PONE-D-24-42950Possible Sarcopenia and Depression among middle-aged and older adults in China: A 9-year Longitudinal SurveyPLOS ONE

Dear Dr. Zhong,

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Sayani Das, PhD

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: No

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1:  It was a pleasure to review the manuscript. The authors have used baseline and follow-up data from CHARLS cohort to investigate the association of possible sarcopenia (PS) and its components (low muscle strength or physical performance) with depression in both cross-sectional and longitudinal analysis. As expected, the study found a positive correlation between the two variates even after adjusting for potential confounders. Though the manuscript is well-written, there are few suggestions to improve the same.

• There are few grammatical errors (Examples – Page 3: Lines 39-41; Page 14: Lines 234-237) in the manuscript. The authors are advised to grammatically review the article and make corrections wherever applicable.

• Page 3: Line 44 – AWGS stands for Asian Working Group for Sarcopenia

• Page 4: Line 64 – Please use full expanded term for CHARLS when mentioned first time in the manuscript.

• Page 5: Line 89 – Please completely describe the handgrip dynamometer used for the device (spring-based or hydraulic). It is not clear whether WL-100 is the brand name or type of dynamometer. Please provide a complete description of the device so that the readers can easily find the dynamometer if they have to.

• Page 14: Line 227 - The authors have written that "..the risk of subsequent depression appeared to increase with “rising” muscle strength..". Please check and replace the word “rising” with another appropriate word (decreasing etc.).

Reviewer #2:  Manuscript ID: PONE-D-24-42950

Abstract: Structured Abstract. Written in a systematic way.

Introduction: Needs minor revision.

(1) Line 38-39 - Authors have only mentioned the effect of age as a potential factor for possible sarcopenia. Highlighting some existing literature that focused on other covariates like sex, socio-economic condition, marital status, health-related behavior etc. would give a better backdrop for the present study.

(2) Line 55-65 - The possible pathophysiological connection of simultaneous occurrence of PS and depression need to be briefly discussed at the introduction. Suggestive reading: Ji Eun Heo et al. (2018). Association between appendicular skeletal muscle mass and depressive symptoms: Review of the cardiovascular and metabolic diseases etiology research center cohort. Journal of Affective Disorders, 238, 8-15.

(3) No hypothesis or objective(s) are mentioned. Authors may create separate section for that.

Methods: Comprehensively written.

(1) Make a separate section 'Data Types' for Possible Sarcopenia, Depressive symptoms, and Confounders.

(2) Line 111 - What do you mean by 'Other' under the variable Marital Status. Please mention.

(3) Details of statistical analyses were systematically mentioned.

Results: Need major modification

(1) Table 2 and Table 3 should include the odds for the confounders as well, including the Model Summary (Adjusted R-square, Prediction Percentage etc.).

Discussion: No comments.

Overall comment: Recommending Acceptance after Minor Revision. Some grammatical errors are there in the manuscript. Authors should check that rigorously.

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Reviewer #1: Yes:  Dr. Sunny Singhal

Reviewer #2: Yes:  Dr. Akash Mallick

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Possible Sarcopenia and Depression among middle-aged and older adults in China: A 9-year Longitudinal Survey

PONE-D-24-42950R1

Dear Dr. Zhong,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Sayani Das, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: (No Response)

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: It is very disheartening that the authors have chosen to disregard the earlier comments and have not made changes or provided reply to them. Please find the comments again for your perusal

1. Introduction - Paragraph 1: The authors have mentioned that the concept of PS (possible sarcopenia) was given by Asian Myasthenia Gravis Working Group (AWGS). However, the reference cited by author mention the group name as Asian Working Group for Sarcopenia. Kindly clarify.

2. Methodology - The authors have mentioned that they have used "Mechanical grip force gauge WL-1000" to assess muscle strength. However, AWGS 2019 guidelines clearly recommend the use of either the spring-type (Smedley) or hydraulic-type (Jamar) dynamometer. The reason for this is because the Asian cut-offs have been derived from the studies using these dynamometers only. As the grip strength measures varies as per the dynamometer used and the authors have not used either of the two recommended dynamometers, kindly provide justification how the AWGS 2019 cut-offs can be used to measure possible sarcopenia in this study.

3. Discussion - Paragraph 1: The authors have concluded that "the risk of subsequent depression appeared to increase with greater muscle strength...". However, in the earlier paragraph in the Results section subsection -"Dose-response relationship between Possible sarcopenia and depressive symptoms", the authors have reported that "It suggests that as muscle strength increases, the risk of depression gradually decreases.". These statements are contradictory to each other. Kindly clarify.

Regards

Reviewer #2: (No Response)

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Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .

Reviewer #1: Yes:  Dr. Sunny Singhal

Reviewer #2: Yes:  Dr. Akash Mallick

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