CNR - Institute of Neuroscience CNR
Institute of Neuroscience


CLESA (Cross-national, Longitudinal, European Study on Aging)



The increased use of data from multidisciplinary, longitudinal studies on aging is providing fresh insights into the dynamic processes that shape later life. These include transitions in health and functional status and incidence of major chronic conditions, such as cancer, dementia, osteoporosis, cardiovascular disease, diabetes. Comparing findings from longitudinal studies across time and cross-nationally is an efficacious step to pursue for increasing our knowledge-base and devising effective policies. However, there exist major obstacles to achieving these goals. In general, there is a lack of standardization in conceptual design, measurement, data collection procedures and analytic approaches. Designing next generation of longitudinal studies requires careful review of current state in the field, from both substantive and methodological points of view. Therefore, a clear and compelling need exists to draw researchers together to address the current effectiveness of longitudinal research in a systematic manner and to plan for collaborative efforts on aging research, from basic science to clinical and epidemiology research.


  • The "Cross-national determinants of quality of life and health services for the elderly" (CLESA) is a 3 year project supported by the European Commission within the V Framework Program, Key Action 6 "The Ageing Population and Disabilities".
  • The project aims at the identification of the determinants of quality of life and health services in older people resident in Finland, Israel, Italy, The Netherlands, Spain and Sweden.

Selected Results




Significant homogeneous predictors of mortality:

  • 80-84 ys (1.57), males (1.6), smokers (1.17), alcohol drinker (0.75), heart disease (1.3), stroke (1.39), cancer (1.75), respiratory disease (1.22).
  • Not significant homogeneous predictors of mortality: manual work, hypertension.
  • Heterogeneous predictors of mortality: marital status, education, drugs use, diabetes, musculoskeletal disease.
  • Traditional country-specific predictors (age, sex, smoke and alcohol) hold significant at "CLESA" level.
  • Heart disease, stroke, cancer and respiratory disease in spite of having different distribution across countries, are homogeneous predictors of mortality.
  • Manual work and hypertension are in the path-way for the above factors and conditions leading to death, and are not directly causes of death.
  • The heterogeneity of the other predictors may be explained with the differences in the socio-cultural environment and health services organization.


  • Zunzunegui MV, Minicuci N, Blumstein T, Noale M, Deeg D, Jylhä M, Pedersen NL, (2007) Gender differences in depressive symptoms among older adults: a cross-national comparison: the CLESA project. 42:198-207.
  • Pluijm SM, Bardage C, Nikula S, Blumstein T, Jylhä M, Minicuci N, Zunzunegui MV, Pedersen NL, Deeg DJ (2005) A harmonized measure of activities of daily living was a reliable and valid instrument for comparing disability in older people across countries. 58:1015-23.
  • Noale M, Minicuci N, Bardage C, Gindin J, Nikula S, Pluijm S, Rodríguez-Laso A, Maggi S, (2005) Predictors of mortality: an international comparison of socio-demographic and health characteristics from six longitudinal studies on aging: the CLESA project. Exp. Gerontol. 40:89-99.
  • Nikula S, Jylhä M, Bardage C, Deeg DJ, Gindin J, Minicuci N, Pluijm SM, Rodríguez-Laso A, (2003) Are IADLs comparable across countries? Sociodemographic associates of harmonized IADL measures. 15:451-9.
  • Minicuci N, Noale M, Bardage C, Blumstein T, Deeg DJ, Gindin J, Jylhä M, Nikula S, Otero A, Pedersen NL, Pluijm SM, Zunzunegui MV, Maggi S, (2003) Cross-national determinants of quality of life from six longitudinal studies on aging: the CLESA project. 15:187-202.


EU Proposal NAS 1: QLRT-2001-02932 (1.8 Milion Euros)



  • Prof. Nancy L. Pedersen, Dept of Medical Epidemiology (Stockholm).

The Netherlands

  • Dr. Dorly J.H. Deeg, Vrije Universiteit, Institute for Research in Extramural Medicine/LASA (Amsterdam).


  • Prof. Marja Jylhä, School of Public Health, University of Tampere (Tampere).
  • Dr. Juhani Lehto, University of Tampere (Tampere).


  • Dr. Angel Otero, Universidad autonoma de Madrid, Centro Universitario de Salud Pblica-CUSP (Madrid).
  • Prof. J. M. Ribera Casado, Madrid University (Madrid).


  • Dr. J. Gindin, Kaplan Medical Center.


  • Dr. Katarzyna Szczerbinska, Jagiellonian University, Collegium Medicum, School of Public Health (Krakow).


  • Dr. Jelena Ceremnych, Institute of Experimental and Clinical Medicine, Center for Gerontology and Rehabilitation, Department of Gerontology Problems (Vilnius).

Czech Republic

  • Prof. Eva Topinkova, Charles University, Department of Geriatrics (Praha).


PI photo

Stefania Maggi

Contact information

email  E-mail

email  049 8211746

Participating staff