SELECT – Unfolding the SEcrets of LongEvity: Current Trends and future prospects. A path through morbidity, disability and mortality in Italy and Europe
Italy is considered one of the countries holding the secrets of high longevity. This notion is not only supported by epidemiological studies (OECD, 2017) but is also highlighted by several studies focusing on the high prevalence of centenarians in some regions (Poulain et al., 2004). This view is however challenged by increasing evidence of “selective” gain in longevity among population and population strata (WHO, 2008; 2015), which could have important implications for disability risk factors and complex evolution of the mortality curves in different countries and cohorts of patients over time. Guillot and Canudas-Romo (2016), for instance, highlight that longevity rankings of countries change substantially when it is analyzed from a cohort perspective —e.g., Italy loses ranks. Moreover, if an increase in longevity is not coupled with a parallel decrease in morbidity, a longer life expectancy could result in more years of diseases and disabilities, which would lead to a substantial increase in costs for the health systems. Hence, this project aims to achieve a broader quantitative perspective by conducting comparative studies between Italy and other countries. Furthermore, we plan to carry out comprehensive analyses of the several processes and factors associate with mortality, morbidity, disability and related risk factors.
Although the aforementioned aspects are of fundamental interest and have increased the availability of rich datasets on morbidity, disability and mortality, there is a current lack of an in-depth and systematic analysis of these data sources to obtain a broader and more accurate quantitative picture of the determinants, mechanisms and future patterns associated with these processes. Indeed, the fast transformation that our society has experienced in recent years calls for more comprehensive datasets, novel statistical models, increasingly targeted interventions and improved evaluation strategies. This will bring us up to speed with the fast paced, heterogeneous and complex changes in the dynamic mechanisms driving morbidity, disability, mortality, and their cross talk. A single perspective and a separate analysis of such complex processes would, in fact, fail to answer the questions associated with current and future longevity.
The goal of this project is therefore to address the aforementioned problems by relying on a highly interconnected and multidisciplinary team with experience in demography, epidemiology and
social and data science. More specifically, we aim to:
1. Systematically collect, organize, reconstruct and link available mortality databases, register data, finer scales surveys on morbidity, and indicators of disability to provide richer and more comprehensive data frames that allow joint modeling of morbidity, disability, and mortality, along with their timely prediction and ranking.
2. Develop novel statistical models and learning methods for the above datasets which can provide a joint and broader picture—well beyond separate models—of the complex, possibly causal, interrelations between morbidity, disability, and mortality, along with their changes across countries, causes-of-death, risk factors, vulnerable groups, and their future coevolution.
3. Identify, review, and assess epidemiological theories and current public health intervention strategies in the light of the new datasets, statistical models, and quantitative findings. Such results will be useful also in identifying and evaluating alternative and potentially more effective interventions via novel simulations methods.
Although Italy will be our starting point, a comparative perspective will be essential in this project. These aims will be pursued through constant collaboration among the research units and continuous interaction with the broader research community means of workshops, conferences, summer schools, and meetings. Website, data repositories and software will also be made available in order to stimulate constant discussion, validation and broader implementation of the advances at each research step, as well as to adhere to the open-data paradigm (e.g., BMJ Campaign www.bmj.com/open-data).
Finally, due to the relevance of the addressed topics for the future of our society, the project will be characterized by active involvement, training and recruiting of a network of junior researchers in demography, epidemiology, social sciences and data sciences to ensure future advances in this field, well beyond the deadlines of the current project. The project will also benefit from a continuous exchanges with national (ISTAT – National Institute of Statistics, Ministry of Health, National Institute for Health) and international (WHO, IUHPE) researchers thanks to the network already available for the research team.
Research area: Why do we age, Age-related diseases
Principal Investigator (PI) and CO-PI:
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