Background <p>Intrinsic capacity decline (the age-related reduction in the composite of physical and mental capacities) is prevalent among Chinese rural older adults.This study aimed to describe the perceptions of intrinsic capacity decline and the corresponding intervention needs among older adults residing in a rural village in northern China.</p> Methods <p>A descriptive qualitative study was conducted. Semi-structured interviews were used to collect detailed accounts of the lived experiences of intrinsic capacity decline among 14 older adults in a rural Chinese village. Data were collected from September to December 2023 and were analyzed using NVivo 12 software. Inductive analysis was used to identify key themes.</p> Results <p>Three main themes were identified: (1) Normalizing decline, which reflected participants’ acceptance of capacity loss as an inevitable part of aging, coupled with low awareness and perceived need for intervention; (2) The social embeddedness of health behaviors, highlighting how engagement in health practices was profoundly facilitated or hindered by family dynamics and peer networks; and (3) Navigating a support vacuum, underscoring the expressed need for accessible, credible information and professional guidance in the absence of systemic support.</p> Conclusion <p>This study provides a detailed description of the multifaceted challenges faced by older adults in this specific rural northern Chinese setting. Participants described a process of intrinsic capacity decline that was often normalized due to a lack of knowledge, deeply influenced by social relationships, and occurred within a context of scarce systemic support. The findings underscore the necessity for interventions that are responsive to the described personal, social, and systemic contexts.</p>