Objective   To explore daily life care need and its influential factors among the oldest elderly in Tangshan city.

  Methods   We recruited 3 448 registered permanent urban residents aged ≥ 75 years with stratified random cluster sampling from 32 communities distributed across all urban areas and covered by 10 community health care centers in Tangshan city, and then conducted a household questionnaire survey among the participants between July 2016 and January 2017 with Activities of Daily Living (ADL), Comprehensive Frailty Assessment Instrument (CFAI), Loneliness Scale, and Social Support Rating Scale (SSRS).

  Results   Of the participants, 1 784 (51.7 %) reported no need of daily life care; 860 (24.9 %) reported moderate need; 804 (23.3 %) reported severe need; and the general demand rate was 48.3 % . The top five needs reported by the participants were public transportation (reported by 38.7 % of the participants), cooking (32.4 %), shopping (31.8 %), doing housework (31.7 %), and laundry (28 %), respectively. Ordinal logistic regression analyses showed that main protective factors for daily care needs were at younger age (odds ratio OR = 0.263), being a empty-nester (OR = 0.591), high degree of frequent participation in community activities (OR = 0.366), high monthly income (OR = 0.324), low loneliness (OR = 0.022), low degree of frailty (OR = 0.179), with a good cognitive function (OR = 0.269), and not suffering from chronic disease (OR = 0.490); while major risk factors for the need included low frequency of receiving services supplied by neighborhood committees (OR = 1.631), with a poor self-rated health (OR = 14.850), less communication with their children (OR = 2.012), and having no health insurance (OR = 1.761).

  Conclusion   About a half of urban oldest-old residents in urban Tangshan need daily life care; the situation needs to be concerned and a comprehensive care service system should be established to meet the demand of the population.