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Article History

Received: 26 July 2026

Accepted: 9 September 2026

First Online: 15 September 2026

Declarations

Ethics approval and consent to participate: This study is a secondary analysis of publicly available, fully de-identified data and therefore required no additional ethics approval or informed consent. The original data collection of each cohort was ethically approved: CHARLS by the Biomedical Ethics Review Committee of Peking University (IRB00001052-11015); HRS by the Institutional Review Board of the University of Michigan (HUM00061128); and ELSA by the London Multicentre Research Ethics Committee (MREC/01/2/91), with subsequent waves approved by the National Research Ethics Service. All participants in the three cohorts provided written informed consent before data collection. All procedures were performed in accordance with the Declaration of Helsinki.

Consent for publication: Not applicable.

Competing interests: The authors declare no competing interests.