Ageing societies face increasing strain on formal and informal care systems, par- ticularly 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, Overwhelm, 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 capac- ity modulates care effort. The findings illustrate hallmark properties of complex adaptive social systems-emergence, heterogeneity, and feedback-demonstrating how computational social simulation can illuminate 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，尤其在低密度山区市镇，稀疏的服务设施与陡峭地形限制了护理可及性。本研究提出一种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数据以及行为异质性，以探究不同服务配置如何影响可及性与护理者负担。该模型应用于意大利皮埃蒙特地区的普雷梅诺市，将基础流动服务分布与位于维拉·贝尔诺基的重新布局方案进行对比。通过每场景40批次、50次随机重复模拟，分析了系统级指标（护理者努力程度、超负荷状态、未受护理时长、步行可达性）与微观空间度量（步行可达性、绕行比率、邻近度）。结果显示整体可及性呈中性，但局部可及性存在显著空间再分配。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投入。研究结果揭示了复杂适应性社会系统的典型特征——涌现性、异质性与反馈机制，证明了计算社会模拟如何能阐明老龄化地域中空间效率、社会公平与护理可持续性之间的政策权衡。