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Article History

Received: 1 July 2025

Accepted: 10 October 2025

First Online: 17 November 2025

Declarations

:

: The authors declare no competing interests.

: The Medical Ethics Committee of the 925th Hospital approved this study (approval No. YNKT202504). As the data utilized were anonymized and accessible to the public via the CHARLS website, the 925th Hospital Review Board classified this study as “non—human subjects” research. Prior to the study, written informed consent was acquired from each participant. This research complied with the principles outlined in the Declaration of Helsinki and received approval from the Ethics Committee of Peking University (IRB00001052-11015). All participants of the China Health and Retirement Longitudinal Study (CHARLS) gave their written informed consent, and the data were anonymized prior to public dissemination. This secondary analysis used fully de-identified, publicly available CHARLS data; individual identifiers were never accessed. Procedures conformed to the CHARLS Data Use Agreement: no individual-level disclosure and files stored on encrypted servers.

: Each author has reviewed and endorsed the manuscript’s final version and agrees to its dissemination. The corresponding author attests that all authors are aware of the submission and have authorized its publication.