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Article History

Received: 21 April 2025

Revised: 9 November 2025

Accepted: 13 November 2025

First Online: 12 December 2025

Declarations

:

: The authors declare no conflicts of interest. Approval was obtained from all authors.

: The CHARLS survey received ethical approval from the Peking University Bioethics Committee (IRB No. IRB00001052-11014). This study utilized publicly available, anonymized data from the CHARLS, which meets the exemption criteria outlined in Article 32 of the Measures for Ethical Review of Life Science and Medical Research Involving Human Subjects, issued on February 18, 2023, by the National Health Commission of China, Ministry of Education, Ministry of Science and Technology, and the National Administration of Traditional Chinese Medicine. Specifically, research using legally obtained public datasets or anonymized data that does not cause harm to individuals, involve sensitive personal information, or pertain to commercial interests is exempt from additional ethical review.