Towards Equitable Representations of Ageing: Evaluation of Gender, Territories, Aids and Artificial Intelligence

Round 1

Reviewer 1 Report (New Reviewer)

Comments and Suggestions for Authors

Dear Colleagues

I have already submitted one detailed review for this paper - in case you did not receive -I believe that this is a well written paper and that it is an important topic that has not been addressed sufficiently as of yet. There are minor editing issues can be addressed easily. I also believe that the conclusions could be elaborated on and limitations of study discussed in more detail. The study evaluated digital images of older adults and found that stereotypes and ageism exists in representation, particularly as it relates to the diversity of the older adult population, positive emotions such as joy, and images of women.  These biased representations are important to note and particularly important given that women make up the majority of the older adult population - it is a point that should be discussed in more detail in the discussion section. A social science theory or framework that can contextualize the discussion would also help understand the implication of the study in more detail. Also as the authors note the older adult population is diverse and it is necessary to have a more diverse and accurate representation of this segment of the population and foster positive attitudes toward use, this point is made but could be emphasized as it is an important finding.  Very interesting article - generally well organized and well-written. thank you

Comments on the Quality of English Language

Well written English no problems detected

Author Response

Comments and Suggestions for Authors

Dear Colleagues

REVIEWER COMMENTS 1: I have already submitted one detailed review for this paper - in case you did not receive -I believe that this is a well written paper and that it is an important topic that has not been addressed sufficiently as of yet. There are minor editing issues can be addressed easily.

RESPONSE 1:

Thank you very much for your thoughtful comments and suggestions. We sincerely appreciate the time and effort you have put into reviewing our paper. Following your feedback, we have thoroughly reviewed the manuscript and addressed the minor editing and typographical issues you pointed out. Your positive remarks about the importance of our topic are greatly encouraging, and we hope that the revisions enhance the clarity and quality of our work.

REVIEWER COMMENTS 2: I also believe that the conclusions could be elaborated on and limitations of study discussed in more detail.

RESPONSE 2:

Thank you very much for your feedback. We have made the changes you suggested by separating the Discussion section and adding a new paragraph on limitations. You will now find the subchapters as follows: 4.1. Challenges and Stereotypes in Digital Imagery, 4.2. Limitations and Strengths, and 4.3. Future Directions and Ethical Considerations. Additionally, we have expanded the limitations section with a new paragraph to further address your concerns:

“The quality and representativeness of AI-generated images, including those produced by models like LoRA AI, still require further evaluation. Issues such as image distortion and lack of diversity, as highlighted in this study, emphasize the need for additional research to assess the reliability and accuracy of these generated images. Variability in image quality and potential biases in training data can affect how emotional images are interpreted, which could have significant implications for inclusion and accuracy in emotion coding. In addition to concerns specific to LoRA AI, it is crucial to consider broader challenges associated with AI-generated imagery. For instance, the training datasets used to develop these models often contain inherent biases that may perpetuate stereotypes or underrepresent certain groups. This is particularly important when evaluating emotional and social representations in images. Furthermore, the algorithms themselves may struggle with accurately depicting nuanced emotional expressions, particularly in diverse populations or complex contexts. Addressing these issues requires not only optimizing AI models but also conducting comprehensive studies that examine the broader implications of these technologies. This includes ensuring that AI-generated images reflect societal diversity equitably and accurately, as well as exploring how different AI models handle various emotional and contextual nuances. By tackling these challenges, future research can contribute to more inclusive and precise representations in AI-generated imagery”

REVIEWER COMMENTS 3: The study evaluated digital images of older adults and found that stereotypes and ageism exists in representation, particularly as it relates to the diversity of the older adult population, positive emotions such as joy, and images of women. These biased representations are important to note and particularly important given that women make up the majority of the older adult population - it is a point that should be discussed in more detail in the discussion section.

RESPONSE 3:

According to your indications, we have added the following paragraph in the subsection 4.1.:

“The study revealed several key findings. First, predominant emotions such as ‘joy’ were observed, along with cases where emotions were unrecognizable, with variations based on gender. This lack of emotional clarity varied by gender, suggesting that the representation of emotions may be influenced by gender biases or stereotypes. For example, women may be depicted with less expressive emotional states compared to men, which could reinforce traditional gender norms. Second, most images depicted older adults in built environments, with few representations in natural settings. This reflects a lack of diversity in the contexts of representation that does not fully capture the reality of older adults' experiences. Third, AI-generated digital images presented challenges in accurately representing emotions and environmental contexts. AI-generated images often exhibited neutral or ambiguous expressions, and the environments were frequently idealized or futuristic rather than reflecting real-life scenarios. This discrepancy between AI-generated images and real-world experiences highlights the need for more nuanced and diverse training data to improve the representation of older adults.”

