Among the 27 European Union member states (EU), Italy has long stood as the country with the oldest population in Europe, closely followed by Portugal, Bulgaria, and Greece in terms of the share of seniors relative to the total population. Seniors are defined as individuals aged over 65, a bracket that, according to the gerontology framework, can be subdivided into three subgroups: young-old (65-74), old-old (75-84), and oldest-old (85 and over). These subgroups generally correspond to the successive phases of health deterioration seen among older adults.
Population aging has become a long-term characteristic in Italy: the trend began in the early 1980s due to both the persistent decline in fertility, with a continuing drop in births and thus fewer young people, and the gradual reduction in mortality at pre-senior ages, which has pushed Italy to rank among the countries with the highest life expectancy.
Non-self-sufficiency and implications for social care services
The exceptional longevity of Italy hides sharp territorial and gender disparities in terms of frailty, functional limitations, and loss of independence.
Geographic mapping of frail aging helps identify the regions where the elderly are most vulnerable and face a greater strain on health and care systems.
One study, published in the International Journal of Environmental Research and Public Health, examines the geography of frail aging in Italy, analyzing the intersection between longevity, health conditions, non-self-sufficiency, and care needs across different territories. Its distinctive contribution lies in moving beyond a purely demographic reading of population aging, linking longer life to the quality of survivorship in later life and to the uneven territorial distribution of public assistance.
Based on official data from Istat, Eurostat, and INPS, this study adopts a regional comparative approach with data disaggregated by sex, age group, and macro-area. The analysis combines indicators of demographic structure, remaining life expectancy at age 65, life expectancy in good health, severe limitations in daily activities, multimorbidity, and care services. This framework allows distinguishing between aging as a numerical increase in the elderly population and aging as a differentiated condition of vulnerability, dependency, and the need for social assistance.
The work addresses two main research questions:
- How are demographic and survivorship conditions of the elderly population distributed across Italy?
- What differences emerge among the various regions of the country in terms of longevity, frailty, and quality of life?
Italian longevity amid regional and gender inequalities
The study links increasing life expectancy to the quality of survival, showing that living longer can often coexist with disability, multimorbidity, and dependence. The report highlights persistent North–South disparities in healthy aging, revealing divergent conditions of access to health and well-being in the late years across Italian regions.
The results show that Italy’s high longevity conceals pronounced territorial and gender inequalities. Central-northern regions exhibit more favorable survival and health profiles, while the Mezzogiorno (the southern regions) and the islands display higher levels of frailty, functional limitations, and reliance on public assistance. Women appear to be especially exposed to this imbalance: they live longer but spend more years in disability and dependence.
Territorial differences in frailty and care needs call for long-term care strategies tailored to regional specifics, particularly in Southern Italy and among older women. The integration of demographic, health, and well-being indicators can promote a more equitable allocation of resources and strengthen the effectiveness of public policies dedicated to population aging.
Upcoming challenges
Future research should integrate this descriptive framework with multivariate or multilevel models capable of accounting for socioeconomic confounders, leveraging linked administrative microdata to overcome the limits of aggregate indicators, monitoring the post-pandemic evolution of the trends documented here, and expanding the comparative perspective to other Southern European welfare systems facing similar patterns of population aging and territorial inequality.
Ultimately, the Italian case underscores the importance of adopting a multidimensional, territorially rooted approach to aging, capable of integrating demographic, health, and welfare perspectives. Only by recognizing the heterogeneity of aging paths and addressing the structural inequalities that underlie them can policies be designed to ensure not only a longer life but also fairer and more sustainable conditions in old age.
Maccheroni C, Pace R, Venere G. The Geography of Frail Ageing in Italy: Longevity, Non-Self-Sufficiency and Implications for Assistance Benefits. International Journal of Environmental Research and Public Health. 2026; 23(8):947. https://doi.org/10.3390/ijerph23080947
Abbonati a Karla Miller
