How actively older persons age in Italy?

Background One scope of the Active and Healthy Ageing framework is to increase awareness on elderly-related topics. The year 2020 has seen an upheaval across the world caused by the COVID-19 emergence, even higher to older persons. Methods In Italy, data gathered by the PASSI d'Argento behavioural surveillance system on general population aged 65+ in the timeframe 2016-2019 describe health conditions, lifestyles and care needs for elderly. Results Basing on physical activity recommended by the WHO globally, 33% of non-physically impaired older persons reaches out those levels, 27% are partially active, 40% is sedentary. 9% fell down within 30 days prior the interview, accessing hospital was necessary in 19% of cases;64% of falling occurred at home, 20% outdoor. 61% refers at least one infrastructural housing issue, 15% perceive higher neighbourhood insecurity. 35% reported difficulties in accessing essential services, especially to local health premises and for necessities. About 19% lives socially isolated, 21% had not any contact (neither by phone) with anyone in a typical week, 71% do not attend collective meetings, such as at a club or church. Nearby 1 out of 3 (29%) represents an asset to the own family/community: 19% looks after cohabiting people, 14% relatives or friends not living together with, 6% engage in volunteering. Participation in training courses or social events (trips/stays organised) regards little more than 2 over65 out of 10: 5% partakes in learning courses, 23% enjoyed those latest occasions. Such low social connectedness is observed even among «younger elderly» (aged 65-74). Nearly 19% referred frailty impacting on their own families mainly, 94% of frail elderly is given help from relatives, 20% from professional caregivers, 12% from acquaintances. All these factors suffer from socio-economic and territorial differences. Among elderly reporting many economic difficulties, social isolation is 31%, frailty 28%, difficult access to services 58%, falling 15%, with a geographic gradient at the expense of the Southern Regions. Conclusions COVID-19 is a clear threat to older persons: in Italy, monitoring ageing dimensions under the pandemic scenario represents even a greater opportunity to have scientific data which describe the impact of health emergency on elderly.

Monitoring cardiovascular diseases and associated risk factors in the adult population to better orient prevention strategies in Italy.

INTRODUCTION: Cardiovascular disease (CVD) is the first cause of death in Europe and over the world. This study analyses health-related behaviours in adults referring doctor-diagnosed CVDs. MATERIALS AND METHODS: We used data from the Italian cross-sectional Behavioural Risk Factor Surveillance System PASSI gathered in 2015-2018. Complex survey design analyses included the Taylor series method for variance estimation and Poisson regression for associations between socio-demographic characteristics and CVD. RESULTS: Among 132,598 respondents, the prevalence of doctor-diagnosed CVD was 5%. Higher percentages are observed among: men, older individuals, socioeconomically disadvantaged people. Compared to the general population, people with CVD have greater risk and aggravating factors, and a worse health status overall. All protective behaviors and lifestyles shall be improved. DISCUSSION AND CONCLUSIONS: In Italy, adults with CVD are more likely to be exposed to aggravating modifiable risk factors: it represents a valuable information for increased preventive interventions, even more in the light of the COVID-19 pandemic scenario.

Depressive symptoms among adults in 2018-2019 and during the 2020 COVID-19 pandemic in Italy.

BACKGROUND: Restrictions due to Coronavirus disease 2019 (COVID-19) has produced a large number of effects on mental health, which are expected to endure over time. In this study, we assessed depressive symptom levels before the COVID-19 pandemic, from January 2018 to December 2019, and during the pandemic in Italy in 2020. METHODS: We used the Patient Health Questionnaire-2 (PHQ-2), which is a screening instrument devised to detect probable depression and which has been annually administered in the framework of the Italian Behavioural Risk Factor Surveillance System since 2008. Depressive symptoms were assessed in a sample of 41,362 18-64-year-old adults surveyed in 2018-2019 and in a sample of 14,612 adults surveyed in 2020. RESULTS: The prevalence of depressive symptoms increased from 6.1% (95% CI 5.8%-6.4%) in 2018-2019 to 7.1% (95% CI 5.6%-8.6%) in March-April 2020. It then declined in May-June to 4.4% (95% CI 3.2%-5.5%) but in July-August it once again increased to 8.2% (95% CI 6.0%-10.4%) and, finally, gradually returned above the pre-lockdown level by November-December 2020 (5.9%; 95% CI 4.7%-7.1%). Compared to before the health crisis, during the pandemic, women and individuals with financial difficulties were found to have a significantly higher risk of depressive symptoms while younger, individuals with a higher education and those living in South Italy became increasingly vulnerable. CONCLUSIONS: While the average response to the pandemic was one of resilience over time, women and younger individuals were found to be particularly prone to the risk of depressive symptoms, as a result of the pandemic. In future investigations, the risk of individuals living in the South of Italy should also be taken into consideration.

What Is the Willingness to Receive Vaccination Against COVID-19 Among the Elderly in Italy? Data From the PASSI d'Argento Surveillance System.

Introduction: Italy was one of the earliest countries to experience a severe COVID-19 epidemic and vaccinating the elderly, who constitute 23% of the population and have experienced the highest mortality rates, is a top priority. Estimating prevalences and understanding risk factors for COVID-19 vaccine hesitancy or refusal are important for development of targeted interventions. Methods: We used data from a specially developed COVID-19 module of PASSI D'Argento, an ongoing surveillance system of residents 65+ years of age to measure the prevalence and identify risk factors for hesitancy and refusal to receive the COVID-19 vaccine. We calculated multinomial regression relative risk ratios to examine the association between demographic characteristics, health status, COVID-19 attitudes and experiences and likely vaccine hesitancy and refusal. Results: Of the 1876 respondents, 55% reported they would accept vaccination and 16% would likely refuse; the remaining 29% were categorized as hesitant. Compared with the acceptance group, we identified several risk factors in common between the hesitancy group and the refusal group, including not having received vaccination against influenza during the previous flu season (hesitancy: RRR = 2.0; 95% CI 1.4-2.9; refusal: RRR = 12.1; 95%CI 7.6-19.4) and lower risk of having had a death from COVID-19 among family or friends (hesitancy: RRR = 4.8; 95%CI 2.0-11.4; refusal: RRR = 15.4; 95%CI 3.7-64.5). The hesitancy group was significantly more likely being worried and they did not know if consequences of the disease would be serious for them. Conclusion: Our findings show the importance of establishing and maintaining active contact between the preventive services, primary care providers and the population because trust is difficult to establish during an emergency like the COVID-19 pandemic. Italian public health is based on a capillary network of general practitioners and having them reach out to their patients who have not previously received influenza vaccine may be a useful strategy for targeting efforts to further encourage uptake of COVID-19 vaccination.