There is a real demographic bubble on the way, with the first waves already present looking at the population statistics. Italy is starting to become increasingly older, with 24.7% of the population already over 65 and a projection of 34% by 2043. For this reason, prevention becomes the indispensable strategic asset for the health of the individual and the sustainability of the public health sector. The objective must in fact be to guarantee not only more years of life, but years of life lived in well-being.
The moral emerges from the conference “Investing for Healthy Aging“, promoted by MSD, which took place in Rome at the Civita Association and involved institutions, scientific societies, clinicians, economists and patient associations and civil society. The discussion focused with particular attention on the fragility of the elderly, on the prevention of avoidable pathologies through immunization strategies and on the sustainability of the National Health System.
More space for vaccinations
We must not read the numbers uncritically, contenting ourselves with the fact that Istat data highlights how Italy is among the oldest countries in the world. To better understand what happens, in addition to the high life expectancy of over 83 years, we need to think about living in good health. And we need to think about this front, given that we are talking about 60 years for men and 57 for women with a high regional gap. This trend puts pressure on the pension, social security and healthcare systems, requiring, among others, the urgent implementation of public policies centered on active ageing, defined by the WHO as “the process of optimizing opportunities for health, participation and security to improve the quality of life with advancing age”.
In this sense, the habit of vaccination protection in adulthood/elderly becomes important. And there is a lot to do: just think about immunization against seasonal flu. Against a minimum objective of 75% for influenza vaccination, for example, data updated to August 2025 show coverage at 52.5% (in the elderly population) and 19.6% in the general population.
Still. Vaccination coverage in the adult population for anti-pneumococcal and anti-herpes zoster vaccinations is not known, but according to data collected by some Regions they are very low, despite scientific research now providing latest generation tools, which guarantee broader and more effective protection for the adult and elderly population against pathologies that cause serious complications, hospitalizations and mortality. Numerous studies demonstrate, in fact, that investing today in the health of adults and the elderly is not only an ethical duty, but a strategic choice to guarantee economic sustainability and social cohesion.
Health, old age and economy
The updated data confirm a constant growth of the over 65 population: as of 1 January 2025, 24.7% of the population is over 65 and, according to Istat forecasts, the share will rise to 34.6% by 2050. This phenomenon is accompanied by a growing gap between life expectancy and years lived in good health or in full autonomy. Added to this is a labor market with more and more older workers, fewer active young people and a growing burden on welfare and health systems.
“This scenario has direct implications on productivity, the organization of care and intergenerational sustainability. It therefore becomes a priority to adopt structured policies that transform aging into an element of strength, enhancing the contribution of the elderly to society and promoting an integrated approach between health, work and social inclusion”
reports Roberta Crialesi, Director of the Integrated Health, Assistance and Social Security System Service, ISTAT.
In today’s society, the perception of being elderly is profoundly changing: people live longer and remain active for longer, and the idea of passive old age is rejected. In this context, the value of health is confirmed as central, not only as a physical condition, but as a sociological and cultural key to quality longevity. Being and staying healthy is even the essential condition for living a third age that is not negatively connoted from the point of view of individual and collective perception.
“Health becomes the prerequisite for autonomy, social participation, individual planning even in older ages. This is why it is essential to invest in it, in terms of prevention, access to care and promotion of healthy lifestyles. Placing health at the center of aging policies means recognizing and enhancing the active role of the elderly in society, building more inclusive and sustainable models, essential in a society that ages at the rate of ours”
adds Ketty Vaccaro, Head of Biomedical Research and Health Area, Censis.
The opinion of the experts
“Demographic ageing, combined with the decrease in the active age population (15-64 years), represents a profound challenge for our country. The effects are reflected on work, productivity and, above all, on the sustainability of the welfare system. In the absence of interventions, the burden on future generations risks becoming unsustainable. For this reason it is necessary to implement far-sighted policies that favor active ageing, enhancing the skills and experience of over 60. An approach of this type not only improves the quality of life of individuals, but generates economic and social benefits for the entire community. Acting now means building a more equitable, resilient society capable of facing demographic changes with responsibility and vision”
indicates Giampaolo Galli, Scientific Director of the Italian Public Accounts Observatory of the Catholic University of the Sacred Heart of Milan.
Moving on to the scientific and health component, it is confirmed that Italy is among the longest-lived countries in the world. But we can also see how this record hides a worrying reality: the last years of life are often lived in conditions of poor health.
“This is where the real challenge arises: it is not enough to live long, you have to live well. To reverse the trend, concrete actions and a healthy longevity strategy are needed that starts well before old age. Prevention must become central in health policies, with targeted, continuous and structured investments. In particular, it is urgent to give priority to the vaccination of adults and the elderly, which is still too neglected on the political agenda. Promote health throughout the lifespan means not only improving the quality of life of citizens, but also making our healthcare system more sustainable and efficient”
reports Michele Conversano, President of Happy Aging.
