Monitoring noncommunicable diseases, risk factors and determinants in older population in Italy

意大利老年人群非传染性疾病、风险因素和决定因素的监测

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Abstract

BACKGROUND: The Italian Institute of Health, ISS, participates as country authority in the European Joint Action PreventNCD to tackle noncommunicable disease burden by effective strategies and policies on health determinants. Within the work on Monitoring, ISS coordinates the task for further enhancing population monitoring systems building on the behavioural surveillance-like model in place in Italy. METHODS: According to the epidemiology-based life course approach, data on health-related behaviours in elderly (aged 65+) are from the PASSI d'Argento system that, since 2016, collects information by continuous interview surveys on representative samples of general population stratified by gender and age in the participating Local Health Units (LHU). RESULTS: Data 2022-2023 relevant to PreventNCD are reported. Combining data collected by PASSI d'Argento surveys since 2012, major NCD risk factors (sedentariness, unhealthy eating, tobacco, alcohol use) are not improving even in presence of chronic co-morbidity. Cancer survivors show a bad physical and mental health status, compared to other NCD patients. Sensory problems (sight, hearing, chewing) affect 25% of older individuals, increasing at 44% among those who experience economic difficulties. These risk factors affect the quality of life, increasing social isolation and reducing autonomy. PASSI d'Argento data identify: 18% opted out needed healthcare, 32% and 28% encountered access troubles to, respectively, health and social services. LHU and commercial premises are hard-to-reach, general practitioner and pharmacy the easier reachable. Obstacles increase by age (68% of over85), gender (39% women vs 23% men), education (50% low level vs 14% university), economic difficulties (55% vs 22% in those who do not have any), geographical gradient (38% South vs 24% North). CONCLUSIONS: In Italy, older individuals are 24% of the population and, due to inequalities, NCD risk factors monitoring is needed as aimed in PreventNCD. KEY MESSAGES: • Monitoring continuously trends of NCD risk factors and determinants in representative sample of older population is crucial to inform effective prevention interventions, programs and strategies. • Older individuals represent a relevant even increasing, population group in Italy and above all after the COVID-19 pandemic data on healthcare access are essential to detect inequalities.

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