Abstract: With the deepening of China's population ageing, the prevalence of chronic diseases and disability among older adults is rising. How to delay the disability and improve the health status of the elderly has become social issues. Data from China's Seventh National Population Census show that in 2020, over 95% of older adults chose home-based elderly care. However, the existing residential buildings in China exhibit insufficient age-friendly home renovation due to outdated building standards and suboptimal spatial planning from earlier periods. To address this issue, China issued the Guiding Opinions on Accelerating the Implementation of Age-Friendly Home Renovation Projects for the Elderly, aiming to improve the quality and capacity of home-based elderly care services by promoting the age-friendly home renovation. However, whether it can effectively promote elderly health still requires further empirical verification.

Based on the data of China Longitudinal Aging Social Survey (CLASS) from 2018 to 2023, this study adopts the two-way fixed effect model to empirically examine the impact, potential mechanism, heterogeneity, and synergistic effect with smart devices of age-friendly home renovation on older adults' health. Grounded in the ICF framework, the study reveals the health-promoting pathways of age-friendly home renovation from physical, social, and psychological dimensions, and its synergistic effect with smart elderly care devices. This study provides practical references for promoting the construction of age-friendly home renovation, developing smart home-based elderly care services, and improving the building of age-friendly environments, thus possessing important theoretical and practical implications.

The findings indicate that age-friendly home renovation not only reduces the degree of disability among older adults but also alleviates the level of depressive symptoms. Mechanism analysis reveals that age-friendly home renovation promotes older adults' health by reducing the risk of falls and social isolation, as well as by promoting positive age identity. Heterogeneity analysis reveals stronger health-promoting effects among older adults aged 75 and above, those in empty-nest households, and those in rural areas. Moderation effect results show that smart devices positively moderate the relationship between age-friendly home renovation and older adults' health. Based on these findings, this study proposes policy recommendations including improving the quality and health benefits of age-friendly home renovation, implementing stratified and targeted renovation strategies, and advancing the deep integration of age-friendly home renovation with smart elderly care.

This study goes beyond previous policy evaluations that primarily focused on community public environments, shifting the unit of analysis to the home environment and examining the health effects of age-friendly home renovation from the perspective of physical and mental health, thereby addressing the limitations in existing research that has paid insufficient attention to the health impacts of family physical spaces. By constructing a systematic pathway across physical, social, and psychological environmental dimensions, this study extends age-friendly home renovation from the traditional “competence-press” fit model toward a new “resource-empowerment” perspective. Furthermore, by incorporating smart devices into the person-environment interaction framework, this study not only expands the analytical framework of person-tool-environment interaction within ecological theory of ageing but also enhances the explanatory power and application value of this theory in the context of smart elderly care.

Keywords: Age-Friendly Home Renovation, Older Adults' Health, Age-Friendly Society

摘要： 推进居家适老化是优化养老服务供给、增进老年健康福祉的重要举措。文章基于2018~2023年中国老年社会追踪调查(CLASS)数据，实证分析了居家适老化水平对老年健康的影响。结果表明，居家适老化水平提升降低了老年人失能程度、减少了老年人抑郁症状；物理空间改造与老年用品配置同时影响失能程度和抑郁症状，设施设备配备仅影响抑郁症状。机制分析表明，居家适老化水平提升通过降低老年人跌倒风险、缓解社会隔离状态、提升积极年龄认同水平促进老年健康。异质性分析显示，居家适老化水平提升对老年健康的促进效应在75岁及以上、空巢家庭以及农村老年人中更显著；进一步分析发现，智能设备应用与居家适老化水平提升产生正向协同效应。研究结论为认识居家适老化的意义，聚焦健康促进的多维路径与人群差异实施分层分类政策，促进居家适老化与智慧养老的融合模式提供了理论依据与政策参考。

关键词: 居家适老化, 老年健康, 老年友好型社会