REVIEWER COMMENTS 4: A social science theory or framework that can contextualize the discussion would also help understand the implication of the study in more detail.

RESPONSE 4:

Thank you for your valuable suggestion. We have incorporated a theoretical framework that contextualizes our discussion within the social sciences, specifically using the theory of social representation. This framework allows us to delve deeper into how digital images and visual stereotypes influence the construction of social perceptions about older adults and assistive technologies. This framework is included in a the new section 4.4.

“Émile Durkheim, a pioneer in the study of collective representations, laid the groundwork for understanding how shared ideas and beliefs within a society influence social cohesion and the way individuals perceive reality. Durkheim posited that these representations are social constructions that emerge from communal life and, in turn, shape the actions and thoughts of the society's members [54]. His approach profoundly influenced subsequent studies on the formation and function of social representations. A notable example is the work of Lévy-Bruhl, who, prior to Moscovici, explored the pre-logical mindset of primitive societies, suggesting that forms of collective thought influence the perception of reality [55].

To better understand the implications of this study, the theory of social representation, developed by Serge Moscovici, has been adopted as the conceptual framework. This theory posits social representations are systems of values, ideas, and practices shared by members of a community, which allow persons to interpret reality and communicate about it. These representations are generated and transmitted through media, discourses, and cultural practices, and have a significant impact on the formation of collective perceptions and attitudes [56 – 58].

In the context of this analysis, digital images representing older adults and assistive technologies not only reflect preexisting social perceptions but also play an active role in constructing and perpetuating these perceptions. For example, the recurrent depiction of older adults in stereotypical settings or with limited emotional expressions reinforces reductive and often negative views of aging, which can influence how society as a whole perceives and values older adults and how they perceiver their environment [59,60].

This theoretical framework allows for an understanding that the lack of diversity and the presence of stereotypes in digital images are not merely visual shortcomings but manifestations of a broader system of social representations that can perpetuate inequities and limit inclusion. Furthermore, these representations have the power to shape the person and collective expectations and behaviors, affecting how older adults see themselves and how they are viewed by others. Furthermore, this dynamic can significantly influence societal attitudes towards older persons are impacting both how they perceive themselves and how they are perceived by others.

The socio-genetic perspective, which builds upon Moscovici's foundational concepts, extends this understanding by considering how biological factors might interplay with social processes in the formation of these representations. While Moscovici emphasized the social and cultural dimensions of representation, the socio-genetic approach adds a layer of complexity by exploring how inherent biological traits might influence or interact with the social construction of reality. This perspective enriches the original theory by integrating insights from genetics and biology into the analysis of how social representations are formed and sustained [61].

Thus, this study not only identifies technical shortcomings in the creation and selection of digital images but also highlights the need for a more nuanced approach to visual content creation. By addressing both the social and biological dimensions of representation, and striving for more equitable and diverse depictions, it is possible to challenge and transform prevailing social narratives. This comprehensive approach aims to foster a more inclusive and respectful portrayal of aging and the technologies that support older adults, ultimately contributing to a more balanced and fair societal view.

Following this, Deborah Lupton has examined how social representations are being transformed in the digital age, particularly in the realm of health and the body. Lupton argues that information technologies and the proliferation of personal data are reshaping perceptions of identity and well-being, while also influencing social narratives about what is considered normal or desirable in terms of health. Her work highlights how digital representations not only reflect preexisting social realities but also actively shape them, promoting new discourses and practices in everyday life. These ideas are particularly relevant for understanding how digital images and other forms of visual content can affect collective perceptions and, ultimately, influence social attitudes and behaviors [62].

This study, therefore, not only exposes technical issues in the generation and selection of images but also underscores the need for a more critical and conscious approach to the creation and distribution of visual content in the digital era and AI-driven environments. AI-driven environments refer to contexts where artificial intelligence algorithms are used to generate, curate, and analyze visual content. These systems can influence the types of images produced and how they are presented, often reflecting and amplifying existing biases. Under this perspective, Ruha Benjamin explores how such technologies can perpetuate social and racial biases, highlighting the importance of addressing these issues to foster more equitable and inclusive digital spaces [63]. By addressing these biases and working towards a more equitable and diverse representation in digital media, dominant social narratives can be challenged and transformed, promoting a more inclusive and respectful view of aging and the technologies that support this demographic group.”

REVIEWER COMMENTS 5: Also as the authors note the older adult population is diverse and it is necessary to have a more diverse and accurate representation of this segment of the population and foster positive attitudes toward use, this point is made but could be emphasized as it is an important finding.

