Main content

Introduction

Concepts of health, based on cultural, traditional and scientific factors differ globally. These factors influence how societies deal with healthy ageing. This paper explores differences between Western and Indian approaches to healthy ageing. It analyses opportunities and challenges for stimulating health ageing globally.

Different approaches to healthy ageing

Biological approaches to healthy ageing

Globally, one of the cornerstones of healthy ageing is the early management of pathologies before they become debilitating and begin to compromise quality of life for individuals and their families. While European practice of medicine is based on understanding features of health through monitoring discrete changes in the body, the traditional Indian methodology – which is deeply rooted in their system of medicine called “Ayurveda and Unani” – focuses on balancing the metabolism of the body using various approaches. These different practices also are noticeable in the approach to ageing.

Culturally, European medical science views ageing as a problem to be solved by technological and medical interventions. [1] The dimensions of social, mental and spiritual needs critical for healthy ageing are often overlooked. The Indian concept sees ageing as a natural process, where the older adults are an integral part of society and generally viewed as the ones with experience and wisdom. The Indian approach emphasises the psychosocial and physical wellbeing of the elderly. [2]

Psychological approaches to healthy ageing

Psychological approaches to healthy ageing outline psychological and social engagement as the measures of well-being, which is one’s capability to realise a meaningful life and have a positive mental setup. Well-being is associated with both personal and professional lives and is related to life satisfaction as it encompasses positivity towards life. Healthy ageing and psychological well-being share a linear relationship, which deepens as one ages. Those who are constructive on aspects such as autonomy, personal growth, positive relations, purpose in life and self-acceptance experience a healthy and satisfying life, particularly in old age.  

Healthy ageing can be stimulated by three measures:

  1. Understanding that the ageing process is affected by social and behavioural dimensions through lifelong dynamic interactions with the biological processes.
  2. Addressing age-related stereotypes. This process occurs in two directions i.e., top-down (from society to an individual) and over time (from childhood to old age). Stereotyping affects human rights and leads to discrimination, eventually affecting health. [3, 4] 
  3. Creating opportunity structures for age-friendly living. To enable adults with a higher age to age well, societies must provide physical, economic, and social structures, including age-friendly environments in personal and professional spheres. Urban infrastructure and public spaces should be designed keeping in mind accessibility and ease of performing daily life activities. [5] 

Traditional Indian methods of Ayurveda and Unani emphasise such stimulating measures, although under the current socio-economic developments, older adults are increasingly under pressure. 

Socio-economic approaches to healthy ageing

The socio-economic approach to healthy ageing emphasises that disadvantages in later life are not solely due to chronological age but often stem from structural inequalities, particularly in access to resources, capital, and opportunities. This leads to unequal experiences at old age and health inequity. 

Education is one of the most powerful predictors of health outcomes. Higher educational attainment is strongly associated with longer life expectancy and better health. Education shapes behaviours like smoking and diet, which impact both physical and mental health. Additionally, higher education is associated with better cognitive health in older adults. [6, 7, 8]

Economic well-being plays a central role in healthy ageing (thereby stressing the need for linking bio and socio-gerontology). Financial security enables better nutrition, safer housing, access to medical care and meaningful engagement in later life. Older adults with steady employment in their early years tend to benefit from better living conditions, savings, pensions, and access to social protection. Wealth can also delay the onset of ageing-related illnesses and improve quality of life. [9] Environmental factors affect living conditions such as housing quality and neighbourhood safety, which in turn affect health and wellbeing, particularly in LMICs where basic infrastructure such as electricity, clean fuel, sanitation, and transportation remain inadequate. [10, 11, 12]

Gender constitutes another axis of inequality in ageing. Women face cumulative disadvantages, including lower labour force participation, unpaid caregiving responsibilities, and restricted access to financial assets. In many LMICs, women also face safety concerns, cultural restrictions, poverty and neglect. 

Race and ethnicity also play a role in healthy ageing. The group identity shaped by race and ethnicity reveals clear disparities in access to basic services among older adults, particularly those positioned at a lower echelon of social hierarchy. For instance, in India, caste hierarchies continue to restrict equitable access to socio-economic opportunities. 

Behavioural factors also affect the likelihood of achieving healthy ageing, though they themselves are shaped by broader social conditions. Individuals who maintain a healthy diet, avoid smoking and engage in physical activities are more likely to enjoy greater longevity. Strong ties with spouse, friends and family can reduce mortality risk. Participation in voluntary and religious organisations also improves overall wellbeing. [13]

Discussion

The concept of healthy ageing as traditionally applied in India has strong elements with an emphasis on psychological well-being.

