Pisa's Aging Population Redefines Old Age With New Perspectives

Pisa, March 19, 2025 – The saying goes that "age is just a number," and the longest-living population in Pisa certainly knows this well. Tuscany is one of Italy's regions with the highest life expectancies, boasting an impressive 84 years for women and between 81 and 82 years for men. In a country that is increasingly aging, the definition of old age has become relative.

According to Professor Fabio Monzani, a geriatrician at Pisa, the patient threshold for geriatrics has been raised from over 65 to over 75 years old. This shift is not without controversy, as some critics argue that this decision was made in order to delay pensions. "In geriatrics, one used to identify elderly patients as those over sixty-five, but now this definition no longer corresponds to reality. Today's sixty-year-olds are active individuals with a quality of life comparable to that of fifty-year-olds," explains Monzani.

How do we determine age? "We should look not so much at chronological age but biological age: an 80-year-old, for instance, can be perfectly autonomous, robust, and have preserved cognitive function. Instead, we need to pay attention to frailty—those individuals, despite still being able to walk and move, have precarious balance and few resources to respond to potential infections,” he adds.

What contributes to frailty? Monzani explains that several factors play a role, including advanced age or the presence of uncontrolled diseases, with those affected needing more social assistance. "Frailer individuals have reduced functional reserve, showing slower walking speeds and often requiring aids,” he notes. In Pisa, there are 105,000 people over 60 years old, a number that is expected to rise.

“It's not so much the numerical data that's relevant, but the distinction between robust and frail individuals, also from a socio-political perspective. The quality of life of a person over sixty or seventy also depends on their context: if they live at home or in a city with a good support network, this will positively impact their well-being. Hence, life expectancy should be considered in relation to quality of life: a healthy 80-year-old may still have more than ten years of active life ahead of them,” Monzani states.

What are the secrets to healthy aging? “In geriatrics, we distinguish between 'accelerated aging' and 'active aging.' The progressive loss of organ function is a natural phenomenon, but there are strategies to slow down this process and age healthily. It’s vital to consider one's well-being from a young age, but you can start at any age,” he states. While genetics plays a role, lifestyle has a greater impact. He emphasizes the importance of having a “healthy mind in a healthy body,” advocating for daily aerobic activities such as walking or swimming and following a balanced Mediterranean diet with adequate protein intake, particularly important for the elderly. “Often, individuals over seventy-five follow unbalanced diets, sometimes due to financial difficulties. It is equally important that their diets are not excessive,” he warns.

The brain, too, needs exercise. “Many individuals, once they retire, stop pursuing interests and relationships, while it’s essential to read, socialize, and engage in playful activities. Mental health is critical: someone with cognitive deficits, for instance, progressively loses their autonomy, and dementia hinders active aging,” Monzani adds. He also mentions that behavioral issues are often treated with pharmacological therapy, which should be delayed as much as possible.