The paper does not support the immediate clinical adoption of aging clocks, geroprotective drugs or AI-based risk tools. It proposes a staged agenda in which every innovation must demonstrate clinical utility, safety, feasibility, equity and cost-effectiveness before entering routine care.<\/p>\n
The Italian longevity paradox <\/p>\n
Italy is among the oldest countries in the world. People aged 65 and over represent 24.1% of the population \u2013 the highest proportion in the European Union \u2013 and the national median age is projected to reach 51 years by 2050.<\/p>\n
Yet longer survival has not been matched by an equivalent increase in years lived without substantial limitations.<\/p>\n
In 2023, life expectancy at birth was 85.4 years for women and 81.4 years for men. Healthy Life Years were 69.6 and 68.5 years respectively, producing a lifespan\u2013healthspan gap of 15.8 years for women and 12.9 years for men.<\/p>\n
The authors stress that this gap is not identical to the number of years lived with diagnosed disease. Nevertheless, it captures a central challenge: Italy has become highly effective at extending life, but less effective at preserving autonomy and function during those additional years.<\/p>\n
Health systems have traditionally measured success through survival. The next step is to measure whether additional years of life are lived with preserved function and independence. Healthspan should progressively become a public-health outcome, not remain only a scientific concept.\u201d<\/p>\n
Longevity medicine as a health-system framework <\/p>\n
The paper defines longevity medicine not as a new specialty, but as a translational framework connecting geroscience, prevention, personalized medicine, digital monitoring and health-system innovation.<\/p>\n
Its purpose would not be to replace geriatrics, primary care or disease-specific specialties. Rather, it would complement them by identifying unfavourable aging trajectories earlier and reducing multimorbidity and disability.<\/p>\n
Healthspan is also influenced by physical inactivity, diet, pollution, socioeconomic inequalities, social isolation, polypharmacy, digital exclusion and regional disparities.<\/p>\n
The SSN remains largely hospital-centred and reactive, while regional fragmentation limits interoperability and continuity of care. Prevention has historically received a modest share of resources, and reimbursement often rewards treatment more readily than long-term risk reduction.<\/p>\n
Five priorities for the SSN <\/p>\n
The authors identify five medium-term priorities.<\/p>\n
First, biological-age biomarkers should be standardized and externally validated. Epigenetic, proteomic and other aging measures may improve risk stratification, but should remain research tools until they improve patient-relevant outcomes.<\/p>\n
Second, interoperable digital platforms could integrate electronic health records, wearables and home sensors. Their value should be judged by effects on function, hospitalisation and care quality, rather than data collection alone.<\/p>\n
Third, Bayesian adaptive platform trials could test nutritional, physical, cognitive and pharmacological interventions more efficiently, using outcomes such as multimorbidity, disability, resilience and mortality.<\/p>\n
Fourth, explainable AI systems could support risk stratification, provided they undergo external validation, privacy safeguards and mandatory bias audits.<\/p>\n
Finally, medical education should include stronger training in healthy aging, functional assessment, multimorbidity, deprescribing and prevention, alongside public communication capable of distinguishing evidence-based interventions from commercial hype.<\/p>\n
Biological plausibility cannot be enough for public healthcare. Italy has the opportunity to become a real-world laboratory for longevity medicine, but every biomarker, algorithm or intervention must earn its place through evidence, equity and measurable benefit.<\/p>\n
An international scientific effort <\/p>\n
Alongside epidemiologist Matteo Fiore and myself, the authors include Luigi Ferrucci of the US National Institute on Aging; Fabrizio d\u2019Adda di Fagagna of IFOM and the Italian National Research Council; Marco Demaria of the European Research Institute for the Biology of Ageing; Vittorio Sebastiano and Andrea Cipriano of Stanford University; Camillo Ricordi of the University of Miami; Marco Quarta of Rubedo Life Sciences and the Phaedon Institute; Antonella Santuccione Chadha of the Women\u2019s Brain Foundation; David Della-Morte; Ennio Tasciotti; and Aureliano Stingi.<\/p>\n
From research to policy and advocacy <\/p>\n
The publication is part of a longer Italian pathway connecting research, policy and advocacy.<\/p>\n
AEON Foundation<\/a> has worked with national and international partners to bring healthy longevity into institutional debate, promote scientific collaboration and develop policy proposals. The Milan Longevity Summit<\/a> has been central to this effort, convening researchers, policymakers, healthcare leaders, investors and innovators around demographic aging and the translation of geroscience.<\/p>\n \u201cLongevity is not only a clinical or epidemiological challenge. It is a window of opportunity for our society,\u201d said Fiore. \u201cIf Italy has the courage to take this path, we will be able to alleviate the socioeconomic burden on the SSN over the medium to long term. Otherwise, demographic winter, combined with an almost exponential increase in the burden of chronic diseases, will make us even more fragile.\u201d<\/p>\n A possible global testbed <\/p>\n Italy combines an aging population, universal healthcare, strong scientific institutions and considerable regional heterogeneity. These characteristics make it a potential testbed for determining whether healthspan-oriented care can work at population scale.<\/p>\n The objective is not to provide every citizen with an aging clock or experimental therapy. It is to create the infrastructure needed to identify which interventions preserve function, prevent multimorbidity and generate value for patients and the public system.<\/p>\n Italy cannot reverse demographic aging through medicine alone. It can, however, influence how those additional years are lived.<\/p>\n The ultimate measure of success will not be longevity alone, but longer lives spent in better health.<\/p>\n About Nicola Marino Nicola Marino is co-founder and Director of AEON Foundation, an organization working at the intersection of longevity science, public policy and clinical translation. He is a researcher and member of the Advisory Board at the Women\u2019s Brain Foundation. He has authored peer-reviewed research on longevity medicine, digital health and data-driven prevention, and is a co-organizer of the Milan Longevity Summit.<\/p>\n","protected":false},"excerpt":{"rendered":"Nicola Marino looks at a new paper proposing an evidence-based roadmap to make healthy longevity a measurable objective…\n","protected":false},"author":2,"featured_media":36673,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[24527,24528,18977,5,24529,9810],"class_list":["post-36672","post","type-post","status-publish","format-standard","has-post-thumbnail","category-italy","tag-aeon-foundation","tag-guest","tag-health-policy","tag-italy","tag-nicola-marino","tag-policy"],"_links":{"self":[{"href":"https:\/\/www.europesays.com\/italy\/wp-json\/wp\/v2\/posts\/36672","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/italy\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/italy\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/italy\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/italy\/wp-json\/wp\/v2\/comments?post=36672"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/italy\/wp-json\/wp\/v2\/posts\/36672\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/italy\/wp-json\/wp\/v2\/media\/36673"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/italy\/wp-json\/wp\/v2\/media?parent=36672"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/italy\/wp-json\/wp\/v2\/categories?post=36672"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/italy\/wp-json\/wp\/v2\/tags?post=36672"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}} <\/p>\n