2024 13 467 26 2 2025 Copyright: © 2025 Shimizu Y et al. 2025 This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background

With the rapid aging of the population, increasing life satisfaction among older adults is essential. Negative perceptions of older adults are internalized, leading to poor mental health. This study hypothesized that participants with more negative perceptions of older adults would have lower life satisfaction.

 Methods

A cross-sectional survey of older adults was conducted across five wards and four cities in Tokyo, Japan. Participants responded to questions regarding demographics, life satisfaction, and negative perceptions of older adults. Data from 285 participants (264 women, M = 71.97 years) were analyzed.

 Results

The intraclass correlation coefficient for life satisfaction concerning residential areas was. 03 (95% confidence interval [CI] = [-.03, .10]). Instead of multilevel models, a multiple regression model with life satisfaction as the dependent variable and negative perceptions of older adults and demographics as the independent variables yielded the best fit. Results indicated that participants with more negative perceptions of older adults reported lower life satisfaction ( β = -.16, 95% CI = [-.28, -.04], p = .008), supporting our hypothesis.

 Conclusions

This study was constrained by limited variance in residential areas and a predominantly female participant pool. Previous studies have shown that higher life satisfaction is associated with increased social participation and extended life expectancy, and interventions aimed at enhancing life satisfaction in older adults are significant. Further exploration is warranted to ascertain whether a causal relationship exists, wherein more negative perceptions of older adults diminish life satisfaction.

 Psychological Well-Being Quality of Life Stereotyping Life Satisfaction Multilevel Models  Japan Society for the Promotion of Science KAKENHI(22H01098) This study was supported by JSPS KAKENHI (22H01098). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Amendments from Version 3

The following modifications were made in this study in line with the reviewers' suggestions. For example, we have added the following statement to the first paragraph of Discussion: “However, the association between negative perceptions toward seniors and life satisfaction is not strong enough, so we should be careful about over-interpreting the results.” Moreover, we have added the following statement to the second paragraph of Introduction: “There are other psychological variables that affect the life satisfaction of older people, although these are not examined in detail in this study. For a review of variables that contribute to life satisfaction among older adults in Asia, please refer to the following literature. 15” In addition, we have also added the following statement to the last paragraph of Discussion: “In this study, we mainly analyzed data from older women, but we should also consider older men in the future.” Thus, the Introduction and Discussion were mainly revised.

 Introduction

Globally, the population is aging rapidly. This is especially evident in Japan, where 29.0% of the population will be 65 years or older by 2022. 1 While social problems associated with aging have become more apparent, older adults generally have a higher level of life satisfaction than other generations. 2 , 3 However, life satisfaction among older adults in Japan has declined in recent years. 4 As life satisfaction among older people is closely associated with a higher level of physical health, 5 increased social participation, 6 and longer life expectancy, 7 , 8 efforts to increase life satisfaction in this demographic are of great importance.

One variable that could be related to life satisfaction among them is negative perceptions toward older adults, which is how older citizens perceive the social group of “older adults.” Some people view older adults in a positive light, while others view them in a negative light. Stereotype embodiment theory (SET) assumes that older adults internalize negative old-age perceptions. 9 Moreover, the SET argues that older adults who hold more negative perceptions are more likely to experience various negative effects. Previous studies have shown that older adults with more negative perceptions have poorer mental health, 10 , 11 lower cognitive function, 12 and slower recovery from illness. 13 Similar to the SET, the risks of ageism model 14 suggest that three factors broadly inhibit active aging: “stereotype embodiment,” “stereotype threat,” and “being a target of ageism.” Based on the above findings, negative perceptions toward older adults among the older participants will be associated with lower life satisfaction. There are other psychological variables that affect the life satisfaction of older people, although these are not examined in detail in this study. For a review of variables that contribute to life satisfaction among older adults in Asia, please refer to the following literature. 15

This study’s aim is examining the relationship between their negative perceptions toward older adults and life satisfaction. In this study, a cross-sectional survey of community-dwelling older adults in Tokyo, Japan, was conducted. The hypothesis is that participants with more negative perceptions toward older adults would have lower levels of life satisfaction. The study will also focus on the effect of the participant’s residential area. In a large survey of residents in a wide range of Japanese cities, it has been reported that people in more urban areas have fewer close neighbors who greet each other. 16 Thus, results may vary depending on the participant’s residential area. Details regarding their residential area are provided in the next section.

 Methods Participants

A paper-based questionnaire survey was used in this study. Participants read the questionnaire themselves and responded using a writing instrument. A power analysis assuming a small to moderate effect size ( ρ = .20, α = .05, 1– β = .80) yielded a required sample size of 193. Three hundred and two older Japanese individuals from Tokyo participated in this study. However, 17 participants were excluded from the analysis because they were < 65 years old. Thus, the data of 285 participants (aged 65–92, M = 71.97 years, SD = 5.16) were analyzed. The participants comprised 21 men and 264 women. They were older adults who voluntarily applied for a health course to train volunteers to read picture books to children, which was held in five wards and four cities in Tokyo from 2021–2022. In addition to population and economic size, each area had different main goals for the health course presented when recruiting participants (e.g., volunteer training, dementia prevention, long-term care prevention, and/or social participation). Participants were informed in advance of the objective(s) of the course. Thus, an exploratory multilevel analysis was conducted to examine the hypothesis, considering the effect of participants’ residential areas. Note that, some areas had more than one of those objectives, while others had only one. In addition, as the course content remains largely the same between areas, the objectives of the course might not have a significant impact on the results. Moreover, it was unclear how strongly participants understood the course objectives. Therefore, this study analyzed the effect of merely residential areas and did not focus on the differences in the objectives of the course. A summary of the participants by residential area is available in the Open Science Framework (OSF) repository ( https://doi.org/10.17605/OSF.IO/X6JSN). 17

