This cross-sectional study investigates the multidimensional facets of ageing and wellness among older and elderly adults in urban slum settings, with an emphasis on epidemiology, risk factors, and the management of chronic diseases. A gender-balanced sample, predominantly from the early elderly age group (60-69 years) and those above that age group or more, revealed stark disparities in education, health awareness, and caregiving burdens, disproportionately impacting women. Family-centric living arrangements emerged as a cornerstone of well-being, fostering superior nutrition, medication adherence, and emotional support, while solitary living heightened risks of neglect, social isolation, and healthcare inaccessibility—exacerbated by socio-economic constraints. The cohort exhibited a high burden of non-communicable diseases, with hypertension, diabetes, cardiovascular disease, and kidney disorders predominant, alongside sensory impairments, thyroid issues, and mental health challenges. Positively, most participants adhered to balanced diets and light physical activity like walking, bolstered by family involvement, though structured exercise and routine check-ups lagged. Findings underscore that healthy ageing hinges on integrated medical care, health literacy, socio-economic enablers, lifestyle behaviours, and familial support. Targeted interventions are imperative to bridge preventive care gaps, prioritize cardiovascular and renal disease management, and uplift vulnerable subgroups. By promoting accessible healthcare, physical activity, and supportive ecosystems, such strategies can enhance dignity, independence, and quality of life in ageing populations.