Italy's substantial lifespan-healthspan divide and aging demographic crisis could be partially addressed by integrating longevity medicine into the Italian National Health Service through five strategic investment priorities, though most constituent tools remain at an exploratory or surrogate stage with clinical utility yet to be established.
Italy has the highest proportion of adults aged 65 or older in the EU, with a projected median age of 51 years by 2050.
A substantial lifespan-healthspan divide exists in Italy, with Healthy Life Years significantly below life expectancy at birth.
The prevalence of multimorbidity and disability exceeds 60% in Italian adults aged 75 years or older, with women bearing a disproportionate burden.
The Italian National Health Service (SSN) is structurally ill-suited to address the emerging burden of age-related disease due to its hospital-centric and reactive orientation.
Longevity medicine is identified as an emerging prevention-oriented discipline that integrates multi-omic biomarkers, digital monitoring, adaptive trial methodology, and life-course risk stratification.
The paper identifies five strategic investment priorities for integrating longevity medicine into the SSN.
This research paper examines a major public health challenge facing Italy: the country has one of the world's oldest populations, yet a large gap exists between how long people live and how long they live in good health. Italian women live to about 85 years on average, but only about 70 of those years are considered healthy. For men, the gap is roughly 13 years. More than 60% of Italians over age 75 have multiple chronic diseases or disabilities simultaneously. The authors argue that Italy's national health system, which is primarily focused on treating illness in hospitals rather than preventing it, is poorly equipped to handle this growing burden. The paper introduces 'longevity medicine' as a potential approach to help close the gap between lifespan and healthspan. This emerging field uses advanced biological testing, wearable monitoring devices, artificial intelligence, and personalized risk assessment to identify health risks earlier in life and intervene before serious disease develops. The authors are careful to note that most of these tools are still experimental and have not yet been proven to improve patient outcomes in clinical practice. They propose five specific areas where Italy could invest to begin building this capability: better biological age tests, connected digital health monitoring systems, more flexible clinical trials, AI tools to predict individual health risks, and updated medical education that incorporates these concepts. This research suggests that transforming Italy's health system from one that primarily reacts to disease toward one that actively works to prevent it could help reduce the personal and financial burden of aging-related illness. However, the authors emphasize that these proposals should be treated as a starting point for evaluation rather than ready-to-implement solutions, and their value will only be confirmed if they can demonstrate real improvements in health outcomes, practicality, and cost-effectiveness within Italy's national health system.
Marino N, Fiore M, Stingi A, Cipriano A, Chadha A, Ricordi C, et al.. (2026). Towards integration of healthspan strategies into the Italian National Health Service.. Aging. https://doi.org/10.18632/aging.206402