Very interesting article - generally well organized and well-written. thank you

RESPONSE 5:

Thank you very much for your feedback. We truly appreciate your insightful comments and suggestions. Your indications have significantly contributed to our understanding and refinement of the concept of positive representations. We believe that incorporating your feedback has not only strengthened our argument but also enhanced the overall clarity and impact of our analysis. By addressing the nuances and implications of positive representations more thoroughly, we aim to offer a more comprehensive and nuanced discussion. Your input has been invaluable in this process, and we are confident that it will lead to a more robust and persuasive presentation of our ideas.

Author Response File: Author Response.docx

Reviewer 2 Report (New Reviewer)

Comments and Suggestions for Authors

The article submitted for review is made in a reliable manner. The topic discussed in the work is a very important issue today, but it seems that the authors made a mistake in the assumptions for the research conducted. The analyzed photos showing infrastructure supporting the elderly are promotional photos and are preceded by research on society, their expectations, preferences and aimed at selling specific products or services and not promoting a healthy lifestyle for the elderly. Therefore, the results give a picture of society and what recipients expect. It seems that the research just conducted is an answer to the question regarding the image of the contemporary perception of the group of older people, which can be compared with social opinion data.

Author Response

Comments and Suggestions for Authors

REVIEWER COMMENTS: The article submitted for review is made in a reliable manner. The topic discussed in the work is a very important issue today, but it seems that the authors made a mistake in the assumptions for the research conducted. The analyzed photos showing infrastructure supporting the elderly are promotional photos and are preceded by research on society, their expectations, preferences and aimed at selling specific products or services and not promoting a healthy lifestyle for the elderly. Therefore, the results give a picture of society and what recipients expect. It seems that the research just conducted is an answer to the question regarding the image of the contemporary perception of the group of older people, which can be compared with social opinion data.

RESPONSE:

Thank you for your valuable feedback. We appreciate your insights and agree that understanding the context in which images are used is crucial. We would like to clarify several aspects of our research in response to your comment:

Our study aims to analyze the representation of older adults in digital imagery, focusing on stereotypes, emotional portrayal, and environmental contexts. While our dataset includes promotional images, it also encompasses a variety of sources to ensure a comprehensive analysis. The primary goal is to uncover patterns and biases in these representations rather than solely critique promotional content.

We acknowledge that some of the images analyzed are promotional. However, we have included a diverse range of images to provide a broad view of how older adults are represented. This approach allows us to understand not only the expectations and preferences reflected in promotional materials but also the general portrayal of older adults in digital media.

Promotional images are indeed designed to market products or services, but they also reflect societal attitudes and can reveal underlying stereotypes and biases. Analyzing these images provides valuable insights into how older adults are perceived and portrayed, which is significant for understanding and addressing representation gaps.

We recognize that societal expectations play a role in how older adults are depicted in media. Our study aims to reveal these expectations and compare them with actual representations. Future research could explore how these portrayals align with or diverge from societal perceptions.

We agree that future research could benefit from a more focused analysis of promotional versus non-promotional images. Additionally, exploring the impact of these images on public perceptions and technology adoption among older adults would provide further insights.

For all of the above, we have included a paragraph in the discussion section, in the subsection of limitations:

“On the other hand, the images analysed in this study include a significant proportion of promotional material. This aspect should be considered when interpreting our findings. Promotional images are often designed to capture attention and promote specific products or services, which can influence how older adults are represented, often focusing on aspects that resonate with target audience expectations and marketing ideals. This promotional orientation can contribute to the perpetuation of stereotypes by depicting older adults in ways that align with prevailing social perceptions and expectations. However, the fact that these images come from promotional contexts does not invalidate their relevance in the discussion about public perception and stereotypes associated with aging. On the contrary, it underscores the need for greater critical reflection on how visual representations influence social perceptions and the acceptance of emerging technologies among older adults. This study aims not only to describe the content of the images but also to understand how these representations may reflect and, in turn, reinforce certain social perceptions and expectations. Future work would benefit from combining image analysis with additional research on how social perceptions and market expectations influence the representation of older adults. This would provide a more comprehensive and critical view of the impact of promotional images on the construction of identity and social integration of older adults.

We hope this response clarifies the intentions and scope of our study and addresses your concerns. Thank you for your thoughtful review.

Author Response File: Author Response.docx

Reviewer 3 Report (New Reviewer)

Comments and Suggestions for Authors

The paper is modern research using advanced AI techniques to assess the perception and representation of the elderly population in the Digital Environment. It is creative research that is also relevant to the present and (especially) future increasing share of the ageing population.

However, specific issues related to the research methodology, data interpretation, and the paper's connection to the field of land use and planning need to be addressed for the paper to reach its full potential.

