Dynamic trends of family-based eldercare vulnerability among older adults in agro-pastoral areas of Xinjiang, China: a longitudinal study

Dynamic trends of family-based eldercare vulnerability among older adults in agro-pastoral areas of Xinjiang, China: a longitudinal study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Dynamic trends of family-based eldercare vulnerability among older adults in agro-pastoral areas of Xinjiang, China: a longitudinal study Na Meng, Pei Wu, Abeibao Aifeire, Qin Liu, Jingyi Yuan, Mei Sun, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7336900/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 17 You are reading this latest preprint version Abstract Background: Population ageing in the context of China’s economic transition exposes older adults to accumulating health risks, shrinking family structures, inadequate economic security and weakening social-support networks. These challenges are further magnified in agro-pastoral regions, where harsh geographical settings, underdeveloped social-security systems, and shortages of both pension and medical services render family-based eldercare increasingly fragile and complex, thereby constraining healthy ageing and sustainable regional development. We therefore examined the dynamic characteristics of family-based eldercare vulnerability among rural older adults in Xinjiang’s agro-pastoral areas and identified its key obstructive factors, aiming to provide an evidence base for targeted policy making in underdeveloped pastoral-agricultural regions. Methods: Using a multistage stratified random sampling design, we recruited 1 400 rural residents aged ≥ 60 years across agro-pastoral counties of Xinjiang, China. Baseline data were collected in 2019, with follow-up waves conducted every two years in 2021 and 2023. Family-based eldercare vulnerability was quantified with an entropy-weighted TOPSIS model. Latent class growth model was employed to delineate distinct trajectories of vulnerability over time, while an obstacle-degree model was applied to identify the principal determinants impeding effective support. Results: The family-based eldercare vulnerability index exhibited an overall increasing trend among the study population. Based on vulnerability trajectories, three distinct subgroups were identified: (1)High-level ascending group (14.09%) – Key barriers: major illness, hospitalization due to illness, depression, widowhood, body mass index, and indebtedness. (2)Medium-level gradual increase group (45.95%) – Key barriers: hospitalization due to illness, grandchild-care, body mass index, unemployment, and lack of daily life care.(3)Low-level stable group (39.97%). Conclusion： Family-based eldercare vulnerability among rural older adults in Xinjiang’s agro-pastoral regions intensified continuously over the study period, and distinct latent trajectory subgroups emerged. Older adults in the medium-level gradual increase group exhibited suboptimal health status and a tenuous family-support network, whereas those in the high-level ascending groupconfronted severe health deterioration and substantial economic strain. Despite shared barriers, subgroup-specific obstacles were also evident, underscoring the need for precisely targeted interventions to strengthen eldercare services. For the Medium-level gradual increase group, priority should be given to promoting health-protective behaviours through tailored health-literacy initiatives, alleviating family caregiving burden, and systematically rebuilding social-support networks. For households in the high-level ascending group, policy efforts should focus on comprehensive medical-security coverage, psychological-crisis interventions, and targeted economic assistance to resolve the family-care predicament. Agro-pastoral old-age family-based eldercare vulnerability dynamic trend obstacle factor Full Text Additional Declarations No competing interests reported. Supplementary Files SurveyQuestionnaire.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 07 Jan, 2026 Reviews received at journal 29 Dec, 2025 Reviews received at journal 14 Nov, 2025 Reviews received at journal 08 Nov, 2025 Reviews received at journal 07 Nov, 2025 Reviewers agreed at journal 31 Oct, 2025 Reviewers agreed at journal 30 Oct, 2025 Reviews received at journal 28 Oct, 2025 Reviewers agreed at journal 26 Oct, 2025 Reviewers agreed at journal 25 Oct, 2025 Reviewers agreed at journal 22 Oct, 2025 Reviewers agreed at journal 19 Oct, 2025 Reviewers invited by journal 28 Aug, 2025 Editor assigned by journal 24 Aug, 2025 Editor invited by journal 14 Aug, 2025 Submission checks completed at journal 14 Aug, 2025 First submitted to journal 14 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7336900","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":508067749,"identity":"90e19b29-0eff-47fd-95da-4c0a2106dab2","order_by":0,"name":"Na Meng","email":"","orcid":"","institution":"Xinjiang Medical University","correspondingAuthor":false,"prefix":"","firstName":"Na","middleName":"","lastName":"Meng","suffix":""},{"id":508067750,"identity":"2d80553c-a743-48d0-8e64-53f1db3bd989","order_by":1,"name":"Pei Wu","email":"","orcid":"","institution":"Xinjiang Medical 