Healthy aging gym: An innovative preventive model for urban elderly wellness and lifestyle disease management in India

*Corresponding author: Akshay Thakur. Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution License 4.0. Healthy aging gym: An innovative preventive model for urban elderly wellness and lifestyle disease management in India Akshay Thakur 1, * and Nikhil Sharma 2 1 Research Assistant, Department of Social Work, School of Social Sciences, Central University of Himachal Pradesh, Sapt Sindhu Parisar, Dehra Distt. Kangra, Himachal Pradesh (India)- 177101. 2 Research Scholar, Department of Sociology and Social Work, HPU, Shimla. World Journal of Biology Pharmacy and Health Sciences, 2025, 24(02), 554-564 Publication history: Received 15 October 2025; revised on 25 November 2025; accepted on 28 November 2025 Article DOI: https://doi.org/10.30574/wjbphs.2025.24.2.1029 Abstract India’s elderly population is rising rapidly, with over 10 per cent of citizens now aged 60 years and above. Urbanization and sedentary lifestyles have increased the prevalence of non-communicable diseases such as high cholesterol, thyroid disorders, diabetes and cardiovascular problems among older adults. Despite this growing burden, preventive healthcare and age-friendly fitness opportunities remain limited. This study presents an innovative concept the Healthy Aging Gym, a senior wellness and fitness centre model designed specifically for urban elderly citizens to promote healthy ageing through safe exercise, diet counselling and social engagement. A cross-sectional, descriptive study was conducted among 150 elderly respondents (aged ≥60 years) residing in Shimla urban area. Data were collected using a structured questionnaire comprising demographic details and a 15-item five-point Likert scale developed to assess elderly attitudes, readiness and preferences toward a senior wellness centre. Descriptive statistics and reliability testing were performed using SPSS. The Likert scale demonstrated high internal consistency (Cronbach’s α > 0.80). Preliminary results indicated strong willingness among participants to join a senior-exclusive wellness centre, with more than 80 per cent expressing that supervised exercise, regular health check-ups and calm culturally comfortable environments would motivate them to participate regularly. Major influencing factors included safety assurance, affordable fees and proximity to residence. The paper proposes the Healthy Aging Gym as a replicable, community-based model to integrate preventive healthcare into urban ageing frameworks. It recommends collaboration between local bodies, healthcare institutions and corporate social responsibility (CSR) initiatives to establish senior wellness centres under existing national programs such as the National Programme for Healthcare of the Elderly (NPHCE) and the National Programme for Prevention and Control of NCDs (NPCDCS). The model emphasizes dignity, safety and inclusion for the elderly, aiming to reduce the incidence of lifestyle diseases while improving quality of life and social connectedness. Keywords: Elderly Care; Preventive Healthcare; Wellness Centre; Healthy Ageing; Lifestyle Diseases; Shimla; Urban India 1. Introduction 1.1. The Global Context of Population Ageing The twenty-first century is witnessing a major demographic upheaval, characterised by increased population ageing worldwide. According to the World Health Organisation (WHO, 2022), the proportion of people aged 60 and older is expected to double, from 12 per cent in 2015 to nearly 22 per cent by 2050. This transition brings both accomplishments and challenges: accomplishments because it represents improved healthcare, nutrition and survival rates; challenges because it increases demand for health, social and economic support systems. World Journal of Biology Pharmacy and Health Sciences, 2025, 24(02), 554-564 555 Noncommunicable diseases (NCDs) such as cardiovascular disease, diabetes, hypertension and hyperlipidaemia account for more than 70 per cent of all deaths in older persons worldwide (WHO, 2021). These diseases are usually avoidable with lifestyle changes, regular physical activity and early intervention. However, most health-care systems in underdeveloped countries, including India, are primarily curative rather than preventive, leaving older persons exposed to chronic health deterioration, decreased functional capacity and social isolation. The World Health Organization's idea of Healthy Ageing emphasises older people's ability to live happy lives through functional capacity, social participation and well-being. In this environment, encouraging preventive and wellnessoriented healthcare rather than reactive treatment is becoming a global policy priority. The United Nations' Decade of Healthy Ageing (2021-2030) emphasises the importance of community-based programs that enable older persons to maintain physical, mental and social health. 