A clear trend in Italy over the last 20 years has been the increasing prevalence of ‘very old’ people (over 75 years of age) within the general population. Routine statistics as well as population surveys and ad hoc epidemiological studies all confirm this trend. The proportion of so-called ‘very old patients in good health’ is the category which is increasing the most. This is due to the economic well-being and generally good living conditions in Italy as well as progress in medical care and the introduction of new treatments and technologies in clinical practice that have improved survival and quality of life. The presence of an increasing number of very old people in the population, with consequent change of the population’s health needs, represents a great challenge both for the healthcare system and for society as a whole.