Moving Barbados forward: a case for investment in exercise for geriatric health.

Barbados faces a geriatric health crisis: by 2060, older adults will comprise 29.1% of the population; NCDs cause 83% of deaths, and adults are inactive. While citizen group exercise programs exist, no government-funded, community-based geriatric exercise program operates at the national scale in Barbados or across the wider Caribbean region. Evidence shows exercise programs reduce fall risk and generate 36 to 127% return on investment, with the greatest financial benefit accruing for the oldest and highest risk patients. A government partnership with Healthier Nation Initiative Foundation, using existing polyclinic infrastructure, offers a cost-effective, scalable, evidence-based preventive strategy. A phased rollout is recommended, starting with Active Agers pilot in Drax Hall, with clinical monitoring supported by relevant stakeholders.