Project Title: European Joint Action ADVANTAGE “A comprehensive approach to promote a disability-free advanced age in Europe: the ADVANTAGE initiative”

Duration of the project: From 01/01/2017 to 31/12/2019


Main Topic

According to the World Health Organization World Report on Ageing (WHO, 2015), healthy ageing is more than just the absence of disease. It can be defined as the process of developing and maintaining the functional ability that enables well-being across the life course. Frailty is a progressive, age-related, multifaceted, and very common decline in physiological systems that results in extreme vulnerability to endogenous and exogenous stressors, leading to a reduction in functional ability and an increased risk of adverse outcomes, such as disability, institutionalization, hospitalization and death.
It has been reported as more prevalent in low-and middle-income countries, and more frequent in women and in people with lower socioeconomic status. Frailty is a potentially reversible dynamic process along the continuum from normal aging to disability, thus offering ample potential for prevention, especially in its early stage.
Although a common definition and characterization of frailty is yet to be achieved, frailty is recognized as one of the major challenges of global population aging, since it heavily affects the well-being of older people and their families, and poses a serious threats to the sustainability of the health and social care systems.
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The aim of ADVANTAGE JA is to mobilize European Member States to develop a shared comprehensive strategic framework to manage older people who are frail or at risk of developing frailty, in order to promote a disability-free advanced age in Europe, enhancing healthy age. This has been achieved through the following steps:

  • to reach a common understanding of frailty and its associated factors, in order to promote the required and sustainable changes in the organization and implementation of care in the health and social systems of EU MSs
  • to share a common European framework for screening, early diagnosis, prevention, assessment and management of frailty
  • to develop a common strategy for frailty prevention and management (Frailty Prevention Approach), including raising awareness and advocacy among stakeholders, especially policy- and decision-makers


Type of study

The Joint Action ADVANTAGE, co-funded by the Third European Health Programme of the European Union [Grant Agreement 724099], is a collective effort involving 22 Member States (MS) and 33 organizations.
The Istituto Superiore di Sanità is one of the institutions designated by the Italian Ministry of Health as partners of the JA, together with Agenzia Nazionale Servizi Sanitari Regionali (AGENAS), Istituto Nazionale Riposo e Cura Anziani (INRCA), Regione Marche and Università Cattolica del Sacro Cuore (UCSC).


Expected results

The main outputs and results of the ADVANTAGE JA are:

  • State of the Art Report on Frailty (SoAR) – Based on the ADVANTAGE JA systematic reviews of scientific and grey literature on different aspects of frailty, it builds a common understanding on frailty and provides an overview of the current evidence on frailty.
  • MS Baseline Situation Report on the Prevention and Management of Frailty – Based on the information collected through a specific survey addressing key informants in order to understand the current approaches (strategies, policies, programmes, actions, plans, etc.) related to frailty in each participating MS.
  • Roadmaps for action on Frailty at MS level – Based on their specific baseline situation and resources, and using the SoAR as the gold standard, each MS was asked to develop a Roadmap for the next four years to enhance the promotion of healthy ageing and address frailty.
  • Frailty Prevention Approach – Specifically addressed to policy and decision makers, technical advisors, healthcare professionals and managers, and all stakeholders involved within the development of national or regional frameworks to enhance healthy ageing, it provides guidance on how to strengthen national/regional capacities and accelerate national/regional efforts to set up or further develop a frailty prevention policy in any MS. The FPA is a practical tool to combat the inequities that currently exist in Europe not only between countries but also within them. This is achieved on a double perspective: a common European framework and a specific attention to each MS conditions, potentialities and resources.


Responsible of the project: Lucia Galluzzo (ISS principal investigator) (

Department/Center: Department of Cardiovascular, Endocrine-Metabolic diseases, and Ageing

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