Background:

Aging is associated with a progressive decline in physical function, increasing the risk of disability, loss of autonomy, and reduced quality of life (Martins et al., 2024). While regular physical activity is a recognized protective factor, adherence to structured programs remains low among older adults (Cacciatore et al., 2019). Digital technologies, particularly mobile applications powered by artificial intelligence (AI), offer a promising path for delivering personalized and accessible home-based interventions (Di Martino et al., 2024; Romeo et al., 2019).

Purpose:

This pilot study evaluates a novel, custom-developed AI-based mobile application uniquely designed for older adults. Unlike existing apps, this platform integrates real-time markerless 3D motion capture through a smartphone camera with dedicated human coaching and dynamic feedback adaptation, offering a tailored exercise experience. We assessed feasibility, adherence, and acceptability, along with changes in physical activity levels and functional ability.

Methods:

Ten older adults completed a four-week program (2–3 sessions/week). Each was paired with a personal coach who remotely monitored progress via a web-based dashboard. The app used AI to create 3D movement models without external sensors, enabling coaches to provide individualized adjustments in real time. Pre-post assessments included SPPB and IPAQ.

Results:

High adherence and satisfaction were reported. The unique combination of AI-driven real-time motion analysis and human support fostered engagement and personalization. Participants highlighted the ease of use and felt empowered in managing their own physical activity.

The age distribution of the population is changing in favor of general aging, and it is estimated that, by 2050, the proportion of older adults will tend to double from 11% to 22% of the total population. This brings new challenges, first and foremost maintaining good health in old age. Most of the years lived in disability result from the progression of preventable chronic diseases, for which behaviors and lifestyle are the main risk factors. Therefore, effective health promotion and primary disease prevention strategies are needed to prevent them. The mission of Public Health 3.0 was defined as the dissemination of the best preventive practices to the entire target population.

The aim of our project was therefore to create tools to spread evidence-based health promotion and disease prevention to the widest number of individuals from a public health perspective. With this vision, digital technologies applied to health make it possible to deliver interventions for health promotion and lifestyle improvement that are accessible on a large scale and at a low cost. However, their effectiveness in the older population is still little studied.

To this end, the following research areas and related instruments were developed for the Italian senior population:

1. A website (www.in-forma.it) dedicated to older adults and their relatives and caregivers was created, which collects the most important scientific evidence in the field of health promotion and disease prevention for older adults. For some areas of health promotion in which scientific literature was lacking (e.g., the effects of the urban environment on the quality of life, caring for pets, cultivating spirituality and religion, having a high social capital and performing artistic activities), specific literature reviews were conducted to support some of the indications on the website. The studies conducted contributed to a solid knowledge base. These were then translated into accessible and practical messages designed to motivate and support the adoption of healthy behaviors. The approach focused not only on disease prevention, but also on the active promotion of well-being, embracing the concept of ‘salutogenesis’. The WHO has, in the past, conducted a census of international websites dedicated to health promotion in older adults. This survey revealed a significant gap in the provision of online information for this population group in our country.

2. An application was developed for smartphones and tablets (prevention for older adults), which lists the main primary and secondary prevention actions to be taken with regard to cancer screening and screening for chronic and psychiatric diseases, recommended vaccinations and primary drug prevention.

3. A report for the prevention departments was compiled, which collects evaluations of the effectiveness of digital health interventions in health promotion for the older population, obtained through a series of systematic reviews in the following areas: a) promotion of recommended vaccinations, b) improvement of sleep quality, c) promotion of physical activity, d) maintenance of social capital, e) increase in adherence to a healthy diet. The results showed that:

(a) Digital health interventions for vaccination promotion can be effective in increasing vaccination coverage for the recommended vaccinations in older adults, especially when conducted through text messaging (SMS).

b) Regarding the improvement of sleep quality, all five identified interventions, which were delivered through mobile device applications, proved to be effective. The interventions used two main strategies: cognitive behavioral therapy for insomnia and the promotion of sleep hygiene through a health education approach.

c) The identified studies showed an effectiveness of digital interventions in increasing physical activity levels of older adults when they included the use of motivational messages and reminders to support an active lifestyle, or when they delivered tailored exercise programs from data collected through digital devices, such as pedometers or accelerometers.

d) Furthermore, a review of the literature was conducted, which showed a positive association between the use of digital technologies in old age and social capital, defined as the set of resources that derive from a person's social network and that can be activated in case of need. Since all the analyzed studies had a cross sectional design, this result may be due to the fact that the use of digital technologies (information and communication technologies, social networks, etc.) may facilitate the maintenance and possibly the increase of social capital, or that older adults who possess greater social capital also receive greater support in the use of digital technologies, which enables them to make greater use of them.

e) A systematic literature review aimed at assessing the effectiveness of digital health interventions in improving the nutrition of older adults is currently in progress.

Research activities and the development of health promotion tools will make it possible to provide the Italian older population with information and advice based on scientific evidence that can motivate the adoption of healthy behaviors and help improve the quality of life in old age, while reducing the burden of disease. Such an approach can have a positive impact both on an individual level and on the National Health Service.