Participants were required to attend the health course venue independently. There were no other exclusion criteria specifically, as long as the participants met the criteria of being 65 years of age or older. Note that the data for this study were collected before the implementation of the health course; therefore, results in this study do not include course effects. This study was approved by the first author’s institution for ethical review.

All procedures were in accordance with the ethical standards of Tokyo Metropolitan Institute for Geriatrics and Gerontology (approval number: 748; June 10, 2020) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all participants in written format.

 Measurements

Negative perceptions toward older adults were measured using the eight adjectives (five-point Likert scale). 18 Participants were asked the following question: “To what extent do you think older adults fit each of the following adjectives?” Adjectives presented to participants included “depressed” and “passive.” The mean was taken as the score (α = .89), with higher scores indicating more negative perceptions toward older adults.

Life satisfaction was measured using the five-items of the Satisfaction with Life Scale 19 measured on a seven-point Likert scale. Examples of items include: “In most ways, my life is close to my ideal.” The mean was taken as the score (α = .86), with higher scores indicating a higher level of life satisfaction. Demographic variables included years of education, age, and sex. Although there may be other confounding individual difference variables, other variables were not measured in this study in consideration of participants’ burden.

 Procedure and analysis

Participants received an explanation regarding the use of survey data for research purposes and agreed to participate in the study. Subsequently, they responded to demographic variables, life satisfaction, and negative perceptions toward older adults. The statistical software R (ver.4.1.0) was used for all analyses. The list of questions, data used in the analysis, scripts for R, histograms for each variable, and summary statistics can be accessed through the OSF.

 Results

The intraclass correlation coefficient (ICC) for life satisfaction concerning residential areas was.03 (95% CI = [-.03, .10]). Therefore, applying a multilevel analysis was not necessary. However, in this study, a simple multiple regression analysis (Model 1), a random effect with an analysis of covariance (RANCOVA) model, including the effect of residential area (Model 2), a random intercept and slope model with a group-level effect of negative perceptions toward older adults (Model 3), and a random intercept and slope model with a cross-level interaction (Model 4) were conducted. These models were compared in Table 1.

Results for each model with life satisfaction as the dependent variable.
Model 1 Model 2 Model 3 Model 4
β 95%CI β 95%CI β 95%CI β 95%CI
NP -.16 ** [-.28, -.04] — — —
NP (individual) — -.18 ** [-.30, -.05] -.16 [-.33, .02] -.15 [-.33, .04]
NP (area) — — -.07 [-.58, .42] -.08 [-.66, .44]
NP (ind.×area) — — — .02 [-.14, .18]
Education years .06 [-.06, .18] .06 [-.06, .18] .06 [-.05, .19] .06 [-.05, .19]
Age -.07 [-.19, .06] -.05 [-.17, .08] -.03 [-.16, .09] -.03 [-.16, .09]
Sex -.09 [-.20, .03] -.09 [-.20, .03] -.09 [-.20, .03] -.09 [-.20, .03]
AIC 808.53 826.30 831.20 836.38
BIC 830.44 851.87 867.72 876.56

Note. β is standardized. NP: Negative Perceptions; Sex: 0 = men, 1 = women; AIC: Akaike’s Information Criterion; BIC: Bayesian Information Criterion.

p < .01.

Life satisfaction was used as the dependent variable in each analysis. In Model 1, a multiple regression analysis including the demographics (years of education, age, and sex) showed that participants with more negative perceptions toward older adults had lower life satisfaction ( β = -.16, 95% CI = [-.28, -.04], p = .008). In Model 2, a RANCOVA model with an individual-level effect (group-mean centering) of negative perceptions toward older adults was conducted and a similar effect to Model 1 ( β = -.18, 95% CI = [-.30, -.05], p = .005) was found. In Model 3, a random intercept and slope model, including a group-level effect (deviating from regional means) of the negative perceptions toward older adults, was employed. The results showed that the individual-level effect ( β = -.16, 95% CI = [-.33, .02], p = .11) and the group-level effect ( β = -.07, 95% CI = [-.58, .42], p = .80) were not significant. In Model 4, a random intercept and slope model, including cross-level interaction, was employed. The results showed that the individual-level effect ( β = -.15, 95% CI = [-.33, .04], p = .18), the group-level effect ( β = -.08, 95% CI = [-.66, .44], p = .77), and the cross-level interaction ( β = .02, 95% CI = [-.14, .18], p = .85) were not significant.

