My neighbour’s mother sits on her balcony most afternoons, watching the street. Her son moved to Bengaluru for work eleven years ago and calls twice a week. A woman comes in the mornings to cook and clean. Otherwise, the flat is quiet from nine to nine. She is 78, in reasonable health, and by the standards of ageing India she is one of the fortunate ones: she owns her home, has a pension from her late husband’s job, and a son who still calls. Millions of older Indians have none of those three things.
India likes to describe itself as a young country, and for another two decades that will still be broadly true. But the older end of the population is growing faster than any plan currently in place to look after it, and the gap between the two is where a very large number of people are quietly spending their last years.
The numbers behind an ageing India
The India Ageing Report 2023, published by the United Nations Population Fund together with the International Institute for Population Sciences, put India’s population aged 60 and above at about 149 million in 2022. That number is projected to double to 347 million by 2050, an increase of 134 percent even as the country’s overall population grows by a comparatively modest 18 percent over the same period. The population aged 80 and above, the group with the highest care needs, is expected to grow by 279 percent.
By 2046, the report projects, India’s elderly will for the first time outnumber its children aged 0 to 14. By 2050, roughly one in every five Indians will be a senior citizen. These are not distant, abstract projections. Someone who is 40 today will be part of that cohort. The systems meant to support them, pension coverage, geriatric healthcare, caregiving infrastructure, are being built, if at all, at a fraction of the pace the demographic curve demands.
What LASI found when it looked closely
Until recently, India did not have detailed, nationally representative data on how its older citizens were actually faring, health, income, and social life together. The Longitudinal Ageing Study in India, or LASI, run by the International Institute for Population Sciences with Harvard and the University of Southern California, filled that gap. Its Wave 1 report, covering a baseline of over 72,000 people aged 45 and above, including more than 31,000 aged 60 and above, found that physical multimorbidity, living with more than one chronic condition at once, affected just over half the study population, and oral health problems affected close to 49 percent.
Roughly 18 percent of respondents rated their own health as poor, and researchers found that this self-rating tracked closely with multimorbidity, functional limitations, and mental health, in that order. Chronic conditions of this kind are also expensive to manage over time, adding to the burden this publication has documented in India’s out-of-pocket health spending, a cost that falls hardest on households with no working-age earner left at home. LASI also measured something harder to quantify: social frailty, a composite of isolation, weak social participation, and lack of support. Women scored consistently worse than men on this measure, which lines up with what community health workers describe anecdotally: widowhood, financial dependence, and household roles that shrink with age hit older women particularly hard.
A pension of two hundred rupees a month has not moved with inflation in over a decade. It was designed to supplement a family’s support, not to replace it, at a time when the family was still assumed to be there.
A pension that isn’t a pension
For elderly Indians below the poverty line, the primary state safety net is the Indira Gandhi National Old Age Pension Scheme, IGNOAPS, part of the National Social Assistance Programme. The central government’s contribution is 200 rupees a month for beneficiaries aged 60 to 79, rising to 500 rupees a month for those 80 and above. States can, and some do, top this up, but the base central figure has stayed effectively unchanged for well over a decade against a currency that buys markedly less than it did when the amount was set.
The scheme currently reaches around 25 million beneficiaries nationally, with roughly 82 percent in the 60 to 79 age band and about 17 percent aged 80 and above. That sounds substantial until it is set against the eligible population: policy researchers estimate that old-age pension schemes in India reach only about 18 to 20 percent of Indians aged 60 and above, a coverage gap driven by a Below Poverty Line eligibility test that excludes people who are poor but not officially certified as such, by inconsistent implementation across states, and by the basic difficulty of navigating paperwork and travel to a government office at 70 or 80 years old with no one to accompany you.
A far older but still-cited UNFPA study, Status of Elderly in Select States of India, found that 49.1 percent of India’s elderly lived in households below the poverty line, a figure that was 48 percent in rural areas and 52 percent in urban ones. A pension that covers a fifth of the eligible population, at an amount that has not kept pace with prices, is not a retirement plan. It is a subsidy that arrives, for those who receive it at all, alongside continued financial dependence on whoever else is in the household, if anyone is.