1. This paper (to be published in the LAND journal) has few connections to land use and planning. Although there are some vague references to ”the built environment” when assessing representative images, no consistent analysis (maybe also maps) could contribute to the spatialisation of the results.

2. The Discussion is a rather large section but does not consider the paper's relevance for future policies and land/spatial planning. These aspects should be largely discussed.

Overall, a spatial dimension should be added or highlighted to make the paper more suitable for publication in the LAND journal.

 

Smaller issues:

- The style should be adapted for some parts of the paper. 

- Also, careful proofreading should be accomplished

Ex. 1. lines 57-60 - repetition of ” moreover”; 2. line 209 refers to section 2, not the whole article, when announcing the three parts; 3. Figure 2 - The 300 are the selected images (from presumably 11 mil. images) and not the initial images; 4. section 3.3. (411-414) should be renamed; 4. Image 3D - does not represent a man (as announced) but a woman.

 

Comments on the Quality of English Language

The English is generally good, but there are some small errors that can be easily corrected. Careful proofreading should be considered.

Author Response

Comments and Suggestions for Authors

REVIEWER COMMENTS 1: The paper is modern research using advanced AI techniques to assess the perception and representation of the elderly population in the Digital Environment. It is creative research that is also relevant to the present and (especially) future increasing share of the ageing population.

However, specific issues related to the research methodology, data interpretation, and the paper's connection to the field of land use and planning need to be addressed for the paper to reach its full potential.

RESPONSE 1:

We sincerely appreciate your thorough review of our paper and your insightful suggestions. Your feedback highlights the innovative aspects of our research. We are grateful for your acknowledgment of the relevance of this work, especially in the context of the growing ageing population.

Your comments regarding the research methodology, data interpretation, and the paper's connection to the field of land use and planning are highly valuable. We will carefully address these specific issues to enhance the paper's clarity and impact. Thank you once again for your constructive feedback, which will undoubtedly contribute to refining and strengthening our study.

REVIEWER COMMENTS 2: 1. This paper (to be published in the LAND journal) has few connections to land use and planning. Although there are some vague references to ”the built environment” when assessing representative images, no consistent analysis (maybe also maps) could contribute to the spatialisation of the results.

RESPONSE 2:

We appreciate the reviewer’s feedback and would like to emphasize how our paper aligns with the objectives of the special issue "Land, Ageing, Gender and Environment: Problems and Challenges from Different Disciplines II." Our study, which evaluates digital images of aids and assistive technologies for older adults, fits well within the scope of this special issue by addressing several critical aspects outlined in the call for papers. Specifically, our research contributes to understanding the spatial and socio-environmental dimensions of ageing, gender, and technology. We examine how digital imagery portrays older adults, with a focus on inclusivity and representation in various environments, including built and natural settings. The findings highlight significant gaps in the representation of older individuals, particularly women, and reveal biases in emotional expressions and spatial contexts. By integrating perspectives from gender studies, environmental psychology, and digital media analysis, our study sheds light on how these representations influence public perceptions and contribute to broader socio-environmental discussions. Furthermore, the use of advanced technologies, such as AI and deep learning, to analyze and propose improvements in digital imagery aligns with the special issue's focus on technological and environmental approaches. Thus, our paper offers valuable insights and proposes actionable methods for enhancing the representation of older adults in digital media, making it a relevant and significant contribution to the ongoing dialogue on land, ageing, and gender.

REVIEWER COMMENTS 3: The Discussion is a rather large section but does not consider the paper's relevance for future policies and land/spatial planning. These aspects should be largely discussed.

Overall, a spatial dimension should be added or highlighted to make the paper more suitable for publication in the LAND journal.

RESPONSE 3:

Thank you for your valuable feedback. We appreciate your suggestion to discuss the relevance of our findings for future policies and spatial planning. We have now incorporated a paragraph addressing this aspect into the discussion section. We have highlighted the persistent stereotypes and lack of diversity in the representation of older adults, as well as the implications for policy and urban planning:

“Additionally, the representation of older adults in digital images reveals a series of persistent stereotypes and a lack of diversity in the depiction of technologies and environments. These observations have significant implications for policy formulation and spatial planning. The prevalence of stereotypical representations, such as the predominant use of basic assistive devices and the exclusion of advanced technologies, underscores the need for policies that promote more inclusive and accurate representation. Public policies should encourage the integration of diverse representations in digital media and educational campaigns to adequately reflect the reality of older adults. Additionally, urban planning should consider the inclusion of both natural and built spaces that meet the needs of older adults, promoting active and healthy aging. Collaboration between policymakers, technology developers, and older adult communities is essential to ensure that environments and technologies are accessible and representative.”

We hope this addition strengthens our paper and aligns with your expectations. Thank you again for your insightful comments.