Model comparisons were conducted using the Akaike’s information criterion and the Bayesian information criterion, and Model 1 was determined to fit the data best. Note that when participants aged under 70 ( n = 103) and 70 or over ( n = 182) were analyzed separately; the results for both groups were similar to those in the main manuscript (see OSF). Similar results were obtained in a multiple regression analysis using a dummy variable for the residential area, with zero for the ward and one for the city (see OSF). Thus, the hypothesis in this study that participants with more negative perceptions toward older adults have lower levels of life satisfaction was supported.

 Discussion

In this study, a cross-sectional survey of community-dwelling older adults in nine areas in Tokyo was conducted to examine the relationship between negative perceptions toward older adults and life satisfaction. Each multilevel model fits the data worse than the simple multiple regression analysis. The results showed that participants with more negative perceptions toward older adults had lower life satisfaction, thus supporting the hypothesis. However, the association between negative perceptions toward seniors and life satisfaction is not strong enough, so we should be careful about over-interpreting the results. Note that a reverse relationship could also be assumed: individuals with lower life satisfaction have more negative perceptions toward older adults. The same association was found when this possibility was examined, as in the main manuscript (see OSF).

In this study, the ICC for life satisfaction in residential areas was small, and the fit of each multilevel model was relatively low. One reason for this may be that the participants were limited to those in a health course, training volunteers to read picture books. While detailed motivations for participating in the course varied from individual to individual, the attitude of “I am interested in picture books” and “I want to work as a volunteer” was probably shared by almost all participants. Thus, possibly, the group-level effect was relatively small due to the presence of factors common to participants across residential areas.

As this study is a cross-sectional survey, it should be examined whether a causal relationship exists between more negative perceptions toward older adults and decreased life satisfaction. Meanwhile, given that older adults with negative perceptions toward themselves have poorer mental health, 10 , 11 positively changing their perceptions toward older adults is important. One way to achieve this is to present people with information that contradicts negative old-age stereotypes. For example, negative stereotypes exist that “older adults are prone to illness,” but it was shown that presenting people with the content that “many older adults are healthy enough and able to live on their own” decreased ageism toward older adults. 20 , 21 Although these findings targeted younger people, a similar experimental manipulation for older adults may affirm their perceptions toward older adults. Future empirical studies are required to positively change the perceptions toward old age among older adults.

In this study, a cross-sectional survey of community-dwelling older adults who voluntarily applied for a health course to train volunteers to read picture books to children in Tokyo was conducted. Although course improvement is not the main objective of this study, the findings of this study can be partially utilized to improve programs aimed at promoting the health of older adults. For example, reducing negative perceptions toward older adults prior to enrolling in a program may make it easier for them to achieve greater life satisfaction. As noted above, this study is limited to the examination of correlations, and longitudinal experiments should be conducted in the future.

This study had three major limitations. First, the areas covered in this study were all located in Tokyo, Japan, and the regional differences were small. Compared with Japan’s underpopulated regions, all nine regions in this study share a high population density and a very small number of people engaged in agriculture, forestry, and fisheries. Therefore, follow-up studies are required to select regions with significantly different geopolitical characteristics from a wide range of prefectures. Second, the participation was skewed toward women. Since this study was conducted before a health course to train volunteers to read picture books to children, women comprised the majority of the participants. Note that results similar to those in the main manuscript were obtained when the analysis was limited to women’s data (see OSF); however, this study could not make adequate comparisons between men and women. It may be important to promote post-retirement social participation, especially with regard to men. Therefore, the findings in this study should be re-examined with a sufficient number of male participants. Third, 95% Cis for the group-level and cross-level interaction effects in Models 3 and 4 were wide. This indicates that the estimates contained large uncertainties. This may be due to insufficient sample size for each area. While it is significant that the survey was conducted in a wide range of areas, the number of participants in each area was insufficient. Therefore, elaborate estimates of group-level effects and interactions should be made in the future.

In this study, a significant association between negative perceptions toward older adults and life satisfaction was found among community-dwelling older adults. Interventions that increase life satisfaction in older adults are meaningful because higher life satisfaction leads to increased social participation and longer life expectancies. Thus, it would be useful to focus on the negative perceptions toward older adults. The strength of this study is that the analysis of the relationship between negative perceptions toward older adults and life satisfaction takes into account the effects of residential areas. Future studies on life satisfaction and negative perceptions toward older adults in a broader geographic area should consider regional effects. In this study, we mainly analyzed data from older women, but we should also consider older men in the future.

Ethical considerations

All procedures were in accordance with the ethical standards of the research committee of Tokyo Metropolitan Institute for Geriatrics and Gerontology, (approval number: 748; June 10, 2020 and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written Informed consent was obtained from all individual participants included in the study.

 Data availability

The data used in the analysis is available in the Open Science Framework (OSF) repository:

Negative perceptions toward older adults and life satisfaction among community-dwelling older citizens in Japan, https://doi.org/10.17605/OSF.IO/X6JSN. 17

The project contains the following data:

old image place4.csv (dataset),

old image place code_3.R (the R codes for analysis),

OSF_supplemental_1.pdf (supplementary file of the manuscript).

This data was collected and formed by the authors of this paper. The license of this data is CC-BY 4.0 International.

