Italy is among the countries with the highest longevity in the world, with a life expectancy at birth that in 2024 exceeded 85 years for women and 81 years for men. Italy also boasts the presence in Sardinia of one of the 5 geographical areas of the planet, the so-called Blue zones, characterized by a surprisingly high concentration of centenarians. As the number of centenarians is exponentially growing throughout the country, other potential Blue zones might be identified in Italy. However, a high concentration of centenarians does not necessarily imply a higher life expectancy. By using mortality and population data at municipality level, this study aims at identifying areas of longevity in Italy according to the two meanings of longevity, i.e. high concentration of long-lived individuals (Blue zones) and high life expectancy at birth (Green zones), so as to shed light on possible different factors that determine the two conditions of longevity. Identifying determinants of longevity at municipality level is of fundamental importance to implement synergic, integrated, targeted interventions and policies at the finest territorial level. This not only will make longevity more and more extended but will also make it more fair.

Cognitive Reserve (CR) helps explain individual differences in age-related trajectories of cognitive decline. Among the effective functions, Motor Imagery (MI)—the mental simulation of actions without any actual movement—supports motor learning and performance and holds promise as a strategy in neurorehabilitation. However, how ageing impacts MI and the role of CR in mitigating these changes remain unclear. The present study compared the performance of 42 healthy older adults (mean age = 70 years) and 37 young adults (mean age = 24 years) on the Hand Laterality Task (HLT), in which participants judged whether a rotated hand image depicted the left or right hand. In addition, we investigated the role of CR level (high vs low) within the older sample. Main results showed that the efficient visual strategy typically used by young adults (especially for back-view hands) was observed in older adults only for the dominant (right) hand, whereas a slower kinaesthetic strategy was used for the left hand. Notably, the visual strategy advantage (right hand, back view) emerged only in older adults with high CR and was absent in those with low CR. These findings highlight the importance of distinguishing between strategy-specific changes in aging and underscore the protective role of CR in maintaining efficient motor imagery processes. In conclusion, CR-informed approaches could improve the precision and effectiveness of motor rehabilitation and cognitive training interventions.

Population aging is a rapidly growing global phenomenon, caused both by the increase in life expectancy and the decrease in fertility rates. This demographic change is modifying the age structure of the population, with a progressive increase in the share of individuals over 65 and a rise in chronic-degenerative diseases, increasing the pressure on care services. Although greater longevity represents an important achievement, it also entails the need for targeted interventions to protect the most frail individuals, those who are more likely to develop adverse events associated with frailty itself. In this work, we propose a frailty indicator as an alternative to those already existing in the literature, with the aim of overcoming some of their limitations. The indicator is built using administrative health database provided by the ULSS6 Euganea, including all individuals aged at least 65 who were residents for the entire observation period, from January 1, 2016 to December 31, 2017. Given the multidimensional nature of frailty, six distinct outcomes were considered, each associated with a specific group of previously identified frailty determinants. For each outcome, a logistic regression model was estimated, using explanatory variables specific to the outcome considered and a principal component analysis was performed on the predicted values of the models, identifying the indicator in the first component. The best method for the index stratification is selected by evaluating various options, including the F1-score, quartiles, and the k-means method. Finally, the index was validated using the same data, but referring to the year 2019.

Managing chronic illness and multimorbidity in older adults increasingly relies on interventions that promote sustained self-care—often through digital tools such as health apps or remote monitoring systems. In this context, motivation to change becomes essential, yet frequently emerges as ambivalence: a tension between readiness and resistance to change. Motivational Interviewing (MI) offers a structured and relational approach to explore this complexity.

This study, conducted within the national Age.It research project, investigates how motivational orientations—toward change or resistance—are linguistically expressed by older adults in the context of digitally-supported self-care. Forty-five older adults (aged 60–80) with multiple chronic conditions participated in a single MI session aimed at promoting engagement in adapted physical activity (APA). The sessions were transcribed and analyzed using the Motivational Interviewing Skill Code (MISC), which classifies statements as Change Talk (CT) or Sustain Talk (ST), and categorizes them into three psychological dimensions: desires, needs, and perceived abilities.