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These challenges are further magnified in agro-pastoral regions, where harsh geographical settings, underdeveloped social-security systems, and shortages of both pension and medical services render family-based eldercare increasingly fragile and complex, thereby constraining healthy ageing and sustainable regional development. We therefore examined the dynamic characteristics of family-based eldercare vulnerability among rural older adults in Xinjiang’s agro-pastoral areas and identified its key obstructive factors, aiming to provide an evidence base for targeted policy making in underdeveloped pastoral-agricultural regions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eUsing a multistage stratified random sampling design, we recruited 1 400 rural residents aged ≥ 60 years across agro-pastoral counties of Xinjiang, China. Baseline data were collected in 2019, with follow-up waves conducted every two years in 2021 and 2023. Family-based eldercare vulnerability was quantified with an entropy-weighted TOPSIS model. Latent class growth model was employed to delineate distinct trajectories of vulnerability over time, while an obstacle-degree model was applied to identify the principal determinants impeding effective support.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThe family-based eldercare vulnerability index exhibited an overall increasing trend among the study population. Based on vulnerability trajectories, three distinct subgroups were identified: (1)High-level ascending group (14.09%) – Key barriers: major illness, hospitalization due to illness, depression, widowhood, body mass index, and indebtedness. (2)Medium-level gradual increase group (45.95%) – Key barriers: hospitalization due to illness, grandchild-care, body mass index, unemployment, and lack of daily life care.(3)Low-level stable group (39.97%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion：\u003c/strong\u003eFamily-based eldercare vulnerability among rural older adults in Xinjiang’s agro-pastoral regions intensified continuously over the study period, and distinct latent trajectory subgroups emerged. Older adults in the medium-level gradual increase group exhibited suboptimal health status and a tenuous family-support network, whereas those in the high-level ascending groupconfronted severe health deterioration and substantial economic strain. Despite shared barriers, subgroup-specific obstacles were also evident, underscoring the need for precisely targeted interventions to strengthen eldercare services. For the Medium-level gradual increase group, priority should be given to promoting health-protective behaviours through tailored health-literacy initiatives, alleviating family caregiving burden, and systematically rebuilding social-support networks. For households in the high-level ascending group, policy efforts should focus on comprehensive medical-security coverage, psychological-crisis interventions, and targeted economic assistance to resolve the family-care predicament.\u003c/p\u003e","manuscriptTitle":"Dynamic trends of family-based eldercare vulnerability among older adults in agro-pastoral areas of Xinjiang, China: a longitudinal study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-04 17:59:17","doi":"10.21203/rs.3.rs-7336900/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-07T13:46:51+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-29T10:04:16+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-14T21:21:36+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-08T12:50:50+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-07T19:51:24+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"83429577563132485051593775486792541227","date":"2025-10-31T13:19:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"118728072118645690489012225643155220537","date":"2025-10-30T12:47:25+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-28T09:23:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"295989558480811506163739322496908460336","date":"2025-10-26T16:43:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"305396098150977269362101208472550111309","date":"2025-10-25T06:50:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"128115922869260778723303317601012591391","date":"2025-10-22T08:57:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"248799946920378683019258079137369530054","date":"2025-10-19T09:38:38+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-29T03:54:56+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-25T01:33:27+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-14T18:26:43+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-14T10:43:13+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-08-14T10:39:22+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fe4bd591-e938-44e5-8519-5667c1db6635","owner":[],"postedDate":"September 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-28T16:57:12+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-04 17:59:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7336900","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7336900","identity":"rs-7336900","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}