 Acknowledgements

The authors acknowledge the continued efforts in the management of survey by Senior Citizen Activities Promotion Section in Welfare Division of Hachioji City in Tokyo, Japan. The authors also thank members of the Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology.

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Competing interests: No competing interests were disclosed.

 4 4 2025 Copyright: © 2025 Nugraha S 2025 This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. recommendation approve

Thank you for making significant improvements to the review given. All of reviewer comments have been revised accordingly. I have no other comment for this article.

In my opinion, this article is very worthy of being accepted.

Is the work clearly and accurately presented and does it cite the current literature?

Partly

If applicable, is the statistical analysis and its interpretation appropriate?

Partly

Are all the source data underlying the results available to ensure full reproducibility?

Yes

Is the study design appropriate and is the work technically sound?

Yes

Are the conclusions drawn adequately supported by the results?

No

Are sufficient details of methods and analysis provided to allow replication by others?

Partly

Reviewer Expertise:

Gerontology, Public Health, Mental Health, Health Promotion

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

 10.5256/f1000research.178731.r370476 Reviewer response for version 4 Seo Chang Hyun 1 Referee University of Nevada Reno, Reno, USA

Competing interests: No competing interests were disclosed.

 4 4 2025 Copyright: © 2025 Seo CH 2025 This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. recommendation approve

I have reviewed the revised version and the authors’ responses to my previous comments. The revisions appear appropriate and sufficiently address the concerns I raised.

I would be happy to update my review status to Approved.

Is the work clearly and accurately presented and does it cite the current literature?

Partly

If applicable, is the statistical analysis and its interpretation appropriate?

Partly

Are all the source data underlying the results available to ensure full reproducibility?

Yes

Is the study design appropriate and is the work technically sound?

Partly

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

Yes

Reviewer Expertise:

Social Policy analysis

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

 10.5256/f1000research.178731.r370477 Reviewer response for version 4 Hudson Joanne 1 Referee Swansea University, Swansea, Wales, UK

Competing interests: No competing interests were disclosed.

 12 3 2025 Copyright: © 2025 Hudson J 2025 This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. recommendation approve

No further comments from me.

Is the work clearly and accurately presented and does it cite the current literature?

Yes

If applicable, is the statistical analysis and its interpretation appropriate?

I cannot comment. A qualified statistician is required.

Are all the source data underlying the results available to ensure full reproducibility?

No source data required

Is the study design appropriate and is the work technically sound?

Yes

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

Yes

Reviewer Expertise:

Exercise Psychology; Older adults

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

 10.5256/f1000research.178089.r368208 Reviewer response for version 3 Hudson Joanne 1 Referee Swansea University, Swansea, Wales, UK

Competing interests: No competing interests were disclosed.

 5 3 2025 Copyright: © 2025 Hudson J 2025 This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. recommendation approve

Thank you for making the changes to your manuscript. These have clarified the issues I raised.

Is the work clearly and accurately presented and does it cite the current literature?

Yes

If applicable, is the statistical analysis and its interpretation appropriate?

I cannot comment. A qualified statistician is required.

Are all the source data underlying the results available to ensure full reproducibility?

No source data required

Is the study design appropriate and is the work technically sound?

Yes

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

Yes

Reviewer Expertise:

Exercise Psychology; Older adults

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

 10.5256/f1000research.169305.r360867 Reviewer response for version 2 Iwasaki Michiko 1 Referee Loyola University Maryland, Baltimore, USA

Competing interests: No competing interests were disclosed.

 11 2 2025 Copyright: © 2025 Iwasaki M 2025 This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. recommendation approve-with-reservations

This study includes community-dwelling older adults who volunteer to support children's reading or take a dementia prevention course. Despite differing motivations, both groups engage in community-based services, justifying their treatment as one. A key limitation is the inclusion of 21 men. Given gender differences in health and ageism, focusing solely on women enhances internal validity while preserving a strong sample (n = 264). Clear reporting of effect sizes is essential, as the Beta coefficient for negative perception (0.18 or 0.16) on life satisfaction is small and should be interpreted accordingly. Lastly, the literature review on life satisfaction is weak, and I strongly recommend updating the introduction and discussion to emphasize older women.

Is the work clearly and accurately presented and does it cite the current literature?

Partly

If applicable, is the statistical analysis and its interpretation appropriate?

Partly

Are all the source data underlying the results available to ensure full reproducibility?

Yes

Is the study design appropriate and is the work technically sound?

Yes

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

Yes

Reviewer Expertise:

Assessment of ageism; caregiving, and minority mental health

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Shimizu Yuho

Competing interests: None.

 26 2 2025

Reply to Reviewer 5

We express our appreciation to the reviewer for their insightful comments on our manuscript, which have helped us significantly improve the paper. Additionally, we have revised our manuscript according to the reviewer’s comments. Please find below our point-by-point responses to the comments.

1) This study includes community-dwelling older adults who volunteer to support children's reading or take a dementia prevention course. Despite differing motivations, both groups engage in community-based services, justifying their treatment as one.

We appreciate the reviewer’s comments. The same point was also raised by Reviewer 3.

