China has transitioned from mild to moderate aging in just over two decades. With a 320 million elderly population, a rising dependency ratio, and a wave of parents of only children entering old age, the elderly care service sector is undergoing a critical shift from expansion to quality improvement. The 2025 National Aging Development Report by the Ministry of Civil Affairs and the National Aging Office shows that the elderly population continues to grow in size and share of the total population. The old-age dependency ratio has risen, with roughly one in every 4.3 working-age individuals supporting a person aged 65 or older. An analysis of recent reports reveals that the total number of elderly care beds has declined for three consecutive years, with the indicator of beds per 1,000 elderly trending downward, signaling a period of structural adjustment in service supply.

As of the end of 2025, China had 323.38 million people aged 60 and above, making up 23% of the total population, and 223.65 million people aged 65 and above, accounting for 15.9%. The dependency ratio for those aged 65 and above stood at 23.1%, and the national average life expectancy reached 79.25 years. The aging process has accelerated significantly. The 60-plus population, 230 million in 2016 and 250 million in 2018, surpassed 300 million for the first time in 2024, and grew by 13.07 million in 2025 alone. Over the past decade, the average annual net increase has been about 10 million. The 65-plus population rose from 150 million in 2016 to 224 million in 2025.

Using the international standard where mild aging is 10-19% of the population aged 60-plus, moderate is 20-29%, and severe is 30% or more, China's 23% share places it firmly in the moderate phase. This transition has occurred much faster than in the West, taking about 23 years compared to over 70 years for the United States and over 40 years for European countries. The pace is expected to accelerate during the "15th Five-Year Plan" period, with the elderly population projected to grow by an average of nearly 14 million annually. Experts predict the elderly population will exceed 400 million by 2035 and peak at 500 million around mid-century, nearing 40% of the total population.

The old-age dependency ratio has risen from 15% in 2016 to 23.1% in 2025, meaning that every 4.3 working-age individuals now support one elderly person. This increase signals growing pressure on family caregiving and pension systems, highlighting a long-term challenge for social security.

The number of elderly care institutions and facilities reached 395,000 in 2025, including integrated medical-nursing facilities, with 7.68 million beds. This includes 3.92 million registered institutions with 4.98 million beds and 356,100 community-based services with 2.7 million beds. The total number of beds has declined since peaking at 8.24 million in 2020, with the 2024 figure falling below 8 million. The number of beds per 1,000 elderly dropped to 23.7 in 2025, the lowest since 2016's peak of 31.62.

Industry experts attribute the decline not to a lack of capacity but to structural overcapacity, particularly in rural and suburban areas where occupancy rates remain low. Market consolidation, stricter fire safety regulations, and a shift toward smaller, more centrally located projects are also driving the trend. While the current adjustment is seen as short-term, the long-term demand for elderly care remains strong, with well-located and high-quality facilities expected to see growth.

In response, the government is intensifying top-level policy efforts. The 2025 "Opinions on Ensuring and Improving Livelihood" prioritizes care for the disabled elderly. The National People's Congress has revised laws to establish "Elderly and Women's and Children's Work Committees" at the community level. The Ministry of Civil Affairs is developing a national strategy document for active aging, planning for the "15th Five-Year Plan," revising the Elderly Rights Protection Law, and promoting the silver economy. The "Expanding Consumption Plan" calls for increasing elderly care consumption, improving the county-township-village service network, and enhancing community-based and institutional care, especially for the disabled and cognitively impaired. The goal is to build a three-tier network by the end of the "15th Five-Year Plan" period, focusing on capacity expansion, quality improvement, and efficiency. This includes upgrading equipment, training personnel, developing technology, expanding affordable options, and fostering professional, chain-operated, and brand-name providers to support home-based care and strengthen services for the disabled.