Abstract Background To investigate the current situation regarding the activities of daily living (ADL) of older adults living at home in Ningxia Hui Autonomous Region of China and to analyze the associated factors of ADL performance so that we can provide references for the implementation of pension policies and long-term care insurance of older adults living at home. Methods We surveyed a total of 1040 older adults who live at home and receive home-based care in Ningxia Hui Autonomous Region by a face-to-face evaluation. A logistic regression model was used to analyze the factors associated with ADL performance. Results In the study, 82.79% of the older adults living at home can live independently. A total of 11.92% of the older adults have mild dysfunction, 4.33% have moderate dysfunction, and 0.96% have severe dysfunction. Multiple logistic analyses indicated that older adults with very difficult economic conditions (OR 3.212; 95% CI(1.209–8.534)) and without a spouse (OR 1.616; 95% CI(1.098–2.377)) were significantly associated with ADL limitations. In addition, the risks of ADL limitations in older adults aged 60–69 years and 70–79 years were 0.187 and 0.4307 times, respectively, that of older adults over 80 years old. The risk of ADL limitations in older adults of the Han nationality was 0.605 times that of the minority population. More highly educated and older adults without diseases have a lower risk of ADL limitations. Conclusions Compared with the national average in China, the number of ADL limitations of older adults in Ningxia is greater and is associated with advanced age, ethnic minority status, low education level, low income, lacking a spouse and having diseases. As the number of older adults increases, maintaining and improving their ability to perform ADL and providing comfortable pension services and health services urgently need to be solved.
