With respect to the future demographic structure of the cities, there are two important issues of concern- “demographic dividend” and population ageing. The former has already been discussed and the latter is discussed here. Because of the fast decline in the age-specific death rates at the age of 60 and beyond, there is a rapid concentration of the aged population.
In addition to falling death rates, declining birth rates also contribute to the relative concentration of the aged in the population of a given country.
From the table, it may be seen that in the countries where population ageing (percentage of aged population is 7 %) appeared in the second half of the twentieth century, it has grown/has been growing much faster than the countries where it appeared before Second World War4. Thus, in India, although, currently (as of 2010) only 7 per cent of the population is aged population, it will double by 2045.
Table: Speed of Ageing in Some Selected Countries
| Countries | Years of Percentage of | Attaining Aged to Total | Specific Population | Years Required to Double from 7% |
| 7% | 10% | 14% | ||
| France | 1864 | 1943 | 1979 | 115 |
| Sweden | 1887 | 1948 | 1972 | 85 |
| USA | 1942 | 1972 | 2013 | 71 |
| Switzerland | 1931 | 1960 | 1982 | 51 |
| UK | 1929 | 1946 | 1976 | 47 |
| Germany | 1932 | 1942 | 1972 | 40 |
| India | 2010 | 2025 | 2045 | 35 |
| Thailand | 2005 | 2020 | 2030 | 25 |
| Japan | 1970 | 1985 | 1994 | 24 |
While this is the scenario of the whole country, in the cities, the issue of population ageing (percentage of aged population) is much more pronounced because both the age-specific death rates (for old ages) and birth rates are comparatively lower here.
For example in West Bengal percentage of the aged population is (as of 2001) 7.1 while in Kolkata it is 9.9 per cent (Das and Bhusan, 2015), again in the inner wards of Kolkata Municipal Corporation the percentage is even higher because working age population leave the inner city in search of better job and lifestyle (Shaw, 2015).
Therefore, it is obvious, that in the near future the issues related to the aged population like diseases occurring in old age, pension etc. will be aggravated.
Apart from these general problems, the unique problem for the senile population in the cities is that they are left alone in the house as working-age members of the family live in other places (in other cities or in different locations of the same city) with their children and spouse. In such circumstances, caring for old age persons is a major issue. While old age persons belonging to well-off families manage to avail of the service of care by paying the private service providers, old ages persons from poor families are unable to afford such services.
A recent study conducted by HelpAge India (2008) in eight cities of India finds that while around 30 per cent elderly suffer from chronic diseases like arthritis, hypertension and diabetes, only 13 per cent of them (total elderly) have health insurance (and this 13 per cent belong to the upper echelon of the society) and less than one-third of the “elderly avail pensions or support of any kind”.
The study also reveals that social security, free medical services, free public transportation, “love and respect from younger ones” and “club/old age homes” are some of the areas prioritised by the elderly; they also want yoga and meditation facilities, “religious discourses”, facility of library and indoor games etc.
Thus in the near future governments and non-government organisations should intervene in these areas with utmost priority to make the life of millions of elderly happy.