REVIEWER COMMENTS 4: Smaller issues:

- The style should be adapted for some parts of the paper. 

- Also, careful proofreading should be accomplished

Ex. 1. lines 57-60 - repetition of ” moreover”; 2. line 209 refers to section 2, not the whole article, when announcing the three parts; 3. Figure 2 - The 300 are the selected images (from presumably 11 mil. images) and not the initial images; 4. section 3.3. (411-414) should be renamed; 4. Image 3D - does not represent a man (as announced) but a woman.

Comments on the Quality of English Language

The English is generally good, but there are some small errors that can be easily corrected. Careful proofreading should be considered.

RESPONSE 4:

Thank you very much for your indications. We have corrected all the smaller issues as you have suggested. Finally, we have reviewed the text to correct typographical errors. We appreciate very much your time and your suggestions.

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report (New Reviewer)

Comments and Suggestions for Authors

As I indicated in the previous review, the presented article is extremely valuable from a scientific point of view. The entire methodology of conducting the research and the results of the research are described thoroughly.

However, there are a few elements missing resulting from the assumed goal. As you write, "the main goal of this article is to assess digital images of aids and assistive devices in the elderly population, from the perspective of gender, age and location, as well as artificial intelligence". It should be explained what the age perspective means, you only analyzed older people and there is no explanation of the research in terms of location (geographical).

The abstract should also be significantly shortened - it should be about 1000 words.

The discussion should be conducted in accordance with the presented research results, i.e. the first results are Presence of aids and assistive aids and this is where the discussion should begin. It should probably also be taken into account what percentage of older people use such devices.

Author Response

REVIEWER COMMENT: As I indicated in the previous review, the presented article is extremely valuable from a scientific point of view. The entire methodology of conducting the research and the results of the research are described thoroughly.

RESPONSE:

Thank you very much for your kind comment and for recognizing the scientific value of our article. We especially appreciate your acknowledgment of the rigor in our methodology and the clarity in presenting the results. Feedback like yours is extremely encouraging and motivates us to continue our work with dedication.

REVIEWER COMMENT: However, there are a few elements missing resulting from the assumed goal. As you write, "the main goal of this article is to assess digital images of aids and assistive devices in the elderly population, from the perspective of gender, age and location, as well as artificial intelligence". It should be explained what the age perspective means, you only analyzed older people and there is no explanation of the research in terms of location (geographical).

RESPONSE:

Thank you for your insightful comments. We appreciate the opportunity to clarify the perspectives of age and location in our study. We have revised the paragraph to explicitly define what we mean by the 'age perspective' — focusing on the different age groups within the older population—and the 'location perspective,' which examines geographical differences in the depiction and accessibility of aids and assistive devices. I believe these changes address your concerns and enhance the clarity of our objectives. Please find the revised paragraph below.

“By 'age perspective,' this study specifically examines how different age groups within the older population (e.g., those in their 60s, 70s, 80s, etc.) may be portrayed differently in digital images and how these representations could reinforce or challenge existing age-based stereotypes. Regarding 'location,' the research analyzes how the availability, design, and depiction of aids and assistive devices vary across different geographical regions, highlighting disparities that may exist between urban and rural areas, or across different countries.”

REVIEWER COMMENT: The abstract should also be significantly shortened - it should be about 1000 words.

RESPONSE:

Thank you for your feedback regarding the abstract length. We would like to clarify that the current abstract is already significantly concise, containing only 490 words. Given the detailed nature of our study, further shortening could result in the omission of essential information that is crucial for understanding the scope and findings of our research. However, if there are specific areas you believe could be condensed without losing key details, we would be happy to consider making adjustments. Your guidance is greatly appreciated.

REVIEWER COMMENT: The discussion should be conducted in accordance with the presented research results, i.e. the first results are Presence of aids and assistive aids and this is where the discussion should begin. It should probably also be taken into account what percentage of older people use such devices.

RESPONSE:

Thank you for your valuable feedback. We have restructured the discussion section in accordance with your suggestions. The revised discussion now begins with the results on the presence of aids and assistive devices, as follows:

“The analysis of digital images depicting older adults revealed several critical insights across various categories. Firstly, the representation of aids and assistive devices predominantly featured ‘glasses’ (74.4%), with less frequent portrayals of ‘canes’ (14%) and ‘wheelchairs’ (4.9%). ‘Hearing aids’ and the use of multiple devices simultaneously were rare, indicating a limited portrayal of the full spectrum of assistive technologies available. Gender representation in these images was skewed, with men depicted more frequently (31.4%) compared to women (25.6%), and a notable portion of images (38%) showing mixed-gender groups.