Organized breast cancer screening programs (OSPs) are critical public health interventions aimed at reducing mortality through early detection and mitigating socioeconomic disparities in preventive care access across Europe. This study investigates the impact of OSPs on mammography uptake and their role in reducing inequalities, using retrospective data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Leveraging longitudinal information on women’s screening behaviours, including initiation, frequency, and discontinuation, we define regular screening as a binary outcome of uninterrupted mammography uptake. We exploit cross-country and regional variations in OSP implementation, such as eligibility criteria and rollout years, to estimate causal effects on screening uptake using a probit model. Years of eligibility serve as the primary explanatory variable, with controls for age, marital status, employment, education, and early-life socioeconomic factors. Based on a sample of 11,980 women, results show that OSPs significantly increase regular screening likelihood, with each year of eligibility raising uptake by approximately 0.7 percentage points. OSPs also reduce education-related disparities, with a modest positive effect for less-educated women (ISCED 0–2), though gaps persist. Despite their effectiveness, less-well educated women remain less likely to engage in regular screening. Policymakers should enhance OSPs with targeted educational campaigns to improve participation among disadvantaged groups, addressing persistent access challenges

Background
Climate change has become an urgent global crisis, causing environmental disruption, health risks, and economic instability. While policymakers are more informed than the general public, they often struggle to convert scientific insights into actionable policies due to institutional limitations, political pressures, and resource constraints. Effective communication is therefore critical in bridging the gap between scientific research and policymaking. This systematic review and metasummary investigates communication strategies that inform and motivate policymakers to support climate action and adaptation efforts. It emphasizes the importance of tailored messaging, interdisciplinary collaboration, and robust science-policy interfaces in tackling climate challenges.
Methods
Following PRISMA guidelines and registered in PROSPERO (ID: RD42024503243), the study conducted a systematic search across eight databases on January 10, 2024, using the PICO framework. Of 650 initial articles, 10 met the criteria for inclusion based on quality and relevance. These studies, published between 2013 and 2021, covered regions in Europe, North America, Oceania, and globally, and employed qualitative, quantitative, and mixed-methods approaches.
Quality assessment tools—CASP, MINORS, and MMAT—were applied based on study design. The meta-summary approach by Sandelowski and Barroso guided thematic synthesis. NVivo 15.0 was used to organize findings into five major themes and 21 subthemes, with frequency effect sizes calculated to assess thematic relevance.
Results: The analysis identified five interrelated themes:
1. Climate Change and Impacts: Effective policymaking depends on clear understanding of climate risks. Vulnerability assessments and local risk perception were key drivers of informed decisions.
2. Policy and Decision-Making Processes: Integrating climate science into policy requires adaptive, evidence-based approaches. Challenges include mismatched data scales and short-term political priorities.
3. Climate Change Communication: Successful strategies included storytelling, scenario archetypes, and participatory engagement. Tailored, accessible, and regionally relevant messages were most effective.
4. Research and Scientific Evidence: National research institutions play a crucial role, but findings are often underutilized due to complexity and limited accessibility. More interdisciplinary and user-focused dissemination is needed.
5.Adaptation and Planning of a Sustainable Future Climate adaptation strategies were more effective when embedded in iterative policy cycles and supported by local engagement. National Adaptation Strategies (NAS) benefited from inclusive and responsive governance.
Strong links were found between communication and both policymaking and adaptation (Jaccard coefficient J=0.8). Other key findings included the importance of science-policy partnerships, participatory approaches, innovative communication tools (e.g., games, letters), and addressing regional disparities, especially in the Global South.
Implications for Research: Future research should focus on developing tailored communication strategies grounded in cognitive and behavioral theories to better engage policymakers. Strengthening the science-policy interface is also essential, which can be achieved through long-term collaboration and the support of boundary organizations that help bridge gaps between researchers and decision-makers. Additionally, there is a need to expand inclusive and participatory approaches, encouraging the co-production of knowledge with stakeholders. It's equally important to assess how communication tools perform across diverse sociopolitical contexts. Finally, promoting global equity must remain a priority, especially by addressing the unique adaptation challenges faced by vulnerable regions.
Conclusion: Effective climate communication is essential to translate science into policy. Strategies must be inclusive, context-sensitive, and collaborative to support resilient and equitable climate action.

Patient-Reported Outcome Measures (PROMs) are gaining relevance in the management of type 2 diabetes, particularly among older adults. These tools provide insight into how patients perceive their own health and well-being, offering a complementary perspective to traditional clinical indicators. Leading organizations such as the ADA and ICHOM now recommend PROMs to capture key dimensions like emotional distress, treatment satisfaction, quality of life, and daily functioning.

This narrative review explores how PROMs can contribute to the identification of psychological and clinical risks in people living with type 2 diabetes. We reviewed studies published between 2020 and 2024, focusing on validated PROMs, both general (e.g., EQ-5D, PROMIS-10) and diabetes-specific (e.g., PAID, DDS, DQOL), with special attention to their use in older populations and routine care settings.

Preliminary findings underscore the clinical utility of instruments such as the PAID scale, which show strong psychometric properties and effectively detect distress and unmet emotional needs. However, PROMs remain underutilized in everyday practice. Their limited correlation with biomedical indicators (e.g., HbA1c or BMI) nonetheless highlights their ability to provide distinct and complementary information.

PROMs can be key components of a more person-centered and precision-oriented model of diabetes care—one that integrates mental health as a core element rather than an optional adjunct.

One of the key themes within the AGE-IT partnership is frailty in older adults, a topic addressed—albeit with different perspectives—across several spokes, particularly spokes 3 and 4.

Specifically, Work Package 5 (WP5) of spoke 4 has focused on defining and measuring frailty, particularly from a healthcare perspective, with close attention to the nature of the data used (administrative or survey-based). A comprehensive literature review and critical analysis on this topic has been published in a volume by Franco Angeli.

As part of this work, a healthcare frailty index has been proposed and validated, which is useful for stratifying the population served by local health authorities. In addition, a very simple, user-friendly Shiny App has been developed, freely available and based on R—an open-source software. The application has been validated at ULSS6 Euganea.

Another major area of analysis has focused on the study of frailty over time and its risk factors. Several articles on this topic are currently under review.

The proposed presentation will offer an overview of WP5’s research on frailty, with particular emphasis on the research findings and on tools developed to support public health.