Sustain Talk was more frequent and nuanced than Change Talk, especially in expressions of doubt regarding both physical effort and the use of unfamiliar digital tools. Desires in ST reflected avoidance of decline and aging; needs emphasized safety, control, and emotional stability. In contrast, CT was linked to aspirations for health improvement, autonomy, and relational trust.

These findings highlight how resistance is often shaped by emotional and technological discomfort. Understanding the language of ambivalence and markers of change in older adults may help tailor motivational interventions that foster engagement in digitally-mediated self-care pathways.

Administrative data, systematically collected by public healthcare services and accredited private providers, are a valuable resource for analyzing frailty at the population level. Their broad coverage provides a nearly complete picture of an individual’s health events over time, including hospitalizations, healthcare and social services, causes of admission, and death, making them a reliable tool to reconstruct health trajectories.
One major advantage is their comprehensiveness: they allow monitoring of events in both public and accredited private facilities, effectively covering almost the entire healthcare system. Collected for official purposes, these data are typically of high quality and regularly updated, enabling timely assessments of frailty, essential for tracking its progression.
However, limitations exist. Designed primarily for administrative use, they lack some relevant information, such as lifestyle or psychosocial factors. Privacy regulations on sensitive health data are also strict. Furthermore, differences in database structure, coding, and content across regions or countries can hinder comparability.
In our study, we developed a frailty indicator based exclusively on administrative data, consisting of eight variables (age, disability, hospitalizations, mental and neurological disorders, heart and kidney failure, and cancer). It showed a good to very good performance in predicting six outcomes.
The indicator was tested using data from ULSS 6 "Euganea" and validated on regional datasets from Piedmont and Turin. The results were consistent over time and populations, due to the standardized structure of administrative data, making the indicator scalable and replicable to monitor frailty in diverse settings.

Introduction:
Burning Mouth Syndrome (BMS) predominantly affects older adults and is frequently associated with cognitive impairment. However, frailty—a critical, multidimensional indicator of health status in the elderly—has never been systematically evaluated in BMS patients. This study aims to comprehensively assess frailty in individuals with BMS, examining physical, cognitive, psychological, and social domains.

Materials and Methods:
A multicenter, case-control study was conducted, enrolling 52 patients diagnosed with BMS and 51 age- and gender-matched healthy controls. Socio-demographic characteristics, education level, and Body Mass Index (BMI) were recorded. Comprehensive assessments included frailty and physical performance [Sunfrail, Short Physical Performance Battery (SPPB)], medication adherence [Morisky Medication Adherence Scale (MMAS)], nutritional status [Prevención con Dieta Mediterránea (PREDIMED), Mini Nutritional Assessment (MNA)], neurocognitive function [General Practitioner assessment of Cognition (GPCog), Quick Mild Cognitive Impairment (QMCI)], psychological well-being and perceived social support [Geriatric Depression Scale (GDS), Social Provisions Scale (SPS)], and quality of life [12-Item Short Form Survey (SF-12)]. Statistical analyses included descriptive statistics, Mann–Whitney U-test, Pearson Chi-Squared test, and t-test.

Results:
BMS patients had significantly lower educational attainment (p = 0.001*). They demonstrated worse outcomes across all frailty domains, including reduced mobility (p = 0.007*), higher medication burden with lower adherence (p = 0.024*), increased healthcare utilization (p < 0.001*), and memory decline (p = 0.001*). Physical performance was poorer (p < 0.05*), and PREDIMED scores significantly differed between groups (p = 0.012*), with BMS patients showing higher BMI (p = 0.0015**). Cognitive impairments were notable in BMS patients (p = 0.012*), with significantly poorer performance in most cognitive tasks (p = 0.000**), except for orientation and delayed recall. Psychological and social domains were markedly impaired (both p < 0.001*), with elevated feelings of loneliness (p = 0.012*). Quality of life was significantly diminished in BMS patients, across both physical (p = 0.0002**) and mental health domains (p < 0.001**).

