Abstract: Background Health vulnerability, assessed through the three dimensions of exposure level, susceptibility and adaptive capacity, enables a holistic and dynamic identification of existing and potential health risks among older adults. However, the experiential aspects of health vulnerability among community-dwelling older adults remain unclear. Objective Understanding the experiences of health vulnerability among older adults in the community provides a reference for developing targeted early identification and preventive intervention strategies. Methods Using purposive sampling, semi-structured interviews were conducted with elderly residents in Nanjing's communities between November 2025 and January 2026. Data were collected through audio recording and transcription, and analysed by two independent coders using a mixed-methods thematic analysis approach combining deductive and inductive methods. Reported in accordance with the International Standards for Qualitative Research Reports (COREQ). Results A total of 20 elderly community residents were interviewed. The interview topics comprised three main themes and nine sub-themes: (1) exposure levels: exposure to the physical environment, exposure to the social support environment, exposure to individual behaviour and lifestyle; (2) sensitivity: physiological sensitivity, psychological sensitivity, sensitivity to social relationships; (3) adaptive capacity: cognition and individual behavioural regulation, emotional and psychological adjustment, seeking and utilising support. Conclusion The health vulnerability of elderly individuals within communities exhibits complex, multi-dimensional experiential characteristics. Addressing this vulnerability requires a three-pronged approach: reducing exposure levels, enhancing individual resilience, and strengthening adaptive capacity. This multifaceted strategy aims to assist older adults in maintaining a state of health equilibrium.

Key words: Health vulnerability, The elderly, Healthy ageing, Community health, Qualitative study

摘要： 背景 健康脆弱性从暴露水平、敏感性和适应能力三个维度出发，可整体性、动态性地识别老年人现有及潜在的健康风险，但社区老年人对健康脆弱性的体验如何目前尚不清楚。目的 了解社区老年人的健康脆弱性体验，为构建针对性的预防干预方案提供参考。方法 采用目的抽样法，于2025年11月—2026年1月选取南京市3个社区的老年人进行半结构化访谈，通过录音、文本转录进行资料收集，由2名独立编码员采用演绎与归纳相结合的混合主题分析法进行分析。按照国际定性研究报告标准（COREQ）进行报告。结果 共访谈20名社区老年人。提炼出3个主题和9个亚主题：（1）暴露水平：物理环境暴露、社会支持环境暴露、个体行为与生活方式暴露；（2）敏感性：生理敏感性、心理敏感性、社会关系敏感性；（3）适应能力：认知与个体行为调节、情绪与心理调适、支持寻求与利用。结论 社区老年人健康脆弱性呈现多维度复杂的体验特征，改善老年人健康脆弱性问题应从降低暴露水平、提升个体耐受性并增强适应能力三方面着手，以帮助老年人维持健康平衡状态。

关键词: 健康脆弱性, 老年人, 健康老龄化, 社区健康, 质性研究