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Article History

Received: 6 March 2025

Accepted: 4 June 2025

First Online: 2 July 2025

Declarations

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: This study is based on data from the Sakai City Older Adults Survey 2020, conducted by the Longevity Support Division, Longevity Society Department, Health and Welfare Bureau, Sakai City Government. The dataset is not publicly available. However, access to the dataset was granted to the researchers upon request, with explicit permission from the Longevity Support Division, Longevity Society Department, Health and Welfare Bureau, and Sakai City Government. This study is part of the doctoral dissertation research at Osaka Prefecture University (now Osaka Metropolitan University), Japan, and has been conducted in accordance with the university’s academic guidelines and approval processes. The study involves the secondary use of fully anonymized survey data collected by the Sakai City Government and complies with the ethical principles outlined in the Declaration of Helsinki (Link: ), particularly in safeguarding participant confidentiality and ensuring the responsible use of research data. In accordance with Japanese regulations, specifically the Act on the Protection of Personal Information (APPI) and guidelines from the Ministry of Health, Labor and Welfare (MHLW) on the Ethical Guidelines for Life Science and Medical Research Involving Human Subjects, the secondary use of anonymized administrative data does not require prior approval from an Institutional Review Board (IRB) or ethics committee. As a result, this study did not require submission to an ethics committee for approval. For further reference, please see Japan’s Act on the Protection of Personal Information (Link: ).

: The authors declare no competing interests.