Australia is bracing for its over-65 population to double by 2050. Meanwhile, India is currently witnessing its elders already crossing the 150-million mark. This brings policymakers to an important question: how can societies care for their ageing population? Sonu Bhaskar ageing lessons
For the Indian diaspora in Australia – many of whom are juggling responsibilities for ageing parents overseas and here – the issue is both personal and urgent.
That’s why the findings of a new Nature Aging paper, ‘Population aging in Japan offers a warning and a template for action’, co-authored by Sydney-based neurologist and researcher Dr. Sonu Bhaskar, strike so close to home. Drawing lessons from Japan, the world’s most aged society, the study argues that reforms made now can prevent health systems from buckling under demographic pressure later.
The Japanese blueprint
Japan’s community-based integrated care system (CICS), which was rolled out nationwide in 2012, remains the most adaptable reform for ageing populations, Dr. Bhaskar tells Indian Link. This neighbourhood-level model connects primary health care, housing, long-term care, and social services – allowing older adults to remain independent and reducing hospital strain.
And the results speak volumes: “In municipalities where CICS is fully implemented, avoidable hospitalisations have fallen by roughly 15–20% and long-term care admissions by about 10% over the past decade.”
For India’s rapidly urbanising states and Australia’s rural heartlands, he calls CICS a “tested blueprint” for shifting care from hospitals into everyday living spaces.
“By investing in local governance, interoperable data systems, and workforce training, countries can shift care from hospitals to everyday living spaces, building a sustainable and compassionate foundation for ageing societies,” he adds. Sonu Bhaskar ageing lessons
Japan’s longevity is unmatched, but health span – the years lived in good health – lags behind. “Between 1990 and 2021, Japan’s life expectancy rose by 5.8 years, yet healthy life expectancy improved by only 4.4 years, leaving an 11-year health-span gap,” Dr. Bhaskar explained.
The warning is clear: extending life without ensuring its quality “misses the heart of what matters”.
He points to policies like frailty prevention, targeted nutrition to combat sarcopenic obesity, and universal mental-health screening in primary care. “By funding these measures as rigorously as treatments that add years, governments can narrow the health-span gap and allow people not merely to live longer, but to live well.”
Mental health: The hidden burden
One in four Japanese over 65 shows significant depressive symptoms, and suicide rates among men over 75 are among the highest in the OECD (a club of countries with advanced economies that includes Japan).
“Loneliness and mental-health struggles among seniors often slip under the radar,” Dr. Bhaskar warned. The remedy? Routine mental-health checks at every primary care visit, combined with “warm, community-led campaigns delivered through local languages, temples, or neighbourhood associations” to dissolve stigma.
The study also highlights how middle-aged adults can protect their future selves. Keeping blood pressure under 130 mm Hg, twice-weekly strength or balance training, and joining group activities all showed powerful long-term benefits.
“Start these habits now,” Dr. Bhaskar urged. “The reward is a vibrant, largely self-reliant future.”
India vs. Australia: Different challenges, shared urgency
If Dr. Bhaskar were to advise policymakers today, his message would be nuanced. For India, the priority is “building care close to home” by creating integrated community hubs and national caregiver support. For Australia, it is “ageing with dignity” – funding mobility and independence, expanding telehealth for rural and Aboriginal communities, and investing in dementia-ready housing “as dementia prevalence is projected to exceed 800,000 by 2050”.
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Hospitals can meet the needs of an ageing population without sidelining younger patients by designing around function rather than age.
Specialised geriatric emergency units, short-stay observation areas, and hospital-at-home programmes have cut average length of stay by nearly 20% and lowered readmissions in frail elders in Japanese pilot sites, he reveals.
“Australia faces a similar challenge: people 65+ already account for about 42% of all hospital bed-days despite being only 16% of the population. Adopting function-first triage and hospital-at-home models will free beds and improve recovery while preserving funding for paediatric and maternity services.”
Lastly, for families straddling India and Australia, his advice is simple but profound. “Gather your family for a heartfelt huddle about your ageing loved ones’ care, discussing their preferences for housing, emergency contacts, nutrition, and emotional well-being long before a crisis hits.”
With ageing populations already reshaping economies and healthcare systems, his call is clear: the time to act – whether through national policy or living-room conversations – is now! Sonu Bhaskar ageing lessons
READ MORE: Duty and distance: Caring across continents and generations