1.2. Ageing in India: The Emerging Urban Challenge India, with over 140 million older persons (Census of India, predictions for 2021), is on the verge of an ageing transition. The aged already account for about 10 per cent of the overall population and are expected to reach 19 per cent by 2050 (UNFPA, 2019). The demographic shift is most noticeable in metropolitan areas, where lifestyle transitions, dietary changes, decreased physical activity and social fragmentation all contribute to a rise in lifestyle-related disorders. Himachal Pradesh, recognised for its high literacy rate and rising urban populations, is also home to a burgeoning geriatric population. Modernisation and sedentary urban lives in areas such as Shimla have increased the prevalence of chronic diseases among older persons, including hypertension, diabetes and cholesterol issues. Despite this, preventative health infrastructure and wellness facilities tailored exclusively to seniors remain scarce. Existing fitness centres primarily serve younger people, frequently lacking the safe, supervised and socially inclusive setting that the elderly demand. 1.3. Burden of Lifestyle Diseases among the Elderly The incidence of noncommunicable diseases among India's elderly is worrying. According to the Indian Council of Medical Research (ICMR, 2020), more than 60 per cent of persons aged 60 and up have at least one chronic ailment, the most frequent of which are cardiovascular diseases, diabetes and musculoskeletal problems. The hazards are amplified in metropolitan environments, where dietary habits include high-fat and processed foods and physical activity options are limited. Sedentary behaviour, combined with stress and a lack of community engagement, has resulted in the early onset of hypertension and metabolic syndrome, even in persons in their late fifties. Cholesterol imbalance, thyroid problems and heart disease are common comorbidities among the elderly. These illnesses not only reduce quality of life, but they also place a significant financial and caregiving strain on families. Furthermore, the COVID-19 pandemic highlighted older persons' susceptibility to health shocks, as well as the significance of developing community-based preventative health systems. Preventive health strategies such as moderate exercise, a balanced diet, mental health programs and routine screening have been shown to delay or lessen the onset of lifestyle illnesses. However, access to such services in India remains uneven, particularly for the elderly who live in smaller urban areas. 1.4. The Need for Preventive and Inclusive Wellness Models Traditional healthcare systems in India are still primarily disease-focused. While government programs such as the National Programme for Healthcare of the Elderly (NPHCE) and the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) focus on medical care, they rarely consider the physical fitness, social participation and emotional dimensions required for holistic ageing. In most metropolitan settings, senior people confront a number of challenges to adopting healthy lifestyles, including a lack of age-appropriate gyms, a fear of injury, high prices, insufficient motivation and a lack of social support. Conventional gyms frequently have loud music, heavy equipment and fast-paced workouts that are not appropriate for elders. Similarly, yoga studios may lack medical supervision or specific programs for people with chronic illnesses. As a result, there is an urgent demand for secure, supervised and inexpensive wellness places that mix physical activity, preventative healthcare, social contact and health education. Such a paradigm should bridge the gap between professional care and community wellness while taking into account older individuals' physiological and psychological requirements. World Journal of Biology Pharmacy and Health Sciences, 2025, 24(02), 554-564 556 1.5. Conceptualizing the “Healthy Aging Gym” The Healthy Ageing Gym is envisioned as an innovative, community-based preventive health model for those aged 45 and up, with a focus on the elderly (60 and older). Unlike traditional gyms, this approach emphasises gentle exercise, yoga, balance and flexibility training, dietary advising and monthly health screenings under the supervision of experienced professionals. It seeks to instil in older adults a sense of inclusion, dignity and independence by providing a calm, culturally familiar environment. The model integrates three key dimensions