When the family that was supposed to care for them leaves
India’s implicit elder-care policy, for most of its modern history, has been the joint family. Multiple generations under one roof meant that ageing parents were cared for as a matter of course, without needing an institution, an insurance product, or a government cheque. That assumption is eroding faster than the policy apparatus around it is adapting.
A National Statistical Office survey published in August 2021, Elderly in India, found that 20 percent of urban elderly and 10 percent of rural elderly were living alone. In a large share of those cases, the reason was not choice but circumstance: the survey found that the mobility of adult children, migration for work, marriage, or education, was cited as the reason for older adults living alone in around three-quarters of instances. The children have not abandoned their parents in any deliberate sense. They have gone where the jobs are, following the same economic logic that drives migration everywhere else in this country, and the parents have been left in a house that was built for a family that no longer lives in it.
What gets lost in that transition is not just company. It is the informal, unpaid care work, helping with medication, accompanying someone to a hospital, simply noticing when something is wrong, that a resident family member used to provide by default and that no scheme has stepped in to formally replace.
What ageing without a plan actually looks like
Strip away the survey language and the lived experience of an unsupported old age in India tends to involve some combination of the following:
- A pension, if one arrives at all, too small to cover medicine, let alone rent or food
- A chronic condition managed without a nearby geriatric specialist, because most public health infrastructure is built around maternal and child health, not ageing bodies
- Long stretches of the day alone, with no one nearby to notice a fall, a missed meal, or a worsening symptom
- No formal channel to report neglect or abuse within the family, and strong social pressure not to use one even where it exists
- A house and a life built for a multigenerational household that has since scattered
The abuse nobody reports
Isolation and financial precarity make a difficult combination on their own. HelpAge India’s most recent elder abuse survey, published in 2024 and covering 5,169 elders and over 1,300 caregivers across 20 cities in 10 states, found that 7 percent of elderly respondents admitted to being victims of abuse, with a further 5 percent declining to answer the question at all, itself a telling data point in a country where discussing mistreatment by one’s own children carries deep social stigma. Among those who did report abuse, sons were identified as the most common perpetrators at 42 percent, followed by daughters-in-law at 28 percent.
Those numbers likely understate the true scale, given how many respondents chose not to answer and how much elder mistreatment in India, financial control, verbal disrespect, simple neglect, never gets named as abuse by the people experiencing it. India does have a law, the Maintenance and Welfare of Parents and Senior Citizens Act, 2007, that obliges children to support elderly parents and gives tribunals the power to enforce it. Awareness of the law among the elderly themselves remains low, and enforcement depends on an older person being willing to formally accuse their own child, a step very few are prepared to take, which mirrors a pattern this publication has traced in the story of India’s internal migrants, whose mobility reshapes the households and support systems they leave behind.
What it would take
None of this requires reinventing the wheel. Countries further along the same demographic curve, Japan, South Korea, several in Western Europe, have already built and stress-tested the components India needs: pension amounts indexed to inflation rather than fixed by decree, geriatric care folded into primary health infrastructure rather than left to private specialists in big cities, community-based day-care and check-in services for elders who live alone, and accessible, low-friction mechanisms for reporting neglect that do not require an elderly parent to formally sue their own child.
Ageing India has pieces of all of this already, IGNOAPS, the 2007 Maintenance Act, LASI’s data infrastructure, but the pieces do not add up to a plan proportionate to 149 million people today and 347 million by mid-century. A pension frozen at 200 rupees a month, a law that depends on an elder’s willingness to accuse their own family, and a health system still organised around younger bodies are not a strategy. They are what happens when a country changes shape faster than its institutions do.
My neighbour’s mother will likely be fine. She has resources that most of India’s elderly do not: a paid-off home, a working pension, a son who calls. The question this country has not yet answered is what happens to the tens of millions who have none of the three, and whether anyone is building the plan before the wave of people who will need it arrives.