Antonio Paoli, Guido Iaccarino, Fabio Lucidi, Francesco Pagnini, Giovanna Boccuzzo, Maddalena Illario
OBJECTIVES: This position paper presents perspectives from Spoke 4 (Trajectories for Active and Healthy Aging) of the Age-It Research Program, which adopts a One Health perspective to examine the interplay of cognitive, behavioral, nutritional, social, and environmental determinants of aging. Addressing these multidimensional factors is crucial to promoting health, independence, and well-being across the life course. METHODS: We reviewed evidence on lifelong determinants of aging, including physical activity, nutrition, mental engagement, and social participation, alongside emerging digital health solutions. The One Health framework guided our analysis, emphasizing the interconnectedness of individual, societal, and environmental influences. Spoke 4 integrates multidisciplinary expertise to translate scientific knowledge into practical tools for communities, healthcare providers, and policymakers. RESULTS: Evidence shows that sustained engagement in physical activity, cognitively stimulating activities, and strong social networks supports resilience, reduces frailty, and preserves independence. Tailored nutritional strategies further enhance functional capacity. Digital technologies-such as mobile apps, wearable devices, and online platforms-demonstrate potential to improve disease prevention and health monitoring. However, disparities in digital literacy and access remain significant barriers, particularly for older adults. DISCUSSION: Spoke 4 of Age-It highlights the need for multidimensional, One Health-based strategies that integrate traditional health determinants with digital innovations. By combining evidence-based interventions with user-centered e-health platforms, scalable and inclusive solutions can be developed to support healthy aging. These efforts provide policymakers and healthcare systems with tools to foster resilience, mitigate frailty, and enhance quality of life in aging populations.