Conference Agenda

Widowhood is a disruptive life event, and in ageing societies, increased numbers of individuals are exposed to this life event. Yet we lack a comprehensive understanding of the demography of widowhood. Using total population data (with information on marital and cohabiting unions), discrete-time event-history, and multistate lifetables, we provide different metrics of widowhood for Finland, namely the lifetime risk, mean age at becoming widowed, widowhood expectancy and variation in years spent widowed, and document their gender and educational differences. We show that the risks of widowhood decrease over time and widowhood occurs at progressively older ages. High-educated have around three year higher mean age at widowhood than the low-educated. Women have higher widowhood risk, expectancy, and a lower mean age at widowhood than men. Widowhood expectancy for women declined from 8 to 6 years and stagnated at around 2 years for men. Low-educated women face highest risks and widowhood years, but these inequalities have been diminishing over time. The current older population may experience reduced exposure to the challenges of widowhood, potentially reliving caregiving burden on families and the state

Frailty is a condition of great interest and relevance in the social and health spheres, given the continuous ageing of the world's population.

The aim of this study is to explore the life course factors that impact frailty and, jointly, to analyse the role of frailty in the risk of mortality.

Data come from the Survey of Health, Ageing and Retirement in Europe (SHARE) on a cohort of 29,221 European individuals aged 50 and older in 2004, followed up to 2022.

Frailty was measured using Fried's phenotype based on five criteria. Risks of pre-frailty and frailty were calculated with respect to wave 1, showing a strong increase in the risk of frailty with advancing age, but also the possibility to recover from pre-frailty. To jointly analyse frailty and mortality, a joint model was applied.

The results show that frailty represents an important risk factor for mortality, with an increasing role with older age. Regarding risk factors for frailty, depression, some chronic diseases, economic difficulties and low education level emerge as relevant. The joint model provides an integrated view of risk factors for frailty and mortality, highlighting the importance of early intervention to prevent and slow down functional decline.

Because increased life expectancy to a large extent, is due to better survival from cardiovascular diseases, cancers, and other chronic conditions, an ever-growing share of the population is living with several diseases – a situation referred to as multi-morbidity. Epidemiologic studies have demonstrated that multi-morbid people are at higher risk of dying, and the Covid-19 pandemics is the most recent illustration of it. Research relying on the underlying cause of death fails to account for this important shift of the epidemiological profile and mortality patterns. An algorithm that allows to classify all death records of a given country according to three main types of morbid process leading to death (simple, multi-morbid and illdefined) has been recently developed. The output of this classification that uses the entire set of causes listed on the death certificates (multiple causes of death), allows to measure the contribution from multi-morbidity to the death processes. In this study, data are for France for years 2002 to 2017. We will examine to what extent the increase in life expectancy over that period has been accompanied by an increase in the indicators of multi-morbidity at death.

This study examines the current situation in Italy of the elderly population living in inland areas in terms of health conditions and use of health and social services. Main objective is to verify if the distance from essential services could emphasise the fragility resulting from the progressive depopulation and ageing of these areas.

Elderly living in inland areas do not evidence a worse health conditions than elderly living in centres, but they use less outpatient health services (52.5% vs 62.1% made specialist visits or examinations). This could explain the higher risk to be hospitalized (213 discharges per 1,000 vs 197). Furthermore, the distance from health services in internal areas is behind the higher percentage of hospitalisations performed outside their region (9.2% vs 5.7%) or geographical area (4.9% vs 2.8%) of residence. A greater allocation of territorial welfare resources is provided to the elderly in internal areas (per capita expenditure is €93 vs €89), but wide differences are recorded among geographical areas.

These results provide evidences of the urgent need to create a proximity network, identifying new models of care and assistance for people living in inland areas, in order to guarantee equity and improve their quality of life.

The accelerated growth of older adults (the over-65s) in Italy fits within the context of the complex, hybrid nature of the pension system and the welfare benefits financed by tax revenues, which often overlap. As a result, older adults are facing growing inequalities in living and health conditions, both in the Centre-North and the South and Islands, as well as between genders. Through differential analyses, this paper considers the progressive increase in older adults, focussing on their most vulnerable component (i.e. the over-85s), highlighting their role in social assistance and care issues. In a comparative framework with the major economies of the European Union, our study illustrates the pension expenditure over the last ten years.

Limited to the current Italian situation, we analyse pension spending in the social security and welfare components, describing the socio-demographic characteristics of beneficiaries. Our results reveal territorial disparities in spending on pensions, welfare benefits, and the socio-demographic characteristics of beneficiaries regarding the economic welfare derived from the number and amount of pensions received.

This has exacerbated, in turn, inequalities in living conditions across households and between genders.

Hospitalization is both a driver and a consequence of increasing life expectancy. However, we lack measures and insights into the relationship between rising life expectancy and inpatient care utilization. We introduce the Net Hospitalization Rate (NHR), which is the average number of hospitalizations from age 𝑥 considering mortality. Using age-specific population exposures, deaths, and hospitalizations covering the total German population (2005–2021), we examined, decomposed and projected NHR period trends. Lifetime hospitalizations increased from 16.2 to 18.2 (women) and from 14.3 to 16.1 (men) throughout 2005–2019. For women, the rise was similarly driven by more hospitalizations and longer life expectancy, while for men, increasing life expectancy played a much larger role. Our findings invite the hypothesis that the treatment of severe conditions might become a main driver of future mortality improvements, underpinning the need for suitable measures to investigate inpatient care as an outcome and driver of mortality changes.