Türkiye, long celebrated for its relatively young population compared to its Organisation for Economic Co-operation and Development (OECD) peers, now stands at a critical demographic crossroads. The nation is undergoing a rapid, recently accelerated transition from a young, growing populace to an aging society, a shift that is set to redefine its economic potential, social structure and political landscape.
A series of structural changes is swiftly leading Türkiye to a demographic crisis marked by a plunging fertility rate and a surging elderly population. While the aging process presents profound challenges, it is not an insurmountable threat but a defining moment that demands immediate, comprehensive and proactive policymaking, particularly the establishment of a robust elderly long-term care insurance system.
The recent data released by the Turkish Statistical Institute (TurkStat) points toward an indisputable, fast-moving crisis. The key indicators of an aging society – a declining total fertility rate (TFR) and a rising median age – are shifting at a pace that compresses the transition seen over centuries in Western nations into mere decades for Türkiye.
Current statistics paint a stark picture: Plunging fertility is the most striking data. According to TurkStat, the Total Fertility Rate (TFR) has dropped to a historic low of 1.48 children per woman in 2024, remaining well below the replacement level of 2.1. In fact, 71 out of 81 provinces now have fertility rates below this crucial threshold. This steep decline from a TFR of 2.38 in 2001 is a primary driver of the impending crisis. Recently, President Recep Tayyip Erdoğan has rightly described this downward trend as a "national disaster," highlighting the existential risk it poses to the country's future.
Rising median age and an increase in elderly dependents within the society are other aspects of the Turkish population crisis. The median age of the country has increased to 34.4 in 2024, up from 32.4 in 2019 and 28.3 in 2007. More critically, the elderly population (aged 65 and over) has grown by 20.7% in the last five years, reaching 9.11 million people in 2024. The proportion of the elderly in the total population has thus risen to 10.6%, classifying Türkiye, by United Nations standards, as a "very aged population" country.
Upon this, the generous welfare regime established in the last two decades and 17 million public pensioners of the country are making the crisis a more complex issue, which could threaten macroeconomic stability and impede development potential.
The real gravity of the situation lies in the demographic projections. Türkiye's demographic window of opportunity, where the working-age population is at its peak proportion, is expected to close in the first half of the 2030s. After this, the dependency ratio will begin to soar. In other words, the country has left merely a decade before hitting the wall of the aging crisis with its full socio-economic consequences.
According to TurkStat’s base scenario projections, the proportion of the elderly population is expected to reach 23.1% by 2050, meaning nearly one in every four people will be over 65. Moreover, by 2075, this proportion is forecasted to reach 31.7%, with one in three people being elderly.
The old-age dependency ratio, which measures the burden on the working-age population, is set to increase from 15.5% in 2024 to 45.5% by 2060. This rapid aging will exert immense pressure across all sectors. As Family and Social Services Minister Mahinur Özdemir Göktaş warned, "The decline in fertility rates and the aging tendency of the population magnify demographic risks." Yet, policymakers should be involved in very urgent structural reforms, as this crisis has already passed the threshold that can be prevented by rhetoric.
The demographic shift is often framed purely as a threat, a burden on the pension system, a shrinking labor force and rising health care costs. However, this perspective risks overlooking the potential for a new paradigm.
In terms of its disadvantages, the economic threat is obvious. A shrinking working-age population (set to fall from 68.4% in 2024 to 55.9% by 2075) must support a rapidly expanding retired population. This strains the existing pay-as-you-go pension system and threatens the country's long-term economic dynamism. The risk is the collapse of the intergenerational solidarity model irreparably.
Moreover, a dramatic rise in chronic health conditions among the elderly is expected to skyrocket public health care expenditures. Socially, the shift will increase the demand for formal and informal long-term care, placing a heavy burden on families, particularly women, who disproportionately provide this care. Within the social transformation of Turkish society, due to reasons such as the weakening of the traditional family structure, increasing urbanization, the lifestyle of Generation Z, and the increase in female workforce participation rates, care is no longer an issue to be handled within the Turkish family.
The aging population can, however, be reframed as an opportunity, particularly through the development of a "silver economy." This requires a change in mindset and policy. Policy makers are used to repeating old rhetoric and offering old policies that have proven ineffective, but we need to think outside the box on this issue.
Extending working life and the productivity of the labor force is the first challenge. In this regard, policies must encourage and facilitate the participation of healthy older adults in the workforce. This could involve flexible work arrangements, vocational training for upskilling and anti-age discrimination laws. Older workers bring invaluable experience, institutional memory and stability. But these activation policies should be designed carefully, not to turn into working elderly poverty.
Innovation in health care and gerontechnology is another challenge ahead of the nation. The rising demand for health services and care can spur innovation in gerontology, telemedicine, assisted living technology and pharmaceuticals. Türkiye could become a hub for these services, creating new high-value jobs and export opportunities.
The elderly population is a major market for specific goods and services, including travel, leisure and customized housing. Catering to this demand can stimulate economic growth and diversification. In addition, if Türkiye starts investing immediately, it can be transformed into a care haven, not just for its elderly but for tens of millions of elderly Europeans. Targeted consumption, investing in the elderly economy and care facilities and infrastructure is key at this point.
The single most critical policy intervention needed to manage this transition is the swift and comprehensive establishment of a Long-Term Care Insurance (LTCI) system.
Türkiye’s current system is fundamentally inadequate to meet the coming wave of demand for long-term care. While the national health insurance covers medical costs, the non-medical, daily living support needs of the frail elderly, known as long-term care (LTC), are mostly left to families and inadequate social services.
Mitigating the financial risk is the main target at this point: The cost of quality long-term care (home care, adult day care or institutional care) can quickly bankrupt middle-class families. LTCI would act as a crucial social safety net, pooling risk and ensuring that no citizen faces poverty due to age-related care needs.
Moreover, a dedicated insurance fund would provide the necessary capital to professionalize the care sector. This includes training and certifying a large workforce of professional caregivers (creating hundreds of thousands of new, dignified jobs), improving the standards of care in institutions and expanding home-based services, which most elderly prefer.
As a major point, by formalizing care, LTCI would relieve the unpaid care burden primarily placed on women. This would free up millions of women to fully participate in the formal economy, a crucial element in bolstering the shrinking labor force and contributing to GDP. This directly counters the argument that a demographic crisis can only be solved by higher birth rates; better utilization of the existing female labour force is an immediate and powerful solution.
Last of all, promoting dignity should be the ultimate goal. A national care insurance system is a statement of societal values – it ensures that aging citizens receive care with dignity, maintaining their independence and quality of life for as long as possible.
In sum, Türkiye is rapidly approaching an aging crisis. The window of opportunity has shrunk to 10 years, and urgent action is needed. It's clear that old policies are failing; visionary reforms are needed.
Establishing LTCI will require political courage and significant structural reform. It demands a transparent, actuarially sound funding mechanism, likely through a mandatory payroll contribution system similar to Türkiye's existing general health care insurance (GSS), but dedicated solely to long-term care. The government must also invest heavily in gerontological infrastructure, including accessible housing, public transport and urban planning that supports an aging population.
The warnings from high-level officials, including President Recep Tayyip Erdoğan, underscore the urgency. The time for a reactive, fragmented response has passed. Türkiye’s demographic change is irreversible. The choice before the nation is not if the population will age, but how it will manage it. By embracing comprehensive reforms centered on a mandatory National Elderly Care Insurance, Türkiye can transform a seemingly looming crisis into a well-managed transition, ensuring a prosperous and dignified future for its rapidly growing elderly population. The opportunity is now to turn the "silver tsunami" into a source of enduring national strength.
