Table of Contents

2017 Month : June Volume : 3 Issue : 1 Page : 3


Mitasha Singh1, Shailja Sharma2, Vidhu Sharma3

1Assistant Professor, Department of Community Medicine, ESIC Medical College and Hospital, Faridabad, Haryana.
2Medical Officer-Cum-Faculty, Regional Health and Family Welfare Training Centre, Kangra, Chheb, Himachal.Preadesh.
3Senior Resident, Department of Otorhinolaryngology, AIIMS, Jodhpur, Rajasthan.

Corresponding Author:
Mitasha Singh,
Assistant Professor,
Department of Community Medicine,
ESIC Medical College and Hospital,
Faridabad-121001, Haryana.


Better health facility and increasing life expectancy led to rise in proportion of elderly (+60 years’ age group) from 6.0 to 8.0 percent and is expected to reach 12.6 percent in 2025. According to census 2011, India has higher proportion of geriatric females as compared to males.1 Population around the world is also aging at fast pace, starting with a decline in infant and childhood mortality that precedes a decline in fertility. At later stages, mortality at older age declines as well.2

How to cite this article

Singh M, Sharma S, Sharma V. Ageing nation and the challenges ahead. Journal of Research in Preventive and Social Medicine 2017; Vol. 3, Issue 1, Jan-June 2017; Page:3

A commonly used dependency ratio is the number of persons aged 15 - 64 per person aged 65 and older is also on rise. These extra years of life added are an achievement in medicine and public health, but the challenges are many. Economic challenge has started haunting many nations and the effect is visible in our country too. Increasing the age of retirement, increasing the voluntary non-monetary productive contributions of the retired and immigration of very large numbers of young workers into the “old” countries are some of the measures to meet these challenges.2

This double-edged sword of increasing life-expectancy or keeping older people alive can do nothing much to prevent delay or significantly treat the degenerative chronic diseases of aging. The focus of our health system has been maternal and child health since time immemorial. The demographic trends alarm the system to get prepared for an unseen epidemic of diseases of older age group. National policy on older persons was adopted by Government of India in 1999. It included various social security schemes for this age group. The policy addresses most of the healthcare problems in an institutional healthcare system, but it completely neglects the non-institutional community-based care.3

Another domain of problem is lack of caregivers. On the population level, informal caregiving is still mainly done by women. Women live longer than men and this is evident from the available statistics. The lack of a spousal caregiver is especially likely to be a problem for older women. Both men and women have fewer children on whom they can call for informal caregiving, because of the worldwide decline in fertility rates, delayed marriage and increasing divorce rates among their children. This in turn will lead to less likely close ties with daughters and daughters-in-law. Adult women who in the past have provided uncompensated care are now more likely than in the past to be working for pay, and thus

have fewer hours to devote to the unpaid roles. Any policy change to meet such social problem will take years to come; however, increased reliance on home health agencies and assisted living communities in which neighbours fulfil many of the roles once reserved for close kin are some examples of self adaptation to these challenges.2

Apart from above-mentioned economic, social and health challenges, a new public health problem has been highlighted by World Health Organisation called Elder abuse. A 2017 study based on the best available evidence from 52 studies in 28 countries from diverse regions including 12 low- and middle-income countries estimated that over the past year 15.7% of people aged 60 years and older were subjected to some form of abuse.4 This is just a tip of ice berg, which was reported. Older people are often afraid to report cases of abuse to family, friends or to the authorities. In some countries, the health sector has taken a leading role in raising public concern about elder abuse, while in others the social welfare sector has taken the lead. National Programme for the healthcare of elderly was launched by Government in 2010. It is still in its inception stage due to shortage of dedicated healthcare manpower, lack of awareness among elderly regarding their rights especially among rural areas and women, failure to focus on regional issues and home-based care.5

For a country which in its future will have a higher proportion of elderly than children, an advanced planning and preparation in form of primordial prevention is needed for successful ageing.



  1. Census of India. Provisional population totals, paper 1 of 2011 India, series-1. New Delhi: office of the registrar general & census commissioner 2011.
  2. Suzman R, Haaga JG. World demography of ageing. In: Llongo DL, Kasper DL, Jameson JL, et al. (eds). Harrison’s principles of internal medicine. 18th edn. United States, Mc Graw Hill 2012.
  3. Verma R, Khanna P. National program of health-care for the elderly in India: a hope for healthy ageing. International Journal of Preventive Medicine 2013;4(10):1103-7.
  4. Yon Y, Mikton CR, Gassoumis ZD, et al. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Glob Health 2017;5(2):e147-56.
  5. Chandrika KB. Health care system of elderly in India: a sociological perspective. Research dimensions 2014;2(8):1-4.

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