Ageing societies face increasing strain on formal and informal care systems, particularly in low-density mountainous municipalities where sparse services and steep terrain constrain access. This study presents a spatially explicit agent-based model that integrates a road-network GIS, synthetic populations derived through Iterative Proportional Fitting, and behavioural heterogeneity to examine how alternative service configurations shape accessibility and caregiver burden. The model, applied to Premeno (Piedmont, Italy), compares a baseline distribution of ambulatory services with a relocation scenario at Villa Bernocchi. System-level indicators (Caregiver Effort, Overwhelmed Caregivers, Hours Not Cared, Walkability) and micro-spatial metrics (Walkability, Detour Ratio, Proximity) are analysed across 40 batches and 50 stochastic replications per scenario. Results reveal aggregate neutrality but pronounced local redistribution of accessibility. Sensitivity analysis shows that spatial impedance dominates accessibility, whereas behavioural capacity modulates care effort. The findings illustrate distinctive properties of complex adaptive social systems - emergence, heterogeneity, and feedback - demonstrating how computational social simulation can highlight policy trade-offs between spatial efficiency, social equity, and care sustainability in ageing territories.

翻译：老龄化社会正面临正式与非正式护理系统日益加剧的压力，特别是在低密度山区市镇，稀疏的服务与陡峭地形限制了护理可及性。本研究提出一个空间显式的基于智能体的模型，该模型整合了道路网络地理信息系统、通过迭代比例拟合生成的合成人口以及行为异质性，以探究不同服务配置如何影响护理可及性与照护者负担。该模型应用于意大利皮埃蒙特地区的普雷梅诺市，将基础门诊服务分布与贝尔诺基别墅的重新布局方案进行对比。研究通过40批次、每场景50次随机重复的模拟，分析了系统级指标（照护者努力程度、不堪重负的照护者、未获护理时长、步行适宜性）与微观空间指标（步行适宜性、绕行比率、邻近度）。结果显示，总体可及性保持中性，但局部可及性出现显著重新分布。敏感性分析表明，空间阻抗主导可及性，而行为能力调节护理努力程度。研究结果阐明了复杂适应性社会系统的独特属性——涌现性、异质性与反馈机制，展示了计算社会模拟如何能够凸显老龄化地区在空间效率、社会公平与护理可持续性之间的政策权衡。