There were some other objectives for the course in addition to those listed in the original manuscript. Some areas had more than one of those objectives, while others had only one. In addition, the objectives of the course may have differed depending on the year of implementation. Therefore, in the past modification, we had added the following statement to the first paragraph of Participants: “ In addition to population and economic size, each area had different main goals for the health course presented when recruiting participants (e.g., volunteer training, dementia prevention, long-term care prevention, and/or social participation).”

Participants knew the objective(s) of the course in advance. However, some areas had more than one of those objectives, while others had only one. In addition, as the course content remains largely the same between areas, the objectives of the course might not have a significant impact on the results (In fact, the effect of the area has not been seen). Moreover, it was unclear how strongly participants understood the course objectives. Based on the above, in the past modification, we had added the following statement to the first paragraph of Participants: “ Note that, some areas had more than one of those objectives, while others had only one. In addition, as the course content remains largely the same between areas, the objectives of the course might not have a significant impact on the results. Moreover, it was unclear how strongly participants understood the course objectives. Therefore, this study analyzed the effect of merely residential areas and did not focus on the differences in the objectives of the course.”

 2) A key limitation is the inclusion of 21 men. Given gender differences in health and ageism, focusing solely on women enhances internal validity while preserving a strong sample ( n = 264).

We thank the reviewer for your helpful comment regarding this point. As stated in the fifth paragraph of Discussion, we have already confirmed that the same results can be obtained by analyzing only women’s data. Please see the supplemental material on the Open Science Framework (OSF) repository.

 3) Clear reporting of effect sizes is essential, as the Beta coefficient for negative perception (0.18 or 0.16) on life satisfaction is small and should be interpreted accordingly.

We thank the reviewer for your helpful comment regarding this point. As you pointed out, the relationship between the variables is not strong enough. Accordingly, we have added the following statement to the first paragraph of Discussion: “ However, the association between negative perceptions toward seniors and life satisfaction is not strong enough, so we should be careful about over-interpreting the results.”

 4) Lastly, the literature review on life satisfaction is weak, and I strongly recommend updating the introduction and discussion to emphasize older women.

We thank the reviewer for this suggestion. We have added the following statement to the second paragraph of Introduction: “ There are other psychological variables that affect the life satisfaction of older people, although these are not examined in detail in this study. For a review of variables that contribute to life satisfaction among older adults in Asia, please refer to the following lite rature. 15 ”

We have also added the following statement to the last paragraph of Discussion: “ In this study, we mainly analyzed data from older women, but we should also consider older men in the future.”

We have submitted the revised version of the manuscript. We look forward to hearing from you regarding our revised manuscript and would happily respond to any further questions and comments you may have.

 10.5256/f1000research.169305.r360865 Reviewer response for version 2 Seo Chang Hyun 1 Referee University of Nevada Reno, Reno, USA

Competing interests: No competing interests were disclosed.

 7 2 2025 Copyright: © 2025 Seo CH 2025 This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. recommendation approve-with-reservations

1. The title wording remains slightly ambiguous regarding the meaning of "negative perceptions toward older adults." Adding a clarification sentence in the Introduction would improve clarity.

2. The sample is heavily skewed toward women (264 women, 21 men), which limits the generalizability of findings. A clearer discussion of this limitation is needed.

3. The 95% confidence intervals (CIs) for the group-level and cross-level interaction effects in Models 3 and 4 are quite wide (e.g., [-0.66, 0.44] in Model 4), indicating a high level of uncertainty in these estimates. Discussing the implications of wide CIs in the limitations section would strengthen the manuscript.

4. The claim that these findings can improve programs promoting the health of older adults appears somewhat speculative, as the study does not directly test interventions. I recommend softening this statement or rewording it to reflect the exploratory nature of the study. For example, instead of stating that the findings 'can improve programs,' the authors could clarify that the results may provide insights for designing future interventions.

Is the work clearly and accurately presented and does it cite the current literature?

Partly

If applicable, is the statistical analysis and its interpretation appropriate?

Partly

Are all the source data underlying the results available to ensure full reproducibility?

Yes

Is the study design appropriate and is the work technically sound?

Partly

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

Yes

Reviewer Expertise:

Social Policy analysis

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Shimizu Yuho

Competing interests: None.

 9 2 2025

Reply to Reviewer 4

We express our appreciation to the reviewer for their insightful comments on our manuscript, which have helped us significantly improve the paper. Additionally, we have revised our manuscript according to the reviewer’s comments. Please find below our point-by-point responses to the comments.

The title wording remains slightly ambiguous regarding the meaning of “negative perceptions toward older adults.” Adding a clarification sentence in the Introduction would improve clarity.

We thank the reviewer for this suggestion. We have added the following statement to the second paragraph of Introduction: “ …negative perceptions toward older adults, which is how older citizens perceive the social group of “older adults.” Some people view older adults in a positive light, while others view them in a negative light.”

 The sample is heavily skewed toward women (264 women, 21 men), which limits the generalizability of findings. A clearer discussion of this limitation is needed.

We thank the reviewer for this suggestion. The fact that the participants are biased toward women is already discussed in the second to last paragraph of Discussion. To elaborate on the content, we have added the following statement to the paragraph: “ It may be important to promote post-retirement social participation, especially with regard to men.”