This representation is significant given that assistive devices are crucial for the daily lives of many older adults. According to data, approximately 70% of older adults utilize at least one form of assistive device. The disparity between this statistic and the depiction in digital imagery underscores a substantial gap in how these technologies are represented. The underrepresentation of hearing aids and other assistive technologies not only misrepresents the variety of aids used by older adults but also reinforces a narrow view of aging that fails to acknowledge the diversity of assistive tools available.

Gender representation in these images was skewed, with men depicted more frequently (31.4%) compared to women (25.6%), and a notable portion of images (38%) showing mixed-gender groups. This imbalance points to a lack of gender inclusivity in digital portrayals of older adults. Furthermore, the absence of diverse gender identities in these images highlights a broader issue of inclusivity.

Emotional portrayal in these images predominantly showed ‘joy’ and ‘unrecognized emotions,’ each at 44.6%, while other emotions such as ‘sadness’ were less common. Gender differences were evident in the emotional representation, with women more frequently associated with ‘sadness’ compared to men, suggesting a potential gender bias in emotional depiction. The Cohen’s Kappa coefficient for emotion agreement was very low (-0.0608), indicating significant variability in emotion classification among observers and highlighting the inconsistency in emotional portrayal.

The environment depicted in the images revealed a strong bias towards built environments (71.9%), with natural environments represented in only 10.7% of the images. Built environments included residential and commercial spaces, while natural settings were primarily aquatic or green spaces. This over-representation of built environments may contribute to a stereotypical view of aging as confined to institutional or controlled settings.

Challenges with AI-generated images were also significant. AI systems often struggled to accurately depict emotions and environmental contexts, resulting in images with neutral or ambiguous expressions and idealized or futuristic settings that do not accurately reflect real-life scenarios. This discrepancy underscores the need for improved training data and more nuanced approaches to AI-generated imagery to better represent older adults.

These findings collectively highlight ongoing issues in the representation of older adults in digital imagery, including the prevalence of stereotypes, gender biases, and limitations in emotional and environmental depiction. Addressing these issues through more inclusive and diverse visual content is essential for creating a more accurate and respectful portrayal of aging.”

Moreover, we have restructured the discussion section. Subchapter 4.1, titled “Social Representation Theory and Its Impact on the Perception of Older Adults in Digital Images,” has been repositioned as the first subchapter to provide a more coherent and relevant structure for the reader.

Please, other minor changes are performed in the document to emphasize the results and redirect the approach.

Thank you very much for your advice.

 

Author Response File: Author Response.docx

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Thank you for this novel study. Below are areas that need significant improvement. 

 Introduction:

1 . Review for a clear and logical flow about why this work is important. 

2. Line 65-67 reads a little confusing. I would recommend deleting "because it's not only objective." 

3. Provide a comprehensive definition of "health support technology."

4. Line 66-67, a transition is needed to connect the "health support technology" with the use of AI. As written is unclear how these two work together in this paper. 

5. Line 72 indicates "war crisis," but it is unclear what is meant. 

6. Lines 82-83 are unclear as written. Please revise.

7. In lines 97-99, you will need to expand more on social networks. It feels out of place to mention X. How does this relate to your study?

8. Line 100 should this read how people are represented vs represent themselves?

9. The introduction would benefit from a clear purpose of this paper at the end. 

 

Methods

10.  Lines 157-160 do not appear to be in English

11. Line 170 it is indicated that the images were coded. However, it does not provide details on how inter-rater reliability was achieved.  

12. Methods would benefit from reorganizing and adding subheadings such as data collection and data analysis. 

13. Rename sampling to Power Analysis

Results

14. Lines 273-279 may be a better fit for the methods. It would help explain the variables you selected versus not.

15. Lines 308-309 are unclear what is meant by “collective imagination of passivity.”

16. Lines 38, it is unclear what is meant by “the space or context that generates”

Discussion/conclusion

17. A careful review of the discussion needs to be done for clarity.

 

18. Discussion would benefit from a clear implication to this work.

Comments on the Quality of English Language

The manuscript does need to be reviewed to ensure that everything is translated into English and that overall clarity. 

Author Response

REVIEWER 1:

Thank you for this novel study. Below are areas that need significant improvement. 

Answer: Thank you for your positive comments and suggestions.

 Introduction:

1 . Review for a clear and logical flow about why this work is important. 

Answer: Thank you for the observations and suggestions. The text has been edited.

2. Line 65-67 reads a little confusing. I would recommend deleting "because it's not only objective." 

Answer: The text has been edited.

3. Provide a comprehensive definition of "health support technology."

Answer: We have changed the words of definition which is now concentrated only in aids and assistive aids. The explanation is given in introduction.

