Introduction

As India advances toward becoming a super-aged society by the middle of this century, the focus must shift from merely increasing lifespan to enhancing healthspan—the period of life spent in good health. Recognising this, the Indian Institute of Science (IISc), Bengaluru, launched a pioneering research initiative titled BHARAT (Biomarkers of Healthy Aging, Resilience, Adversity, and Transitions). It aims to map physiological, genetic, environmental, and socio-economic indicators that define healthy ageing in the Indian context.

The Need for India-Specific Healthy Ageing Parameters

Global research in ageing has largely been Western-centric, leading to the development of diagnostic thresholds, biomarkers, and treatment regimes based on non-Indian populations. This lack of contextual relevance often results in misdiagnosis and inappropriate treatments in countries like India. For instance, biomarkers such as cholesterol, vitamin D, or C-reactive protein (CRP) may exhibit different baseline levels among Indians due to genetic, nutritional, and environmental factors, but are often interpreted using Western standards.

Furthermore, while life expectancy has increased globally, the incidence of age-related disorders like Parkinson’s and dementia is projected to rise sharply in India—by 168% and 200%, respectively, by 2050. Thus, there is an urgent need to identify early biomarkers that can predict organ deterioration before the onset of overt disease.

BHARAT Study: Objectives and Methodology

BHARAT is part of IISc’s Longevity India Programme, and seeks to establish a Bharat Baseline—a reference for what is physiologically normal for the Indian population across age groups. It will build a comprehensive, multidimensional database that includes:

• Genomic biomarkers (genetic predisposition to diseases)
• Proteomic and metabolic profiles (pathway-level health indicators)
• Environmental and lifestyle factors (pollution exposure, dietary habits)

Crucially, it acknowledges that chronological age does not always match biological age, and seeks to develop more nuanced, organ-specific age markers that could enable preventive and personalised interventions.

Role of Artificial Intelligence

Given the complexity and volume of biological and lifestyle data, artificial intelligence (AI) and machine learning models are essential tools in this initiative. These technologies will aid in pattern recognition, risk prediction, and simulation of intervention outcomes, ultimately helping researchers select the most effective strategies before launching costly human trials.

Challenges and the Way Ahead

India’s vast genetic, geographic, and socio-economic diversity presents both opportunities and challenges. The BHARAT team faces hurdles such as:

• Difficulty in recruiting healthy adult volunteers
• Securing long-term public and private funding
• Scaling the study to ensure pan-India representation

However, the potential impact is profound. By building an India-specific ageing dataset, BHARAT can influence the development of better diagnostics, public health policies, and preventive healthcare systems for an ageing population.

Conclusion

The BHARAT study marks a critical shift in India’s biomedical research priorities, focusing not only on longevity but on quality of life during ageing. As India prepares to navigate the challenges of demographic transition, initiatives like BHARAT will be instrumental in creating a resilient, inclusive, and health-aware society, rooted in evidence that reflects its own people.

In News:

India is undergoing a demographic transition, with its senior citizen population (aged 60+) currently at 15 crore, projected to rise to 32 crore by 2050. This unprecedented ageing poses socio-economic challenges, especially in urban areas like Bengaluru, where shrinking family structures leave many elderly citizens isolated and purposeless. To address these concerns, a new sector—age-tech—is emerging, leveraging technology to support the physical, emotional, and cognitive well-being of the elderly.

Understanding Age-Tech and its Role

Age-tech refers to technology-driven solutions tailored to the elderly’s needs. Bengaluru has emerged as a hub of innovation in this domain. Platforms like Sukoon Unlimited, founded in 2024, create communities where seniors engage in emotional counselling, volunteering, group therapies, and concierge services. Notably, both service providers and receivers are senior citizens, fostering peer support and a sense of purpose. Sukoon’s community has grown from 200 to 6,000 members across 400 towns in a year.

Technology is also being used to combat loneliness. WHO in 2022 highlighted that one in four older adults suffers from social isolation, increasing mortality risk. AI-powered conversational tools are being employed by platforms like Sukoon to provide companionship in over 100 languages.

Employment and Purpose in Silver Years

Age-tech also facilitates post-retirement employment. Wisdom Circle, for instance, connects retired professionals with employers seeking experienced talent. With 95,000 users and 1,500 companies onboard, it promotes hybrid and part-time roles. Beyond financial gain, seniors are driven by the need for relevance and contribution to society—many even apply for lower-paid or non-profit roles.

Addressing Cognitive and Physical Health

The cognitive health of seniors is another pressing concern. Over 80 lakh Indians currently suffer from dementia. Ivory, a cognitive health start-up, offers neuroscience-backed assessments to detect risks early and recommends personalized brain training. It has over 30,000 users, predominantly women from urban areas.