Conclusion:
BMS patients exhibit greater frailty and profound declines in physical and cognitive functioning compared to age-matched controls. Their medical profile is more complex, characterized by lower therapeutic adherence—likely due to the challenges of chronic pain management—and exacerbated by social isolation and psychological distress. This study underscores the multidimensional vulnerability of BMS patients and highlights the urgent need for personalized, multidisciplinary interventions to enhance care and quality of life in this underserved population.

Abstract

Reading represents an engaging and stimulating activity that can support the maintenance of cognitive abilities, as people age. However, it has been extensively documented that reading is also influenced by the aging process itself, requiring intact sensory and cognitive components. Given that the cognitive mechanisms underlying age-related decline in reading ability remain insufficiently investigated, the aim of this study was to examine whether attentional components, particularly selective visuospatial attention, contribute to this decline. The study involved 120 neurologically healthy older adults (age range: 60–88 years), who underwent a neuropsychological assessment measuring reading abilities, global cognitive functioning, attention, and visual skills. Results showed that, beyond global cognitive functioning and visual capacities, some attentional components, as assessed by the simple reaction times task, go no-go task, Stroop test and Symbol Digit Modalities Test, significantly mediate the relationship between age and reading. Furthermore, the specific component of visuospatial attention appears to moderate this relationship: individuals showing greater decline in visual search tasks also exhibited a more significant age-related decrease in reading performance. Our findings emphasize that reading is a multifaceted cognitive process, and its decline in aging arises from the interplay of several factors. The moderating role of visuospatial attention further underscores also the importance of accounting for individual variability in healthy aging.

Extended Abstract

Theoretical Background

Reading is a stimulating activity beneficial for cognitive functioning in older adults, preventing cognitive decline. However, scientific literature has extensively shown that reading is also affected by physiological cognitive changes that occur in aging, as it relies on both sensory functions and multiple cognitive processes to guarantee an efficient performance. In our recent work on this topic (Pegoraro et al., 2024), we found that only the Symbol Digit Modalities Test (i.e., a complex neuropsychological task, involving processing speed, working memory, sustained attention) significantly mediated the relationship between age and reading performance, thus helping to explain age-related reading decline. However, the cognitive mechanisms contributing to the decline in reading ability in healthy aging remain largely unclear.

The aim of the present study was to further investigate and detail the role of attention, particularly selective visuospatial attention component, in age-related decline in reading ability.

Materials and Methods

Participants. A total of 125 participants were recruited for the current study, including those from the previous one (Pegoraro et al., 2024). Four participants were excluded due to history of neurological disorders, and one for not being a native Italian speaker. The final sample thus included 120 participants (74F/46M; age range 60-88; mean age = 70.64 ± 5.48; education = 12.44 ± 4 years).

Instruments. The neuropsychological assessment battery included both standardized and non-standardized tests assessing global cognitive functioning (Montreal Cognitive Assessment, i.e., MoCA), reading (lists of spaced and unspaced words and non-words; an ecological newspaper reading test; Rate of Reading Test, RRT), visual skills (Milan Eye Chart, MEC), and various attentional components (Symbol Digit Modalities Test; Sustained-Paced Finger Tapping, SPFT; Brevis Test; Stroop Test; Open-source Open-access Reaction Time Test, OORTT). Additionally, participants' reading habits were assessed through close-ended questions, specifically designed for the project.

Statistical Analysis. Mediation and moderation models were performed to assess the impact of attentional variables on the relationship between age and reading performance.

Main Findings

Results showed that, beyond global cognitive functioning and visual capacities, attention, as assessed by the OORTT and Stroop test, is a significant mediator of the relationship between age and reading. Our results also confirmed the previous findings regarding the mediating role of Symbol Digit in the age-reading relationship. Instead, the specific component of visuospatial attention appeared to moderate this relationship: individuals showing declines in the selective and focal components of visuospatial attention, not in the orientation one, exhibited a more pronounced age-related decrease in reading performance. Overall, our findings highlight that reading is a complex cognitive process whose decline results from the interaction of multiple factors. The moderating role of visuospatial attention also underscores the importance of individual variability in healthy aging.

Implications for Future Research

Our work provides a basis for the future development of a cognitive test battery, specifically designed to assess reading skills in older adults, as well as for designing tailored cognitive intervention to face the reading decline.