The Prevalence and Influencing Factors of Care Need among Community-dwelling Older People in Three Provinces of China

Background With the aging population, research on elderly care has increasingly become a focal point. Previous surveys on the demand rate for elderly care have shown significant variation (8.54% to 53.15%) and lack large-scale study evidence. Objective To understand the prevalence and influencing factors among community-dwelling older people in three provinces of China. Methods The study subjects were from the baseline survey of Prevention and Intervention on Neurodegenerative Disease for Elderly in China conducted in 2019. This survey employed a multi-stage stratified cluster random sampling method, selecting a total of 16 199 elderly individuals aged 60 and above from 16 districts and counties across Liaoning, Henan, and Guangdong provinces. The questionnaire covered basic demographic characteristics (gender, age, urban/rural residence, marital status, education level, occupation, weight, living situation), current care needs, chronic disease status, the Patient Health Questionnaire (PHQ-9), the Mini-Mental State Examination (MMSE), the Activities of Daily Living (ADL) scale, self-rated health status, daily exercise habits, and the number of falls. The PHQ-9 was used to assess the psychological health of the elderly, the MMSE was used to evaluate cognitive function, and the ADL scale or self-reported need for care was used to assess elderly care needs, defined as the presence of BADL or IADL disabilities, or a self-reported need for care. Logistic regression analysis was used to explore the influencing factors of elderly care needs. Results The prevalence of care needs among community-dwelling older people in three provinces was 14.57% (95%CI=14.02%-15.11%), and the prevalence of care needs increased gradually with age, consistently higher among females than males in all age groups. The results of multifactorial analysis showed that the risk of care need increased 7% (OR=1.07, 95%CI=1.06-1.08) for each additional year of age. Compared with illiteracy, the ORs of care need for those with primary school, secondary school, high school and above were 0.33 (95%CI=0.29-0.37), 0.24 (95%CI=0.20-0.28), 0.17 (95%CI=0.12-0.22), respectively. Compared with daily exercise, the OR of care needs for those who did not exercise daily was 1.17 (95%CI=1.05-1.30) .Compared with those who did not suffer from chronic diseases, the ORs of care needs for those who suffered from 1-2 kinds and those 3 or more kinds of chronic diseases were 1.29 (95%CI=1.10-1.51) and 1.57 (95%CI=1.35-1.82). Compared with normal cognitive function, the OR of care need for those with abnormal cognitive function was 2.02 (95%CI=1.79-2.27). Compared with good self-assessed health status, the OR of care need for those with fair health status and those with poor health status were 1.29 (95%CI=1.14-1.46) and 2.68 (95%CI=2.27-3.16). Compared with those did not having fallen, ORs of care needs for those with 1-2 and 3 or more falls were 1.23 (95%CI=1.06-1.43) and 2.00 (95%CI=1.59-2.52). ORs of care needs for those with mild and moderately severe depression compared to those with a good mental status were 1.14 (95%CI=1.21-1.65) and 2.05 (95%CI=1.69-2.48) . Conclusion The demand for elderly care among community-dwelling older adults of China is notably high. This demand is particularly elevated among individuals who are older, have poorer physical and psychological health, and have experienced a higher frequency of falls.