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Article History

Received: 26 May 2023

Accepted: 30 November 2023

First Online: 6 December 2023

Declarations

:

: The study protocol was approved by the Ethics Committee of Tokyo Metropolitan Institute of Gerontology (R22-026). This study was conducted in accordance with the code of ethics set by the Declaration of Helsinki and its future amendments or comparable standards. All participants provided written informed consent. For additional consent of surrogates of older people, we followed the recommendations of the Global Alliance for Genomics and Health’s Ageing and Dementia Task Team (17). This recommendation states that researchers should presume that people with dementia have capacity until they demonstrate otherwise. We have been communicating with the participants in this study for seven years. All health professionals involved in the project, including the geriatric psychiatrist, judged that they have a consistent willingness and sufficient capacity to participate in the study on an understanding basis. Therefore, consent was not obtained from legally authorized proxies. In addition, participants in this study were not eligible for guardianship system in Japan. The reason is that, in Japan, legally authorized representatives cannot be carried out unless the person has severe dementia and is unable to protect their property (known as guardianship). The study protocol has been approved by the Ethics Committee of Tokyo Metropolitan Institute of Gerontology as described in this statement.

: Not applicable.

: The authors declare that they have no competing interests.