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Research Perspective|Volume 18|pp 854—860

Towards integration of healthspan strategies into the Italian National Health Service

Nicola Marino1,2,*, Matteo Fiore3,*, Aureliano Stingi1, Andrea Cipriano4,5, Antonella Santuccione Chadha2, Camillo Ricordi6, David Della-Morte7,8, Fabrizio d’Adda di Fagagna9,10, Marco Demaria11, Marco Quarta12,13, Vittorio Sebastiano14,15, Luigi Ferrucci16, Ennio Tasciotti17,18
  • 1AEON Foundation, Brussels, B-1000 Belgium
  • 2Women’s Brain Foundation, Basel 4052, Switzerland
  • 3University of Bologna, Bologna 40126, Italy
  • 4Department of Obstetrics and Gynecology, Stanford School of Medicine, Stanford University, Stanford, CA 94305, USA
  • 5Institute for Stem Cell Biology and Regenerative Medicine, Stanford School of Medicine, Stanford, CA 94305, USA
  • 6Cell Transplant Center, Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
  • 7Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome 00133, Italy
  • 8Department of Neurology, Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
  • 9IFOM ETS - The AIRC Institute of Molecular Oncology, Milan 20139, Italy
  • 10Institute of Molecular Genetics (IGM), National Research Institute (CNR), Pavia 27100, Italy
  • 11European Research Institute for the Biology of Ageing (ERIBA), University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen 9713 AV, Netherlands
  • 12Rubedo Life Sciences, Mountain View, CA 94043, USA
  • 13Phaedon Institute, Alameda, CA 94501, USA
  • 14Department of OBGyN, Stanford University, 265 Campus Drive, Stanford, CA 94305, USA
  • 15Department of Biological Chemistry, University of California Irvine, Irvine, CA 92617, USA
  • 16National Institute on Aging, NIH, Bethesda, MD 20892, USA
  • 17Human Longevity Program, IRCCS San Raffaele Hospital, Rome 00166, Italy
  • 18Department of Quality of Life and Health Promotion, San Raffaele University, Rome 00166, Italy
* Equal contribution
Received: December 16, 2025Accepted: June 3, 2026Published: July 16, 2026
https://doi.org/10.18632/aging.206402

Copyright: © 2026 Marino et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Italy currently ranks among the world’s oldest nations, with adults aged ≥65 years accounting for 24.1% of the population — the highest proportion in the EU — and a projected median age of 51 years by 2050. While life expectancy at birth reaches 85.4 years for women and 81.4 for men, Healthy Life Years amount to only 69.6 and 68.5, respectively, documenting a substantial lifespan–healthspan divide. The prevalence of multimorbidity and disability exceeds 60% in adults aged ≥75 years; women bear a disproportionate share of this burden, both as patients and as caregivers. Meanwhile, the Italian National Health Service (Servizio Sanitario Nazionale, SSN) remains hospital-centric, regionally fragmented, and predominantly reactive, with prevention accounting for a historically modest share of total expenditure. Against this background, longevity medicine is an emerging, prevention-oriented discipline that aims to extend healthspan — defined here as the portion of life lived in good health, with preserved physical and cognitive function and without significant disability or multimorbidity. It integrates multi-omic biomarkers, digital monitoring, adaptive trial methodology, and life-course risk stratification within a translational framework. Although most constituent tools remain at an exploratory or surrogate stage, and clinical utility has yet to be established, the emphasis on early intervention and precision prevention offers potential to reduce the accumulation of age-related disease and ease long-term pressure on the SSN. This position paper analyzes Italy's demographic and epidemiological trajectory, examines the structural constraints of the SSN, and outlines the scientific foundations of longevity medicine. It advocates for multidisciplinary translational research and identifies five strategic investment priorities: (i) clinically validated biomarkers of biological age; (ii) interoperable digital monitoring platforms; (iii) Bayesian adaptive multimodal trials; (iv) explainable-AI risk stratification tools; and (v) longevity-informed curricula in medical training. These proposals should be regarded as a staged agenda for evaluation; their relevance will depend on whether they deliver measurable gains in patient-relevant outcomes, feasibility, and cost-effectiveness within the SSN.