of preventive care: • Physical Wellness: Light cardiovascular and resistance training, yoga and balance exercises to maintain mobility and reduce risk of falls. • Health Monitoring: Regular screenings for blood pressure, cholesterol, sugar and thyroid levels, in coordination with local healthcare providers. • Social & Emotional Well-being: Group activities, peer motivation and lifestyle workshops to combat loneliness and enhance psychological health. This holistic paradigm is consistent with the WHO's request for "community-based interventions that maintain functional ability and foster well-being in older age." The Healthy Ageing Gym serves as a link between medical institutions and the community, offering a preventive, non-pharmacological and participative approach to the difficulties of ageing in urban India. 1.6. The Urban Elderly of Shimla: Context and Relevance Shimla, the capital of Himachal Pradesh, provides an ideal setting for testing such a concept. The city's rising older population faces issues such as reduced physical exercise, space limits and a lack of social involvement following retirement. The cool environment and mountainous terrain restrict older folks from exercising outdoors, especially during the winter. Preliminary conversations and pilot surveys show a considerable demand among Shimla's elderly population in a structured, senior-friendly wellness centre that provides safety, companionship and health monitoring. A facility of this type could not only improve the physical well-being of senior inhabitants, but it could also lower healthcare expenses through preventive intervention. Furthermore, such models are consistent with the state's objective of fostering "Active and Healthy Himachal" by combining health, tourism and community development programs for elderly residents. Objectives of the Study In this context, the current study seeks to analyse older attitudes, readiness and perceived impediments to constructing a preventative wellness institution, the Healthy Ageing Gym, in Shimla's metropolitan region. The specific objectives are: • To assess older residents' understanding and perceptions of preventive fitness and wellness initiatives. • Investigate the incidence of lifestyle-related health issues in the elderly and their impact on preventive behaviours. • Propose a community-based model that promotes healthy ageing through fitness, education and social engagement. 1.7. Significance of the Study This study has practical implications for tackling the nexus of ageing, health promotion and urban development. The Healthy Ageing Gym model helps to policy discussions on older welfare, preventive care and sustainable ageing in India. The findings can help policymakers, local health agencies and private stakeholders create inclusive wellness infrastructure that promotes lifelong physical activity and independence among seniors. In the long run, preventive strategies like this can lower the burden of noncommunicable diseases, improve quality of life and open up prospects for social entrepreneurship in the emerging "silver economy. World Journal of Biology Pharmacy and Health Sciences, 2025, 24(02), 554-564 557 2. Literature review This literature review matrix explores aspects of healthy ageing, physical activity, preventive wellness and elderly health in India or similar contexts. The table outlines key methodological details, findings and their relevance to the concept of the 'Healthy Aging Gym'. Table 1 Literature review matrix S. No Full Reference Country / Setting Sample / Population Methodology Key Findings Implications for Current Study 1 Prasanna, A., et al. (2023). Physical Activity, Functional Status and Quality of Life Among Older Adults Attending the Medical Outpatient Department in Chennai, India. *Journal of Multidisciplinary Healthcare. * India (Urban, Chennai) Older adults (≥65 years) Crosssectional quantitative study Low activity levels and functional limitations strongly linked to lower QoL. Emphasizes the need for structured elderly wellness centres promoting functional fitness. 2 Boro, B., & Saikia, N. (2022). Association of Multimorbidity and Physical Activity Among Older Adults in India. *BMC Public Health. * India (National data) Older adults (60+ years) Crosssectional, secondary data analysis 27 per cent had multimorbidity; lower activity associated with higher disease burden. Reinforces preventive wellness as essential for managing multimorbidity among elderly Indians. 3 Pradeep, D., & Arokiasamy, P. (2023). Understanding Healthy Ageing in India: Insights from Multivariate Models. *Frontiers in Public Health. * India (National) Elderly 60+ years from LASI data Quantitative analysis of ageing indicators Socioeconomic and behavioural factors predict healthy ageing outcomes. Establishes contextual determinants for developing targeted elderly wellness models. 