Objective   To examine frailty-related needs of daily care and spiritual comfort and to analyze the relationship between the degree of weakness and needs of daily care and spiritual comfort among oldest old residents.

  Methods   We recruited 3 448 residents aged ≥ 75 years from communities covered by 10 community health care centers in Tangshan city of Hebei province with stratified cluster random sampling; then we conducted a face-to-face interview among the residents with the Comprehensive Frailty Assessment Instrument (CFAI), Activity of Daily Living Scale (ADL), and University of California, Los Angeles (UCLA) Loneliness Scale from July 2016 to January 2017.

  Results   Among the 3 448 participants with valid information, the prevalence of frailty was 100 % and the frail condition tended to be severe with the increment of age (P < 0.05). Of the participants, 860 (24.9 %) and 804 (23.3 %) were evaluated with low and high demand for daily care according to their ADL scores; whereas, 61.0 % of the participants reported daily care demand by themselves and the ratio was higher than that of ADL assessment. More than a half (2 021, 58.6 %) of the participants selected their children to provide the daily care they required. There were 1 071 (31.06 %), 1 664 (48.26 %), and 713 (20.69 %) of the participants reporting low, moderate, and high demand for spiritual comfort. The proportion of the participants assessed with moderate and high demand for spiritual comfort was 68.94 %, much higher than that of those for demand of daily care; while, the number of the participants with the self-reported demand for spiritual comfort was 2 441 (70.17 %), similar to that for daily care. Of the participants requiring spiritual comfort, 1 906 (78.08 %) selected their children to provide the spiritual comfort. Multivariate analysis showed that age and the degree of frailty were the influencing factors of demand for daily care and spiritual comfort.

  Conclusion   More daily care and spiritual comfort should be provided to community oldest old persons according to their frailty conditions.