Orthopaedic health is also crucial. Around 50% of seniors need assistance with basic mobility. TransleadMedtech, an IISc-incubated start-up, has developed assistive chairs and commodes to aid mobility without power sources. With rising knee replacements, such innovations are critical for safety and dignity in ageing.

Challenges and the Digital Divide

Despite potential, age-tech faces hurdles. Experts warn that over-engineering tech can alienate elderly users. Solutions must be designed with the user’s needs, not just tech potential, in mind. The urban-rural divide is stark—most services target urban, financially independent seniors, excluding rural and low-income populations.

Additionally, rapid digitisation has excluded many elderly from essential services like transport and e-commerce. Digital illiteracy also exposes them to scams. Startups like Elderra work to bridge this gap by training seniors in basic digital tools.

Way Forward

For age-tech to become inclusive, the government must play an enabling role. Public-private partnerships can make these services affordable and accessible. Ageing with dignity should be a national priority, combining technology, policy, and empathy to ensure India’s elderly are not left behind in the digital era.

In News:

India has been witnessing significant demographic changes due to decades of family planning policies. This has led to declining fertility rates in certain States, particularly in the southern and smaller northern regions.

Introduction: Demographic Shift in India

• Southern States’ Fertility Trends: States like Tamil Nadu, Kerala, Andhra Pradesh, and Telangana have fertility rates below the replacement level (around 1.4–1.5), while Bihar, Uttar Pradesh, and Madhya Pradesh have higher fertility rates (2.6–3).
• Ageing Population: Southern States face the challenge of an ageing population, with Kerala projected to have 22.8% of its population aged 60+ by 2036, while Bihar will have only 11%.

Economic and Health Impact of Population Decline

• Economic Consequences:
  • Dependency Ratio: The old-age dependency ratio (the number of elderly for every 100 working-age individuals) has increased significantly in some States. Kerala, for example, had a ratio of 26.1 in 2021, signaling a crisis point.
  • Loss of Demographic Dividend: States with declining fertility rates face the loss of a demographic dividend, i.e., the economic benefit from a large working-age population, which is increasingly burdened by elderly dependents.
  • Health Expenditure: Rising healthcare costs, especially for cardiovascular diseases in southern States, will strain public health systems. The southern States, although comprising one-fifth of India's population, spent 32% of the country’s total out-of-pocket expenditure on cardiovascular diseases in 2017-18.
• Challenges of Low Fertility:
  • Declining Labour Force Participation: Policies encouraging higher fertility may also reduce women’s labour force participation, undermining the economic growth of these States.
  • Economic Pressures: Southern States, despite higher tax contributions, face a diminished share of central resources due to slower population growth. This is a point of concern in inter-State fiscal relations.

Political Implications of Uneven Population Growth

• Impact on Federal Structure:
  • The uneven population growth across States will lead to significant changes in the delimitation of constituencies after the current freeze on seat allocation in Parliament expires in 2026.
  • Redistribution of Lok Sabha Seats: Northern States like Uttar Pradesh and Bihar will likely gain more seats, while southern States like Tamil Nadu, Kerala, and Andhra Pradesh will lose seats due to their declining population shares.
• Challenges in Federal Relations:
  • Southern States’ economic contributions through taxes are disproportionate to the resources they receive from the central pool, leading to growing tensions between high-growth and slow-growth regions.
  • The shift in political power post-delimitation could increase regional disparities, potentially leading to political tensions between States.

Solutions and Policy Recommendations

• Pro-Natalist Policies:
  • Southern States are considering pro-natalist policies to incentivize higher fertility rates. However, such measures have been largely unsuccessful internationally, especially when women’s economic independence and educational choices are restricted.
  • International Experience: Attempts to incentivize childbearing, without addressing broader socio-economic factors like gender equality, have generally failed in other nations. Maternity benefits, gender-neutral parental leave, and childcare support are key to increasing fertility sustainably.
• Gender Equity and Work-Family Balance:
  • Work-family policies that support paid maternity and paternity leaves, affordable childcare, and gender-neutral employment policies are essential to empower women to balance family and career.
  • Studies indicate that countries with higher gender equity have better fertility rates because women are less likely to forgo childbearing for career reasons.
• Increasing Retirement Age:
  • One way to reduce the old-age dependency ratio is to increase the retirement age, which would allow older workers to remain employed longer and support a sustainable economy.
  • Social Security and pension reforms should also be considered to accommodate the ageing workforce and reduce the economic burden on younger generations.
• Managing Migration:
  • Migration policies should be adjusted to manage the influx of economic migrants into southern States, who contribute to the economy but continue to be counted in their home States for fiscal and political purposes.
  • Migration-based policy reforms could address the challenge of an ageing population in states with declining fertility while ensuring equitable resource distribution across States.