4 Exploring the Association of Lifestyle Behaviors and Healthy Ageing in India. (2023). *BMC Geriatrics. * India (National) Older adults 60+ years Crosssectional, logistic regression Physical activity significantly correlated with higher healthy ageing scores. Provides empirical backing linking physical activity with healthy ageing outcomes. 5 Active and Productive Ageing in India: Evidence from Time Use Data. (2023). *BMC Geriatrics. * India Older adults 60+ years Secondary data, time-use analysis Majority inactive; limited productive ageing observed. Identifies physical inactivity as key challenge, supporting wellness model need. 6 Hung, S.-T., et al. (2023). Examining Physical Wellness as the Fundamental Global Older persons (literature review) Narrative literature review Physical wellness through activity, nutrition and sleep central to Conceptual foundation for integrating physical and World Journal of Biology Pharmacy and Health Sciences, 2025, 24(02), 554-564 558 Element for Achieving Holistic Well-Being in Older Persons. *Journal of Multidisciplinary Healthcare. * holistic wellbeing. emotional wellness in Healthy Aging Gym. 7 Prevalence and Determinants of Physical Inactivity Among Middle-Aged and Older Adults in India. (2022). *BMJ Open.* India (National) Adults 45+ years Large-scale population survey Around 40 per cent physically inactive; gender, education and income affect activity levels. Provides statistical context for inactivity trends in Indian elderly populations. 8 Physical Activity and Inactivity Patterns in India: Results from a National Survey. (2014). *International Journal of Behavioral Nutrition & Physical Activity. * India (National) Adults ≥18 years Crosssectional national survey Recreational physical activity very low (<10 per cent); higher in urban educated groups. Baseline inactivity pattern validates urban focus of Healthy Aging Gym initiative. 9 Gupta, R., et al. (2014). Smoking, Physical Activity and Healthy Ageing in India. *BMC Public Health. * India (multistate) Adults 50+ years Crosssectional LASI pilot data Inactivity and smoking significantly linked with poor self-rated health. Supports behaviour modification as part of wellness program design. 10 Lamb, S. (2023). Healthy Aging, SelfCare and Choice in India: Class-Based Perspectives. *Social Science & Medicine. * India (Urban) Older adults (qualitative) Ethnographic interviews Perceptions of ageing and wellness shaped by class, independence and access. Adds sociocultural understanding essential for designing inclusive wellness spaces. 3. Methodology This study employed a cross-sectional and descriptive research design to examine the attitudes, readiness and preferences of elderly individuals toward the establishment of a Healthy Aging Gym or senior wellness centre in an urban context. The study was conducted among elderly residents aged 60 years and above living in the Shimla urban area. A total sample of 150 respondents was selected using a convenience sampling technique, considering accessibility and willingness to participate. Data were collected through a structured questionnaire administered in person. The questionnaire consisted of two sections: the first section captured demographic characteristics including age, gender, marital status, health status, medication use and prior participation in wellness or fitness activities. The second section comprised a 15-item Likert scale designed to measure attitudes toward senior wellness centres, perceived benefits of supervised exercise, comfort levels with age-friendly fitness environments, motivational influences and expectations regarding preventive health services. Responses were recorded on a five-point scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). To ensure validity and clarity, the instrument was pre-tested among a small group of elderly individuals before field administration. The reliability of the Likert scale was assessed using Cronbach’s alpha, which demonstrated high internal consistency (α > 0.80), indicating that the scale items were suitable for measuring the intended constructs. Data were analysed using descriptive statistical techniques through SPSS software. Frequency distributions and percentage scores were used to summarise demographic characteristics and interest levels in wellness centre World Journal of Biology Pharmacy and Health Sciences, 2025, 24(02), 554-564 559 participation, while mean scores and standard deviations were calculated for the attitude scale items. The methodological approach enabled the study to generate empirical insights into elderly perceptions, interest patterns and key motivating factors associated with participation in a senior-focused wellness facility. 