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Article History

Received: 15 June 2025

Accepted: 17 September 2025

First Online: 14 October 2025

Declarations

:

: All of the participants received a written explanation from their JAGES municipality and provided their written consent when responding to the survey. Participants were informed about the significance, objectives, and methods of the research, their voluntary participation as research subjects, the publication of anonymized data, and their right to withdraw without penalty. This information was provided both in writing and orally by the principal investigator. Consent was obtained through the participant signing a written consent form. This research focused exclusively on individuals aged 65 years or older and did not include minors. All data were fully anonymized, and participants explicitly consented in writing to the use of their anonymized data for research purposes. This research was conducted in accordance with the 1964 Declaration of Helsinki (and its amendments) and the ethical guidelines for life sciences and medical research involving human subjects as outlined by the Ministry of Health, Labour and Welfare of Japan. The study was reviewed and approved by the Institutional Review Board of Hokkaido University (Certificate No. 24–32; 1 July 2024).

: Consent was obtained through participants’ signatures on a written consent form.

: The authors declare that they have no competing interests.