4. Line 66-67, a transition is needed to connect the "health support technology" with the use of AI. As written is unclear how these two work together in this paper. 

Answer: the text has been edited to make these connections clearer.

5. Line 72 indicates "war crisis," but it is unclear what is meant. 

Answer: This sentence has been deleted.

6. Lines 82-83 are unclear as written. Please revise.

Answer: The text has been edited.

7. In lines 97-99, you will need to expand more on social networks. It feels out of place to mention X. How does this relate to your study?

Answer: Thank you for the observations. The social networks are not included in our analysis (but it was treated in a previous study by some authors of the work team). This sentence has been deleted.

8. Line 100 should this read how peoplearerepresented vs represent themselves?

Answer: The text has been edited.

9. The introduction would benefit from a clear purpose of this paper at the end. 

Answer: The objective of this work is included at the end of the introduction.

Methods

10. Lines 157-160 do not appear to be in English

Answer: We understand that this comment refers to the lines about the descriptors used in the searches. As indicated in the manuscript, to broaden the scope we replicated searches with descriptors in both English and Spanish, so the words are not translated.

11. Line 170 it is indicated that the images were coded. However, it does not provide details on how inter-rater reliability was achieved.  

Answer: The codes referred to the way of rigorously classifying the categories within the Excel database (where the images were systematized). Although no statistical processes were performed to assess reliability, as we indicated, to reduce information bias, all images were reviewed at least twice by two inde-pendent researchers.

12. Methods would benefit from reorganizing and adding subheadings such as data collection and data analysis.  

Answer: Sub-sections were added.

13. Rename sampling to Power Analysis

Answer: The text has been edited (sampling to Power Analysis).

Results

14. Lines 273-279 may be a better fit for the methods. It would help explain the variables you selected versus not.

Answer: Thank you for your observation. We consider that all the variables included in the methods section (Table 1) were reported in the different solved sections. We would also like you to provide more clarity on this comment for inclusion in subsequent versions of this manuscript.

15. Lines 308-309 are unclear what is meant by “collective imagination of passivity.” 

Answer: As we have indicated in the introduction (from a theoretical approach), in some sections of the results we allude to the "collective imaginary". However, for the sake of clarity we made an edit in the text on this aspect for greater clarity.

16. Lines 38, it is unclear what is meant by “the space or context that generates”

Answer: It was a typo, thanks for the observation. This sentence is deleted.

Discussion/conclusion

17. A careful review of the discussion needs to be done for clarity.

 Answer: Some changes were made based on this comment.

18. Discussion would benefit from a clear implication to this work.

Answer: In accordance with this comment, we have made some changes to the discussion and deleted some paragraphs that were far from the specific implications of this work and subtitles are added.

Comments on the Quality of English Language

The manuscript does need to be reviewed to ensure that everything is translated into English and that overall clarity. 

Answer: Based on the above comments, further modifications were made to the text, considering the English expressions.

Reviewer 2 Report

Comments and Suggestions for Authors

This study presents an intriguing examination of the social circumstances of older adults by selecting images from a picture database that depict aspects of their lives. Below are some recommendations for the article:

1. 1. The introduction contains some irrelevant content that could be streamlined to directly relate to the research objectives and content.

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3. 2. When selecting images, it would be beneficial to further clarify why criteria were established for "Representations of the environment of older people within different spaces"， "Presence of types of health support devices," and "Emotions." Particularly, the connection between emotions and the former two criteria could be highlighted.

4. 3. Regarding the research design, can images selected from known databases truly represent the representations of older people in real-life social settings? How can the limitations of a research design that may lead to a disconnect between images and reality be addressed?

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6. 4. What are the differences between images generated by AI and those from the database, and can these differences be emphasized further?

I hope these recommendations help improve the clarity and focus of the article.

Comments on the Quality of English Language

The English writing of this paper is clear and appropriate.  

Author Response

This study presents an intriguing examination of the social circumstances of older adults by selecting images from a picture database that depict aspects of their lives. Below are some recommendations for the article:

Answer: Thank you for your positive comments and suggestions.

 

1. The introduction contains some irrelevant content that could be streamlined to directly relate to the research objectives and content.

Answer: Thank you for the observations and suggestions. The text has been edited.

 

2. When selecting images, it would be beneficial to further clarify why criteria were established for "Representations of the environment of older people within different spaces"， "Presence of types of health support devices," and "Emotions." Particularly, the connection between emotions and the former two criteria could be highlighted.

Answer: The text has been edited and incorporates ideas about the connections between emotions and the former two criteria could be highlighted.

 

While for images from digital repositories, general criteria were used, in the case of AI-generated images (since it was an exploratory component), including these criteria were more specific in order to achieve greater specificity. These clarifications are included in this new version of the manuscript.

