Associations Between Intrinsic Capacity Profiles and Unmet Home- and Community-Based Care Need Patterns Among Older...

Background: Home- and community-based care services are expanding in China, but older adults differ substantially in both functional capacity and unmet service needs. This study aimed to identify intrinsic-capacity profiles and patterns of unmet home- and community-based care needs and to examine their associations among community-dwelling older adults in China. Methods: Data were obtained from 10,405 adults aged ≥65 years in the 2018 Chinese Longitudinal Healthy Longevity Survey. Intrinsic-capacity profiles were identified using scale-aware finite-mixture modeling with continuous and ordinal indicators, and unmet-need patterns were identified using latent class analysis. Associations between the two classifications were examined using chi-square tests and multinomial logistic regression. Missing covariate data were handled using 20 multiple imputations, and regression estimates were pooled using Rubin's rules. Results: Five intrinsic-capacity profiles and three unmet-need patterns were identified. The overall crude association between intrinsic-capacity profiles and unmet-need patterns was very small and not statistically significant (χ²(8) = 14.77, p = 0.064; Cramér's V = 0.027). In the primary adjusted model, the Cognition-Preserved Locomotion-Psychological Vulnerability Profile showed the most consistent association with Pattern 1 versus Pattern 3 (OR = 1.30, 95% CI 1.13-1.49), whereas the Very Severe Multidomain Impairment Profile showed a weaker nominal association (OR = 1.40, 95% CI 1.02-1.92) that was not maintained in the extended model. Given the multiple profile contrasts examined, these coefficient-level findings should be interpreted cautiously. No intrinsic-capacity profile was significantly associated with the Low-Need/Light Health Protection Pattern versus the High-Need pattern. Conclusions: Both intrinsic capacity and unmet home- and community-based care needs showed substantial heterogeneity. Intrinsic-capacity profiles alone did not correspond closely to unmet-need patterns, although a specific adjusted association was observed. Integrating intrinsic-capacity assessment with direct evaluation of service needs and broader social and health-related factors may provide a more appropriate basis for person-centered community care planning.