Saudi Arabia elderly care systems face structural, workforce, and cultural challenges despite Vision 2030 progressSaudi Arabia Faces Challenges in Caring for Aging Populations

Saudi Arabia is undergoing a major demographic transition, with the proportion of older adults projected to increase from 5% in 2015 to over 20% by 2050. Although improvements in healthcare have extended life expectancy, the rapid growth of the elderly population is placing increasing pressure on the country’s health and social care systems. Persistent challenges—including shortages in the geriatric workforce, heavy reliance on migrant caregivers, cultural reluctance toward institutional care, and disparities in rural service provision—limit the system’s ability to respond effectively. While Vision 2030 has introduced reforms promoting integrated, modernized, and digitally enabled elder care, the evidence base specific to aging in Saudi Arabia remains limited and fragmented. This systematic review aims to consolidate existing evidence, identify critical gaps, and evaluate the alignment of current initiatives with Saudi Arabia’s demographic trajectory. This PRISMA-guided systematic review consolidates existing literature to assess the current state of elderly care in Saudi Arabia, identify system gaps, and evaluate how ongoing initiatives align with the nation’s demographic trajectory. Sources published in English or Arabic between 1995 and 2025 were retrieved from major academic databases and grey literature. Studies were screened for relevance and subsequently analyzed using thematic synthesis. The review indicates that Saudi Arabia’s elderly care system is evolving but remains under strain. Expansion of long-term care services, hospital-based geriatric programs, and policy alignment with Vision 2030 reflect measurable progress. However, several barriers persist, including a growing chronic disease burden, rising healthcare costs, digital illiteracy among older adults and some providers, and continued dependence on foreign labor in caregiving roles. This systematic review finds that Saudi Arabia’s elderly care system is evolving but faces persistent structural, workforce, and cultural challenges that require urgent attention. Strategic, technology-supported, and workforce-focused reforms are essential to meet the demands of a rapidly aging population. Significant gaps in data and research on aging in the country remain, underscoring the need for further evidence to support informed policy development and long-term planning.