The older adult population in India is rapidly increasing, set to reach 230 million by 2036. It is estimated that by 2046, the proportion of older adults (60+ years) will surpass the proportion of children in India, marking a major demographic transition. Cardiometabolic diseases are a key driver of morbidity and mortality among older adults in India. The growing burden of multimorbidity, mental health vulnerability, financial instability and social isolation often complicate the management of cardiometabolic risk. Despite multiple policy initiatives and programs, the cardiometabolic risk in older adults remains a significant challenge. Fragmented detection, limited community involvement, and insufficient integration with mental health, rehabilitation services and social support continue to limit the progress and sustained control.