Objective To investigate the disparities in the activities of daily living (ADL) among older adults living in urban and rural areas of Sichuan Province, China and the influencing factors, and to provide a basis for promoting the health of older adults and formulating relevant policies.

Methods Using data from the Seventh Health Services Survey of Sichuan Province, we enrolled 7369 older adults from urban and rural areas and analyzed their ability to perform ADL and the relevant influencing factors. All participants were aged 60 years or older. Chi-square tests and logistic regression were performed to identify the influencing factors.

Results  The ADL impairment rate among older adults living in urban areas of Sichuan Province was 17.7%, which was higher than the rate of 13.8% among older adults living in rural areas. According to the results of logistic regression analysis, age ≥ 80 years (odds ratio OR = 3.725; 95% CI, 2.460-5.639), accidental injuries (OR = 2.375; 95% CI, 1.597-3.532), and good sleep quality (OR = 0.420, 95% CI: 0.289-0.612) were factors influencing ADL among older adults living in urban areas, while age ≥ 80 years (OR = 1.867; 95% CI, 1.459-2.390), being married (OR = 0.805; 95% CI, 0.664-0.976), accidental injuries (OR = 1.936; 95% CI, 1.564-2.397), and participation in social activities (OR = 0.417; 95% CI, 0.352-0.495) were factors influencing ADL among older adults living in rural areas.

Conclusion  There are differences in ADL impairment rates and the relevant influencing factors between urban and rural older adults in Sichuan Province. These findings underscore the need to consider urban-rural differences when adopting relevant policies and measures.