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Does the introduction explain the objective of the research presented in the preprint?

Yes

The authors did a great job providing credible literature on the topic for readers to better understand. They also provided adequate and up-to-date citations of literature. In concluding the background, they then provided objectives that aligned with the highlighted problem. However, we suggest that they consider providing more data related to the prevalence of key outcomes, including mortality, to strengthen the introduction. Generally good with few editing issues, for example, citation number 16 and minor language errors.

Are the methods well-suited for this research?

Neither appropriate nor inappropriate

We applaud the researchers for carefully structuring the format they carried out their research. Despite this, we did not see the justifications for the study design and how it fits the study aim. Purposive sampling is known to work best with qualitative but not for inferential statistics. Is it possible for the researchers to look back again and consider a random sample or take this as a limitation to their study? In the case where this is considered a limitation, it should be justified. The reason is that it creates selection bias. Also, we noted incomplete sentences such as: "Part 1 Screening Instruments: The 6-item Cognitive Impairment Test (6-CIT) developed by Brooke and Bullock in 1999 [34] and translated into Thai by Suparb Aree-Ue and Phichpraorn Youngcharoen in 2020 [32]..........." Regarding the study tools, we would like to have a further description of the versions considered from different authors, literature, and why they were selected for this particular work. More details also on how the tool (s) were validated. This would help in knowledge translation. The grouping of the outcome variable [For analytical purposes, these responses were recoded into two categories: (1) the abstaining and unchanged activity group and (2) the group reporting reduced frequency and duration, facilitating dichotomous analysis of SA patterns postdiagnosis.], is not very clear. The groups seem to overlap. Can the authors have a look at the difference between abstaining and reduced SA in the grouping? Regarding ethical considerations, we suggest authors take this as the last subheading in this section, discuss a little further, including how informed consent was obtained, how participants were approached, the Ethical Approval number, how participants' psychological distress issues were handled, and how the study authors adhered to overall ethical principles. Data management (it should be a section of its own): Was it stored in the cloud, and could authors explain the security issues around their chosen data storage option? Who had access to the data, and with whose permission? The data analysis also needs more details and clarification. For instance, statistical roles demand that after choosing a statistical model for binary data, Crude Odds Ratios and Adjusted Odds Ratios should be performed to better inform results and understanding. Fantastic, authors attempted to calculate their sample size. However, we suggest mentioning the exact method used for sample size calculations. Optional: authors might consider using a flow chart to summarize their methods, as this would make it easy to understand.

Are the conclusions supported by the data?

Somewhat supported

This is due to the concerns raised about statistical analysis and the method section overall.

Are the data presentations, including visualizations, well-suited to represent the data?

Somewhat appropriate and clear

We agree with the data presentation because most of the data can be presented on a table but some of the tables on the result section have too much data making it somehow difficult to visualize or make more sense of the data. Thus, the inclusion of chart would have made the data presentation more visually appealing.

How clearly do the authors discuss, explain, and interpret their findings and potential next steps for the research?

Neither clearly nor unclearly

We appreciate the author's efforts; however, the fact that their age grouping was too wide (18–60 and >60 years) is a call for concern that greatly affects results and room for hidden knowledge, as young people <25, for instance, and people >25 might not react to diseases in the same way. Thus, need to further narrow the grouping. The authors often presented their tables before explaining their results. The role of the thump is: present results in a coherent manner in all circumstances before citing charts or tables. We also noticed that authors erroneously misplaced some important elements in the conclusion section, which normally includes future implications of their study findings, recommendations, strengths, and limitations.

Is the preprint likely to advance academic knowledge?

Highly likely

This is because NCDs are generally becoming global public health issues that, if not addressed properly, might greatly affect treatment outcomes, the social wellbeing of the patients, and thus contribute to more NCD challenges of mental health.

Would it benefit from language editing?

Yes

Would you recommend this preprint to others?

Yes, but it needs to be improved

Is it ready for attention from an editor, publisher or broader audience?

No, it needs a major revision

Competing interests

The authors declare that they have no competing interests.