   The 95% confidence intervals (CIs) for the group-level and cross-level interaction effects in Models 3 and 4 are quite wide (e.g., [-0.66, 0.44] in Model 4), indicating a high level of uncertainty in these estimates. Discussing the implications of wide CIs in the limitations section would strengthen the manuscript.

We thank the reviewer’s helpful comment regarding this point. We have added the following statement to the second to last paragraph of Discussion: “ Third, 95% Cis for the group-level and cross-level interaction effects in Models 3 and 4 were wide. This indicates that the estimates contained large uncertainties. This may be due to insufficient sample size for each area. While it is significant that the survey was conducted in a wide range of areas, the number of participants in each area was insufficient. Therefore, elaborate estimates of group-level effects and interactions should be made in the future.”

  The claim that these findings can improve programs promoting the health of older adults appears somewhat speculative, as the study does not directly test interventions. I recommend softening this statement or rewording it to reflect the exploratory nature of the study. For example, instead of stating that the findings ‘can improve programs,’ the authors could clarify that the results may provide insights for designing future interventions.

We thank the reviewer’s helpful comment regarding this point. As course improvement is not the main objective of this study, we have added the following statement to the fourth paragraph of Discussion: “ Although course improvement is not the main objective of this study, the findings of this study can be partially utilized to improve programs aimed at promoting the health of older adults.”

We have attached the revised version of the manuscript. We look forward to hearing from you regarding our revised manuscript and would happily respond to any further questions and comments you may have.

 10.5256/f1000research.169305.r359028 Reviewer response for version 2 Hudson Joanne 1 Referee Swansea University, Swansea, Wales, UK

Competing interests: No competing interests were disclosed.

 29 1 2025 Copyright: © 2025 Hudson J 2025 This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. recommendation approve-with-reservations

(1) Exploring the role of residential area in the relationship under investigation is relevant but it would be helpful if some literature were included in the Introduction to provide a rationale for including residential area as a factor in the study.

(2) Please identify which Wards and Cities were categorised as volunteering and dementia prevention in the supplemental material if this is relevant. 

(3) Were the volunteers aware of the main goal for the health course (dementia prevention or volunteering)? If so, would this have influenced participant recruitment? 

(4) I'm not quite clear on whether or not residential areas with different main goals for the health course were compared  - this is particularly important if volunteers were aware of these (see comment above). Please could you clarify this? 

(5) Please review the following statement in the Discussion as the study was not aimed at finding out how to improve such programmes but at the relationships between individual difference factors in people attending them : "The findings of this study can be utilized to improve programs aimed at promoting the health of older adults." This comment is related to the answer "partly" to the final question above.

Is the work clearly and accurately presented and does it cite the current literature?

Yes

If applicable, is the statistical analysis and its interpretation appropriate?

I cannot comment. A qualified statistician is required.

Are all the source data underlying the results available to ensure full reproducibility?

No source data required

Is the study design appropriate and is the work technically sound?

Yes

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

Yes

Reviewer Expertise:

Exercise Psychology; Older adults

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Shimizu Yuho

Competing interests: None

 9 2 2025

Reply to Reviewer 3

We express our appreciation to the reviewer for their insightful comments on our manuscript, which have helped us significantly improve the paper. Additionally, we have revised our manuscript according to the reviewer’s comments. Please find below our point-by-point responses to the comments.

 

Exploring the role of residential area in the relationship under investigation is relevant but it would be helpful if some literature were included in the Introduction to provide a rationale for including residential area as a factor in the study.

Response: We appreciate the reviewer’s comments. We have added the following statement to the last paragraph of Introduction: “ In a large survey of residents in a wide range of Japanese cities, it has been reported that people in more urban areas have fewer close neighbors who greet each other. 15 Thus, results may vary depending on the participant’s residential area. Details regarding their residential area are provided in the next section.”

  

Please identify which Wards and Cities were categorized as volunteering and dementia prevention in the supplemental material if this is relevant.

Response: We thank the reviewer’s helpful comment regarding this point. There were some other objectives for the course in addition to those listed in the original manuscript. Some areas had more than one of those objectives, while others had only one. In addition, the objectives of the course may have differed depending on the year of implementation. Therefore, we have added the following statement to the first paragraph of Participants: “ In addition to population and economic size, each area had different main goals for the health course presented when recruiting participants (e.g., volunteer training, dementia prevention, long-term care prevention, and/or social participation).”

  

Were the volunteers aware of the main goal for the health course (dementia prevention or volunteering)? If so, would this have influenced participant recruitment?

Response: We thank the reviewer’s helpful comment regarding this point. We have added the following statement to the first paragraph of Participants: “ Participants were informed in advance of the objective(s) of the course.”

  

I'm not quite clear on whether or not residential areas with different main goals for the health course were compared. This is particularly important if volunteers were aware of these (see comment above). Please could you clarify this?

