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Article History

Received: 12 February 2026

Accepted: 17 April 2026

First Online: 21 April 2026

Competing interests

: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

: This study was based on data from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative longitudinal survey of Chinese adults aged 45 years and older. The CHARLS study protocol was approved by the Ethics Review Committee of Peking University (IRB00001052–11015). All participants provided written informed consent at the time of enrollment. All procedures involving human participants were conducted in accordance with the ethical standards of the institutional research committee and with the Declaration of Helsinki and its later amendments. The present study involved secondary analysis of de-identified publicly available data, and no additional ethical approval was required.