The rapid growth in the ageing population, particularly in India and other low- and middle-income countries with underdeveloped welfare systems, poses significant challenges. The COVID-19 pandemic has further widened these gaps in health and economic opportunities particularly due to limited public health capacity and lack of political will. A comprehensive approach to healthy ageing must therefore go beyond medical care, addressing educational disparities, economic insecurity, gendered disadvantages and social exclusion. Public institutions and inclusive policies can play a pivotal role in achieving these objectives by mitigating social inequality and fostering environments that support dignity and well-being in old age.

Conclusion

This article posits that healthy ageing results from a complex interplay of biological, psychological, and socio-economic factors that vary across cultural and economic contexts. Using comparative perspectives from Western countries and India, we argue that while advanced healthcare systems in the Western world manage various aspects of physical ageing, the Indian context offers insights into the psychological and social dimensions of ageing, often overlooked in biomedical models. 

The contrasts between European and Indian approaches to ageing reveal important lessons. An optimal strategy would be to integrate both personalised medicine and technological advances with traditional wisdom and community-based care. Healthy ageing requires developing age-compatible conditions, for instance age-friendly infrastructure, healthcare systems, psychological well-being, social inclusion, inclusive workplaces, positive age stereotypes and intergenerational engagements.  

Addressing socio-economic disparities is equally essential. Improving access to education can significantly reduce inequalities in ageing outcomes. Policies must be inclusive, equitable, and culturally sensitive to ensure that all older adults, regardless of health status or background, can age with dignity and fulfilment. Ageing should not be viewed as a burden but as a time of contribution, purpose, and well-being. 

References

  1. Ioppolo, G., F. Vazquez, M. G. Hennerici, and E. Andrès. 2020. “Medicine 4.0: New Technologies as Tools for a Society 5.0.” Journal of Clinical Medicine 9(7): 2198.
  2. Patwardhan, B. 2014. “Bridging Ayurveda with Evidence-Based Scientific Approaches in Medicine.” EPMA Journal 5(1): 19.
  3. Levy, B. R., and E. Leifheit-Limson. 2009. “The Stereotype-Matching Effect: Greater Influence on Functioning When Age Stereotypes Correspond to Outcomes.” Psychology and Aging 24: 230–233.
  4. Marcia Ory, Melane Kinney Hoffman, Margaret Hawkins, Brigid Sanner, Robin Mockenhaupt (2003). Challenging aging stereotypes: Strategies for creating a more active society. American Journal of Preventive Medicine, 25 (3): 164-171
  5. Wong, R. Y. 2018. “A New Strategic Approach to Successful Aging and Healthy Aging.” Geriatrics (Basel) 3(4): 86.
  6. Avila, R., M. A. A. Moscoso, S. Ribeiz, J. Arrais, O. Jaluul, and C. M. C. Bottino. 2009. “Influence of Education and Depressive Symptoms on Cognitive Function in the Elderly.” International Psychogeriatrics 21: 560–567.
  7. Das, Ayushi, and Preeti Dhillon. 2024. “Understanding Healthy Ageing in India: Insights from Multivariate Regression Trees.” Aging Clinical and Experimental Research 36: 158.
  8. Okamoto, S. 2019. “Socioeconomic Factors and the Risk of Cognitive Decline Among the Elderly Population in Japan.” International Journal of Geriatric Psychiatry 34: 265–271.
  9. Preston, S. H. 1975. “The Changing Relation Between Mortality and Level of Economic Development.” Population Studies 29: 231–248.
  10. Firdaus, G. 2017. “Built Environment and Health Outcomes: Identification of Contextual Risk Factors for Mental Well-Being of Older Adults.” Ageing International 42: 62–77.
  11. Muhammad, T., T. Meher, and T. V. Sekher. 2021. “Association of Elder Abuse, Crime Victimhood, and Perceived Neighbourhood Safety with Major Depression Among Older Adults in India.” BMJ Open 11: e055625.
  12. Srivastava, S. 2021. “Geriatric Mental Health Issues from India.” In Ageing Issues in India: Practices, Perspectives and Policies, edited by M. K. Shankardass, 301–309. Singapore: Springer.
  13. Walen, H. R., and M. E. Lachman. 2000. “Social Support and Strain from Partner, Family, and Friends: Costs and Benefits for Men and Women in Adulthood.” Journal of Social and Personal Relationships 17: 5–30.

Affiliations: 1 Group Leader, Heidelberg Institute for Global Health, Heidelberg University; 2 Assistant Professor, Kazi Nazrul Islam Mahavidyalaya; 3 Professor, Department of Developmental Biology and Genetics, Indian Institute of Science

Corresponding author: Dr. Suboor Bakht bakht@hcsa.uni-heidelberg.de