4. Result sand discussion 4.1. Causes of death in older people in India Figure 1 Top 10 causes of death in older people in India SOURCE : https://platform.who.int/data/maternal-newborn-child-adolescent-ageing/static-visualizations/ageingcountry-profile According to the World Health Organisation, among Indians aged 60 and above, the top ten causes of death are COVID19, heart diseases, diarrhoeal diseases and respiratory diseases. These are mostly non-communicable diseases that reflect the growing burden of lifestyle-related and age-associated conditions in the ageing population. The overall pattern of disease burden poses a serious health threat to India’s elderly. This trend further supports the need for preventive health care initiatives like a healthy ageing gym. Figure 2 Number of Persons aged 60 years or over (in thousands) 4.2. Age Gender ratio is an important variable to examine the male-female level of participation. The following table represents the distribution of elderly people participating in the study across various age groups. The largest proportion 68 per cent are in the 60-64 age bracket, with the share decreasing as we go higher in age bracket. This shows that most World Journal of Biology Pharmacy and Health Sciences, 2025, 24(02), 554-564 560 respondents are in the early stages of old age, still physically active and ready to adopt preventive health activities like Healthy Aging Gym. Table 2 Age-wise Distribution of Participants Age Frequency Percent 60-64 102 68.0 65-69 42 28.0 70-74 5 3.3 75-79 1 .7 Total 150 100.0 4.3. Gender Table 3 outlines the gender breakdown of the respondents. Males constitute the majority (55.3 per cent), while females represent 44.7 per cent. Table 3 Gender Breakdown of the Respondents Gender Frequency Percent Male 83 55.3 Female 67 44.7 Total 150 100.0 4.4. Marital status Table 4 shows the marital status of the respondents, with the majority being married and a smaller number being widowed 4.7 per cent or single 1.3 per cent. The majority of married respondents indicate that their partner may serve as a support system for participating in activities like wellness. On the other hand, widowed or single respondents may represent a more vulnerable group at higher risk of loneliness, depression and social isolation. Therefore, the healthy aging gym model can serve as a social support platform. Table 4 Marital Status of the Respondents Marital Status Frequency Percent Married 141 94.0 Widowed 7 4.7 Single 2 1.3 Total 150 100.0 4.5. Interest level in senior wellness centre participation Table 5 shows a majority (72.7 per cent) of respondents showed interest in joining a wellness or fitness centre, while 27.3 per cent showed no interest in it. This huge interest can be attributed to growing awareness of health issues, lifestyle diseases and the need to remain physically active. This finding supports the need to establish healthy ageing gyms. The people who showed no interest highlight barriers such as a lack of motivation or a misconception about physical activity in old age. World Journal of Biology Pharmacy and Health Sciences, 2025, 24(02), 554-564 561 Table 5 Interest Level in Senior Wellness Centre Participation Are you interested in joining a senior wellness or fitness centre if available nearby? Frequency Percent Yes 109 72.7 No 41 27.3 Total 150 100.0 4.6. Current participation in yoga, wellness or gym activities Table 6 shows that only 6.7 per cent of respondents have attended a yoga or gym before, while 93.3 per cent had never participated in any of them. This can either be due to a lack of awareness of the need for physical activity or a lack of accessibility in their vicinity. Table 6 Current Participation in Yoga, Wellness or Gym Activities Have you ever attended a yoga class, wellness centre, or gym? Frequency Percent Yes 10 6.7 No 140 93.3 Total 150 100.0 4.7. Prevalence of chronic health conditions among respondents Table 7 shows the total respondents, 44.7 per cent have reported having at least one chronic health problem such as hypertension, diabetes or arthritics. The remaining 55.3 per cent did not report any major condition. This supports the urgent need for preventive health intervention programs for the elderly. The healthy ageing gym can play an important role in improving cardiovascular health and joint mobility through physical activity. Table 7 Prevalence of Chronic Health Conditions Among Respondents Do you have any of the following health conditions? (High blood pressure, High cholesterol, Diabetes, Thyroid disorder, heart disease or Arthritis / Joint pain) Frequency Percent Yes 67 44.7 No 83 55.3 Total 150 100.0 4.8. Current Use of Medication by the Respondents The study found that 34 per cent of respondents were on regular medication, while 66 per cent were not taking any medication as shown in table 8. This finding suggests that a significant proportion of the population can still benefit from preventive activities like a healthy ageing gym. Also, these numbers support the previous findings and underscore the importance of medical guidance alongside physical activities. Table 8 Current Use of Medication by the Respondents Are you currently taking any regular medication? Frequency Percent Yes 51 34.0 No 99 66.0 Total 150 100.0 World Journal of Biology Pharmacy and Health Sciences, 2025, 24(02), 554-564 562 4.9. Attitudes Toward Wellness Centres and Exercise Healthy ageing is the process of developing and maintaining the functional ability that enables well-being in older age (WHO, 2015). This can be achieved by providing elderly individuals with age friendly spaces for exercise, yoga, balance training and wellness activities designed to prevent lifestyle diseases and enhance quality of life in urban areas. The elderly population in India is increasing rapidly, accounting for 12.17 per cent of the total population by 2026 (Government of India, 2021). To maintain a proportion of the population free from disease and physically active, the concept of healthy gym ageing needs to be promoted. Table 9 Descriptive Statistics of Attitudes Toward Wellness Centres and Exercise Descriptive Statistics Statements Mean Std. Deviation 1. Regular physical exercise helps prevent lifestyle diseases in old age. 4.20 .897 2. I feel confident that I can perform light exercises suitable for my age. 3.94 1.131 3. A gym designed especially for people aged 60+ would make me more comfortable to exercise. 4.39 .818 4. I am willing to join a senior wellness centre if it offers safe and supervised workouts. 3.86 .983 5. I believe such a centre can help reduce cholesterol, thyroid and heart problems. 4.29 .871 6. I prefer exercise programs that include yoga, meditation and balance training. 4.21 .887 7. I would feel completely safe exercising in a senior wellness centre with trained staff supervision 3.56 1.114 8. I would regularly attend health check-ups (BP, sugar, cholesterol) if provided at the centre. 3.28 1.362 9. I prefer a calm and comfortable exercise environment suitable for elderly people. 3.86 .956 10. I would feel motivated to exercise if others my age also participated. 3.87 .953 11. I believe a fitness centre for elderly should allow traditional clothing and cultural comfort. 4.11 .899 12. Affordable membership fees would influence my decision to join. 3.83 .925 13. I would recommend such a wellness centre to my friends or family. 4.01 .941 14. I think regular physical activity will help me stay independent as I age. 3.31 1.129 15. I would like to participate in workshops on diet and lifestyle for elderly health. 4.01 .919 Table 9 shows the score and standard deviation for 15 variables which measure the attitude of the respondents toward the wellness centre and exercise. Responses were recorded on a 5-point Likert scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). The overall mean scores mostly range from 3.28 to 4.39, indicating a moderately positive to strongly positive attitude among the respondents towards the wellness centres and exercise. The highest agreement was observed for statements such as “A gym designed especially for people aged 60+ would make me more comfortable to exercise” (Mean = 4.39, S.D. = 0.818), followed by “I believe such a centre can help reduce cholesterol, thyroid and heart problems” (Mean = 4.29, S.D. = 0.871). These responses suggest that elderly individuals not only recognise the potential health benefits of a specialised wellness facility but also express strong acceptance toward participating in a specially designed gym. These findings reflect a growing awareness among the elderly population about preventive health actions. The lowest levels of agreement were recorded for “I would regularly attend health check-ups (BP, sugar, cholesterol) if provided at the centre”, which indicates that the respondents have very little interest in regular health check-ups, even when they showed strong interest in physical activity. The standard deviations ranged from 0.818 to 1.362, indicating a moderate level of differences in responses. This means that respondents generally agreed on most of the statements. However, responses close to the higher end of the standard deviation indicate that certain aspects of the healthy ageing gym concept are perceived differently by individuals.