3. Regarding the research design, can images selected from known databases truly represent the representations of older people in real-life social settings? How can the limitations of a research design that may lead to a disconnect between images and reality be addressed?

Answer: Thank you for the suggestions. These ideas (limitation) are included in the discussion.

4. What are the differences between images generated by AI and those from the database, and can these differences be emphasized further?
5. Answer: Thank you for the suggestions. These ideas are included in the discussion.

 

I hope these recommendations help improve the clarity and focus of the article.

 

Comments on the Quality of English Language

The English writing of this paper is clear and appropriate.  

Reviewer 3 Report

Comments and Suggestions for Authors

This manuscript contains numerous academic paper format errors (citation errors), image inaccuracies (such as incomplete display of Figure 1, and Figure 2 appearing to be copied from elsewhere), and the title appears to be two separate titles (as the author has used a period). Therefore, I believe the quality of this paper is questionable. While the topic and theme of this paper are very interesting (about health support devices and AI), what confuses me is that this manuscript has almost no relevance to this journal 'Land', especially with the keyword 'land'. Additionally, although the author claims there are images depicting built environments, most of the images shown in the paper are indoors, with very limited elements reflecting built environments. In terms of analytical methods, although this article leans heavily towards qualitative analysis, with hardly any analytical methods presented. It only involves simple probability statistics, thus casting doubt on the scientific rigor of the paper. I don't think this article resembles an empirical academic paper very much. Based on the above, my opinion on this paper is to reject it.

Comments on the Quality of English Language

Minor editing of English language required

Author Response

This manuscript contains numerous academic paper format errors (citation errors), image inaccuracies (such as incomplete display of Figure 1, and Figure 2 appearing to be copied from elsewhere), and the title appears to be two separate titles (as the author has used a period). Therefore, I believe the quality of this paper is questionable. While the topic and theme of this paper are very interesting (about health support devices and AI), what confuses me is that this manuscript has almost no relevance to this journal 'Land', especially with the keyword 'land'. Additionally, although the author claims there are images depicting built environments, most of the images shown in the paper are indoors, with very limited elements reflecting built environments. In terms of analytical methods, although this article leans heavily towards qualitative analysis, with hardly any analytical methods presented. It only involves simple probability statistics, thus casting doubt on the scientific rigor of the paper. I don't think this article resembles an empirical academic paper very much. Based on the above, my opinion on this paper is to reject it.

 

 

Answer: Thank you for your return and we appreciate your indications. We would like to add that this paper has modified in the terms you have suggested and, based on your comments, the following changes were made:

- Citation errors have been revised

- Regarding Figure 1 it is sent in an editable version and a footnote is added at the bottom of the figure clarifying it, since it was elaborated for this work. Figure 2 corresponds to a Stata v. 14 output generated for this work (the comment is also added to the footnote of Figure 2).

- In the title, the period is replaced by a colon.

- This manuscript is part of a specific monograph on Land from an interdisciplinary approach.

- On the environment variable (built and natural), the categories were imputed following those reported in previous studies (as indicated in methods).

- We have considered your comments and those of the other reviewers in this new version. We look forward to further comments and suggestions.

Thank you.

 

 

 

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Although the article has made some improvements, there are clear issues that remain. 

Introduction

- The narrative needs to better describe the need for this study. Make a stronger argument as to why sex, environments, are important units for analysis.

- Several typos were identified. 

Methods

- Improved but I found it difficult as written to replicate

- What codebook was developed to ensure the inter-coder reliability of the emotions?  

-206-209 is not very clear

Results

- 283-291 seem to be methods and not results

- Image 1: How do you define something without expression? I would argue she has an expression. 

- In line 299, you refer to health support technologies, but you make the distinction in the introduction that has a different meaning. 

- Figure 3 without colors is confusing to interrupt

- Review 300-301 for accuracy of statement.

- Review 329-333 for typos and accuracy of reporting results. For instance, your indicate contemporaries did not reach 3%. I'm assuming you mean women if so then the statement seems inaccurate. 

- Label image 3 a b c d

- Line 341-342 read for clarity. 

- Delete the last sentence of 344

- Delete the first sentence 348

- Lines 347-355 seems more part of the discussion

Discussion

-You make several inferences about stereotypes that have been drawn from your work. However, "stereotypes" weren't used in part of your analysis. You will need to do this if it is to be tied to your work.

- Line 381, you indicate that this is consistent with other studies. Explain what is? and how so?

- Overall the discussion needs to be improved to make clear the implications from your work.

Comments on the Quality of English Language

Writing needs improvement.

Reviewer 2 Report

Comments and Suggestions for Authors

The paper has reached the level of publication.