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.

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