Photo: M.Dörr & M.Frommherz/Adobe Stock
Aging is a mega trend reshaping our world. Global economies and societies are transforming as 2.1 billion people prepare to cross the silver line by 2050. Simultaneously, a technological revolution is disrupting our way of working, connecting, and living. But it often ignores the needs of the elderly. The Quad nations (Australia, India, Japan, and the United States) are at the intersection of these trends, possessing advanced technological capabilities and growing elderly populations. However, despite its leadership in health security and technology, the Quad has yet to fully address the needs of its most vulnerable demographic—the elderly.
In 2024, Quad nations accounted for 24.9 percent of the global 65 and over population. Currently, 29.8 percent of Japan's population is over 65 with only 1800 board-certified geriatricians to provide specialized care. By 2050, the U.S. expects a 47 percent rise in its elderly population, burdening older Americans with high long-term care costs not covered by Medicare. Australia anticipates 4.5 million seniors between the ages of 65 to 74 by 2066, with rural seniors struggling to access healthcare. India's current fertility rate is 2 births per woman, and by 2046, its elderly will outnumber children. Aging societies have created shared challenges like chronic diseases, and social isolation of the elderly across the Indo-Pacific. By 2050, one in four people in Asia and the Pacific will be over 60, demanding urgent attention.
The Quad, established to ensure a prosperous Indo-Pacific, is uniquely positioned to address this challenge. To protect its seniors and ensure regional prosperity, the Quad must prioritize aging as a strategic focus.
Quad AgeWell Program
Seniors face challenges like falls, limited mobility, cognitive decline, loneliness, and disparities in eldercare access due to old age. The U.S. spends $754 million annually on fatal falls in seniors over 65. Social isolation affects Japanese seniors, with 68,000 lonely at-home deaths projected in 2024. One-third of senior Australians live in rural and remote areas, affecting healthcare access. In India, 18 percent of the population needs assistive technology, but high costs hinder affordability.
Technological interventions can manage these challenges. Assistive robots can aid with chores and dexterity. Wearables with fall detection and smart home systems can enhance elders' safety. Walkers and wheelchairs with navigation and tracking can improve mobility. Telehealth can make healthcare more accessible for seniors. Yet, eldercare innovation remains an underexplored opportunity by the Quad tech giants. Moreover, adoption rates of existing med tech products remain low among seniors due to a lack of user-centric design, poor accessibility and usability, and high out-of-pocket costs.
To bridge this gap in eldercare innovation, the Quad should launch an AgeWell Program under its Health Security Partnership, focusing on inclusivity, innovation, and collaboration for gerontechnology. This program can revolutionize eldercare by leveraging Japan’s healthcare robotics, the U.S.'s advanced AI and R&D capabilities, India’s cost-effective STEM innovations, and Australia’s digital health expertise.
Eldercare Innovation Fund
Pooling public-private funding, the Quad can establish an Eldercare Innovation Fund under the AgeWell Program. The program can provide grants, and mentorship to incentivize STEM talent and start-ups to develop user-centric eldercare products. Pilot projects can be launched in Quad nations to test solutions before scaling, and market entry support for cost-effective and disruptive products can be provided. These innovations will revolutionize eldercare and empower seniors to live safe, healthy, and autonomous lives.
Historically, natural disasters in the Indo-Pacific have disproportionately affected seniors due to reduced mobility, chronic health conditions, and slower evacuation times. The 2004 Indian Ocean tsunami, which spurred the formation of the Quad, caused 13,954 deaths among those over 60 and displaced 92,762 seniors. Japan’s Tōhoku earthquake and tsunami in 2011 resulted in 56.7 percent senior fatalities. In Australia, between 2001 and 2018, over 69 percent of heatwave deaths were among those over 60. In the United States, 50 percent of the deaths caused by Hurricane Katrina of 2008, were among individuals over 75. Despite this, the Quad’s Humanitarian Assistance and Disaster Relief (HADR) efforts lack guidelines to address these vulnerabilities.
Aging Resilience Framework
To protect seniors from natural disasters and climate challenges in the Indo-Pacific, the Quad can adopt an Aging Resilience Framework under its HADR partnership. Under this framework, the Quad should develop age-friendly evacuation protocols that can be integrated into its yearly scenario-based tabletop exercises. Quad’s operational teams can practice joint simulation exercises for senior evacuation. Implementing teleconsultation models will improve on-ground geriatric care during disasters. By integrating these measures, the Quad can significantly enhance the safety of its senior populations during natural disasters.
Aging presents the Quad with unique challenges and opportunities. By establishing the AgeWell Program and integrating aging resilience into its HADR efforts, the Quad can create a safe, and inclusive future for its elderly. These initiatives will position the Quad as a regional and global leader in eldercare innovation and disaster resilience.
Sakshi Kataria is a program coordinator/research assistant with the Chair on India and Emerging Asia Economics at the Center for Strategic and International Studies, Washington, DC.
