Syllabus: Population
Source: TH
Context: IISc Bengaluru launched the BHARAT study to establish India-specific biomarkers for healthy ageing. It aims to bridge gaps in diagnostics caused by Western-centric health data.
About Healthy Ageing in India:
What is Healthy Ageing?
Healthy ageing refers to maintaining physical, mental, and functional well-being in older age. It emphasizes quality of life, not just longer life. Biological age often differs from chronological age.
- Ageing is a continuous process marked by molecular and cellular changes like telomere shortening. Factors like early-life infections, pollution, and social support shape how one ages.
- g., a 60-year-old may have the organ health of a 75-year-old.
Data & Statistics on Ageing in India:
- Rising Elderly Population: By 2050, 20% of Indians (319 million) will be 60+ years. (UNFPA India)
- Disease Burden: Parkinson’s disease in India projected to rise by 168%, dementia by 200%. (Lancet, 2024)
- Gender Disparities: Women outlive men but face higher disability-adjusted life years (DALYs).
- Economic Impact: Increasing elder dependency ratio burdens healthcare and pensions.
E.g., NSSO 75th round shows only 28% of elderly have any formal pension. - Healthcare Gaps: Geriatric services are limited in PHCs and district hospitals.
E.g., Less than 5% PHCs have geriatric OPD services (MoHFW survey).
Features of Healthy Ageing:
- Functional Ability: Maintain ADLs (activities of daily living) like cooking, walking, bathing.
- Resilience to Stress: Quick recovery from illness or physiological stress like surgeries.
- Mental Wellbeing: Absence of depression, social isolation, and cognitive decline.
- Preventive Biomarkers: Use indicators like CRP, HDL, or metabolite levels to detect sub-clinical ageing.
- Contextual Health Standards: Culturally and biologically adapted parameters.
Why India Needs Focus on Healthy Ageing?
- Rapid Demographic Transition: Ageing rate in India is faster than in many OECD countries.
E.g., Elderly dependency projected to rise to 35% in Kerala.
- Mismatched Diagnostics: Western lab values don’t reflect Indian genetics and nutrition.
E.g., B12 “deficiency” is common due to vegetarian diet, but may not indicate pathology.
- Social Security Void: Only a fraction of elderly receive pensions or health insurance.
E.g., Indira Gandhi Old Age Pension Scheme covers <20% of aged poor.
- Rural-Urban Gaps: Rural elders lack access to health services, transport, and social care.
E.g., Tamil Nadu’s geriatric wards are concentrated in urban zones.
- Intergenerational Strain: Shrinking family size reduces traditional care structures.
E.g., Increase in elder homes in Maharashtra and Karnataka.
Challenges in Ensuring Healthy Ageing:
- Data Scarcity: Lack of Indian-specific longitudinal data on biomarkers and ageing.
E.g., Most data come from Western cohorts like Framingham or NHANES.
- Cultural Resistance: Elders often distrust hospitals, AI-based tools, or early screening.
E.g., Refusal to undergo cancer screening in elderly from tribal belts.
- Financial Constraints: Geriatric healthcare gets low budget priority.
E.g., NHM lacks a dedicated ageing component despite NPHCE.
- Sampling Bias: Collecting data from healthy elders is difficult due to pre-existing illness.
E.g., BHARAT study flagged challenge of finding non-comorbid samples.
- Environmental & Nutritional Burdens: Early-life infections and malnutrition affect ageing trajectories.
E.g., High childhood undernutrition leads to early-onset diabetes in adults.
Initiatives Taken:
- BHARAT Study by IISc: Builds India’s first bio-bank of ageing indicators across domains.
- National Programme for Health Care of Elderly (NPHCE): Focus on geriatric clinics and home care.
- Longitudinal Ageing Study of India (LASI): Tracks elder health, social trends, and functional abilities.
- Senior Citizen Health Insurance (RSBY, AB PM-JAY): Includes coverage for common elder illnesses.
- Geriatric Courses under AYUSH & MBBS: Introduced geriatrics as a super-specialty and PG subject.
Way Ahead:
- Create India-Specific Health Benchmarks: Adjust CRP, HDL, B12, and BP cut-offs to Indian baselines.
- Expand BHARAT Nationally: Cover all ecological, ethnic, and dietary zones in India.
- Use AI for Predictive Diagnostics: Model ageing patterns and organ decline early.
g., Liver or kidney age prediction for better intervention timing. - Geriatric Literacy Campaigns: Sensitize public about healthy ageing practices.
g., Campaigns via ASHA/Anganwadi workers. - Convergence with NDHM: Integrate elderly biometric and clinical data into Ayushman Bharat Digital Mission.
Conclusion:
India’s rapidly ageing population demands urgent attention to context-specific, data-backed health interventions. Initiatives like the BHARAT Study are timely steps toward achieving functional longevity rather than just extended life expectancy. Investing in preventive elder care today ensures a healthier, more productive ageing population tomorrow.
