By applying the entropy method and the coupling coordination degree model, this study quantitatively analyzed the comprehensive development levels and coupling coordination degree of the logistics and elderly care industries in 31 provinces and municipalities across China from 2013 to 2022. Additionally, exploratory spatial data analysis (ESDA) and a geographical detector model were employed to investigate the spatio-temporal evolution characteristics and influencing factors of the coupling coordination between the two industries. The findings reveal that the comprehensive development indices of both industries exhibit an upward trend, though the logistics industry lags relatively behind during the study period. The coupling coordination relationship between the two industries remains stable and improving, with a spatial distribution characterized by higher levels in the east than in the west and higher levels in the south than in the north. Specifically, “high-high” agglomeration types are primarily concentrated in East and Central China, while “low-low” agglomeration types are mainly found in Northwest China. Human capital and economic development level are the two dominant factors influencing the coupling coordination degree, exhibiting a bivariate enhancement interaction effect. Finally, based on these findings, it is recommended that in “low-low” agglomeration regions, efforts should focus on strengthening infrastructure construction and industrial support, as well as establishing elderly-oriented delivery systems whereas in “high-high” agglomeration regions, emphasis should be placed on industrial structure optimization and innovation capacity enhancement, promoting smart logistics and technology-driven elderly care. Additionally, attention should be given to regional balanced development, human capital improvement, and economic growth to foster interregional equilibrium and coordinated growth.