Response: We thank the reviewer for this suggestion. As indicated in the above response, participants knew the objective(s) of the course in advance. However, some areas had more than one of those objectives, while others had only one. In addition, as the course content remains largely the same between areas, the objectives of the course might not have a significant impact on the results (In fact, the effect of the area has not been seen). Moreover, it was unclear how strongly participants understood the course objectives. Based on the above, we have added the following statement to the first paragraph of Participants: “ Note that, some areas had more than one of those objectives, while others had only one. In addition, as the course content remains largely the same between areas, the objectives of the course might not have a significant impact on the results. Moreover, it was unclear how strongly participants understood the course objectives. Therefore, this study analyzed the effect of merely residential areas and did not focus on the differences in the objectives of the course.”

  

Please review the following statement in the Discussion as the study was not aimed at finding out how to improve such programmes but at the relationships between individual difference factors in people attending them: “The findings of this study can be utilized to improve programs aimed at promoting the health of older adults.” This comment is related to the answer “partly” to the final question above.

Response: We thank the reviewer for this suggestion. As course improvement is not the main objective of this study, we have added the following statement to the fourth paragraph of Discussion: “ Although course improvement is not the main objective of this study, the findings of this study can be partially utilized to improve programs aimed at promoting the health of older adults.”

We have attached the revised version of the manuscript. We look forward to hearing from you regarding our revised manuscript and would happily respond to any further questions and comments you may have.

 10.5256/f1000research.169305.r316523 Reviewer response for version 2 Zalewska Anna 1 Referee Faculty of Health Sciences, University of Lomza, Lomza, Poland

Competing interests: No competing interests were disclosed.

 28 8 2024 Copyright: © 2024 Zalewska A 2024 This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. recommendation approve

I thank the authors for making corrections according to the comments. I have no more comments.

Is the work clearly and accurately presented and does it cite the current literature?

Partly

If applicable, is the statistical analysis and its interpretation appropriate?

Yes

Are all the source data underlying the results available to ensure full reproducibility?

Yes

Is the study design appropriate and is the work technically sound?

Partly

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

Partly

Reviewer Expertise:

health sciences

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

 10.5256/f1000research.163548.r297567 Reviewer response for version 1 Nugraha Susiana 1 Referee https://orcid.org/0000-0002-6723-742X Public Health Department, Faculty of Health Science, Universitas Indonesia, University of Respati Indonesia, Jakarta, Special Region of Jakarta, Indonesia

Competing interests: No competing interests were disclosed.

 16 7 2024 Copyright: © 2024 Nugraha S 2024 This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. recommendation approve-with-reservations

This paper discusses about the negative perception of being older adult is associated with life satisfaction. The title of this paper is little bit biased in wording. the term of "negative perception of older adult" tend to created ambiguous meaning for reader. I suggest you to add some sentence to avoid any ambiguity.

The introduction part does not clearly highlight the important of this study, as well as the state of art of this study has not well described.

The method section does not clearly explain the instrument being used and its measurement techniques. The role of other confounding variable might necessary to identify.

I would like to see some discussion of the finding of the papers in relation to recent findings and development in active ageing program in Tokyo. The conclusion should concisely mention the finding as well as the implication of the study to the program and policy development.

Is the work clearly and accurately presented and does it cite the current literature?

Partly

If applicable, is the statistical analysis and its interpretation appropriate?

Partly

Are all the source data underlying the results available to ensure full reproducibility?

Yes

Is the study design appropriate and is the work technically sound?

Yes

Are the conclusions drawn adequately supported by the results?

No

Are sufficient details of methods and analysis provided to allow replication by others?

Partly

Reviewer Expertise:

Gerontology and Public Health

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Shimizu Yuho

Competing interests: None

 17 7 2024

Reply to Reviewer 2

We express our appreciation to the reviewer for their insightful comments on our manuscript, which have helped us significantly improve the paper. Additionally, we have revised our manuscript according to the reviewer’s comments. Please find below our point-by-point responses to the comments.

The title of this paper is little bit biased in wording. the term of “negative perception of older adults” tend to created ambiguous meaning for reader. I suggest you to add some sentence to avoid any ambiguity.

We thank the reviewer for this point. We have revised the title of our paper.

The introduction part does not clearly highlight the important of this study, as well as the state of art of this study has not well described.

We sincerely thank the reviewer for this point. We have added the study’s aim and strength to the third paragraph of Introduction: “ This study’s aim is examining the relationship between their negative perceptions toward older adults and life satisfaction. In this study, a cross-sectional survey of community-dwelling older adults in Tokyo, Japan, was conducted. The hypothesis is that participants with more negative perceptions toward older adults would have lower levels of life satisfaction. The study will also focus on the effect of the participant's residential area, details of which are provided in the next section, along with information about the participant.”

The method section does not clearly explain the instrument being used and its measurement techniques. The role of other confounding variable might necessary to identify.

We thank the reviewer’s helpful comment regarding this point. We have added the following statement to the first paragraph of Participants section of Methods: “ A paper-based questionnaire survey was used in this study. Participants read the questionnaire themselves and responded using a writing instrument.” We have also added the following statement to the second paragraph of Measurements section of Methods: “ Although there may be other confounding individual difference variables, other variables were not measured in this study in consideration of participants’ burden.”

I would like to see some discussion of the finding of the papers in relation to recent findings and development in active ageing program in Tokyo. The conclusion should concisely mention the finding as well as the implication of the study to the program and policy development.

