Abstract: This study aims to construct a grading system index system for TCM health management of the elderly in order to enhance the precision and personalisation of TCM health management. After sorting out the relevant national policy documents and research results through literature research, and integrating the concepts related to TCM and modern health management methods, a multi-dimensional indicator system covering the "Classification and Determination of Physical Qualities of Chinese Medicine for the Elderly Version" scale, lifestyle, health status assessment, auxiliary examination, and physical examination was preliminarily constructed. Subsequently, experts in multiple fields were invited for consultation to score and screen the indicators. Three primary indicators were identified through hierarchical analysis, including the TCM Physical Fitness Classification Scale, auxiliary examination and physical examination, and the corresponding secondary indicators were identified. The results of the study showed that the index system of the grading system of TCM health management for the elderly was centred on TCM physical quality identification, supplemented by physical examination and auxiliary examination, and assessed the health status of the elderly through quantitative indicators, which made the assessment results more comprehensive, objective and comparable. This study not only provides a scientific basis for health risk identification of the elderly, but also lays a solid foundation for subsequent personalised health management and precise health intervention.