What long-term care services may elderly people need in Beijing: evidence from the heterogeneous of physiological, psychological, and social characters†
Abstract
Objective
To develop a functional classification for older adults and compare the characteristics and service needs across different categories to inform targeted long-term care service planning.
Methods
A cross-sectional study was conducted among 5997 older adults (≥60 years) from 8 communities in Beijing, selected via stratified random sampling through activities of daily living levels. Data were collected via electronic questionnaires assessing demographics, functional status, physiological factors, psychological status, social engagement, and perceived needs for 18 long-term care (LTC) services. K-means clustering analysis was applied to activities of daily living (ADL) and IADL scores to identify functional groups. Between-group differences were analyzed using ANOVA and chi-square tests. Multivariate logistic regression examined factors associated with different disability levels.
Results
Four distinct functional clusters were identified: “Healthy” (70.8%), “Mildly Disabled” (16.2%), “Moderately Disabled” (7.7%), and “Severely Disabled” (5.3%). Compared to the healthier groups, disabled groups were significantly older, had lower education levels, higher comorbidity burdens, greater polypharmacy, more severe sensory impairments, higher rates of falls, longer daytime sleep, and increased prevalence of depressive symptoms and social isolation (all P < 0.05). The need for most LTC services, especially personal care, home-based services, and caregiver support, increased significantly with the level of disability (P < 0.001). However, “health knowledge guidance” was highly demanded across all groups.
Conclusions
Significant heterogeneity exists among older adults with different functional statuses. Integrating services such as chronic disease and medication management, sensory screening, nutritional support, and psychosocial interventions into the LTC system is recommended. Service planning should consider the graded needs across functional categories, prioritizing preventive education while ensuring adequate personal care for disabled individuals. The clustering approach offers a data-driven reference for developing nuanced LTC classification standards.
© 2026 Ji-Yuan Liu, Yi-Jia Zhang, Ying Wu, published by Shanxi Medical Periodical Press
This work is licensed under the Creative Commons Attribution 4.0 License.