We thank the reviewer’s helpful comment regarding this point. We have added the following statemen to the fourth paragraph of Discussion: “ In this study, a cross-sectional survey of community-dwelling older adults who voluntarily applied for a health course to train volunteers to read picture books to children in Tokyo was conducted. The findings of this study can be utilized to improve programs aimed at promoting the health of older adults. For example, reducing negative perceptions toward older adults prior to enrolling in a program may make it easier for them to achieve greater life satisfaction. As noted above, this study is limited to the examination of correlations, and longitudinal experiments should be conducted in the future.”

We have submitted the revised version of the manuscript. We look forward to hearing from you regarding our revised manuscript and would happily respond to any further questions and comments you may have.

 10.5256/f1000research.163548.r297565 Reviewer response for version 1 Zalewska Anna 1 Referee Faculty of Health Sciences, University of Lomza, Lomza, Poland

Competing interests: No competing interests were disclosed.

 5 7 2024 Copyright: © 2024 Zalewska A 2024 This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. recommendation approve-with-reservations

Thank you for the opportunity to review this paper. This is a timely issue to explore. It is mostly clear paper, there is, however, issues that must be resolved before the study can be accepted for indexing. Several comments and suggestions for the authors.

- In the abstract, instead of a hypothesis, the authors should state the aim.

- In the abstract, authors should not describe limitations in their conclusions.

- In the abstract, authors should not refer to other studies in their conclusions, but present a conclusion from their own research.

- The introduction does not exhaust the topic.

- There is no clearly defined aim of the study.

- The last part of the introduction regarding the organization of research should not be included in it (it is part of the material and methods subsection).

- Lack of clear inclusion and exclusion criteria.

- The results lack an all-encompassing table, a flowchart for the selection of patients included with the step-by-step reasons for exclusion.

- Can the authors provide the Cronbach’s alpha value for scales used?

- In addition to the limitations, it is also worth describing the strengths of the study.

- Research articles usually do not use the word „we”, „our” and regularly use passive verbs.

Is the work clearly and accurately presented and does it cite the current literature?

Partly

If applicable, is the statistical analysis and its interpretation appropriate?

Yes

Are all the source data underlying the results available to ensure full reproducibility?

Yes

Is the study design appropriate and is the work technically sound?

Partly

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

Partly

Reviewer Expertise:

health sciences

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Shimizu Yuho

Competing interests: None

 17 7 2024

Reply to Reviewer 1

We express our appreciation to the reviewer for their insightful comments on our manuscript, which have helped us significantly improve the paper. Additionally, we have revised our manuscript according to the reviewer’s comments. Please find below our point-by-point responses to the comments.

In the abstract, instead of a hypothesis, the authors should state the aim. In the abstract, authors should not describe limitations in their conclusions. In the abstract, authors should not refer to other studies in their conclusions, but present a conclusion from their own research.

We appreciate the reviewer’s comments. Along with the reviewer’s comments, we have revised the Abstract.

The introduction does not exhaust the topic. There is no clearly defined aim of the study.

We thank the reviewer’s helpful comment regarding this point. We have added the following statement to the third paragraph of Introduction: “ This study’s aim is examining the relationship between their negative perceptions toward older adults and life satisfaction.”

The last part of the introduction

Regarding the organization of research should not be included in it (it is part of the material and methods subsection).

We thank the reviewer’s helpful comment regarding this point. We have added the following statement to the first paragraph of Methods: “ In addition to population and economic size, each area had different main goals for the health course presented when recruiting participants (e.g., volunteer training and/or dementia prevention). Thus, an exploratory multilevel analysis was conducted to examine the hypothesis, considering the effect of participants’ residential areas.”

Lack of clear inclusion and exclusion criteria. The results lack an all-encompassing table, a flowchart for the selection of patients included with the step-by-step reasons for exclusion.

We thank the reviewer for this suggestion. In this study, participants were older adults who voluntarily applied for a health course to train volunteers to read picture books to children. There were no other exclusion criteria specifically, as long as the participants met the criteria of being 65 years of age or older. Therefore, we have determined that the flowchart regarding participant exclusions is unnecessary. Accordingly, we have added the following statement to the first paragraph of Methods: “ Participants were required to attend the health course venue independently. There were no other exclusion criteria specifically, as long as the participants met the criteria of being 65 years of age or older.”

Can the authors provide the Cronbach’s alpha value for scales used?

We thank the reviewer for this suggestion. We have added the Cronbach’ alpha for each scale.

In addition to the limitations, it is also worth describing the strengths of the study.

We thank the reviewer’s helpful comment regarding this point. We have added the following statement to the last paragraph of Discussion: “ The strength of this study is that the analysis of the relationship between negative perceptions toward older adults and life satisfaction takes into account the effects of residential areas. Future studies on life satisfaction and negative perceptions toward older adults in a broader geographic area should consider regional effects.”

Research articles usually do not use the word “we”, “our” and regularly use passive verbs.

We thank the reviewer for this point. The text has been corrected to a form that does not use “we” or “our.”

We have submitted the revised version of the manuscript. We look forward to hearing from you regarding our revised manuscript and would happily respond to any further questions and comments you may have.