The aim of this study is to develop a multidimensional assessment tool based on findings from the AGE-IT comprehensive study conducted from April to June 2025. AGE-IT aimed to explore differences in quality-of-life perceptions among older Italians, drawing on data from 1,631 participants across three diverse Italian regions (Emilia-Romagna, Abruzzo, and Puglia), and collected with a range of standardized tools. Given the lack of evidence-based data on the comprehensive evaluation of objective and subjective quality-of-life perceptions among older people, this study proposes an index that explicitly accounts for a review of these dimensions, including both objective and subjective QoL. Thus, for this present study, the Quality-of-Life Perception Index was developed using data from the AGE-IT study to provide a more holistic and nuanced understanding of quality of life by assigning greater specific weight to a set of territorial variables. The objective Quality-of-Life Perception Index demonstrated acceptable reliability and showed significant variations across regions, sex, age, and mobility status. Women reported significantly higher objective quality of life than men, and transport autonomy emerged as a critical determinant of well-being. The index showed moderate positive correlations with subjective quality-of-life measures, supporting its criterion validity. These findings provide a foundation for comprehensive quality-of-life assessment in older populations and demonstrate that digital skills are strongly linked to advanced forms of e-health engagement, while similar skill levels translate into different uptake levels across countries. For practitioners, this implies that improving e-health adoption requires not only digital skills training but also user-centred service design and system integration, while for researchers it highlights the need to move beyond single indicators and treat later-life digital health inclusion as a context-dependent, hierarchical process rather than a binary divide.

The global population is undergoing a significant demographic shift, with a rapidly increasing proportion of older adults. This “graying” of society presents both opportunities and challenges, making the well-being and quality of life (QoL) of the elderly a paramount concern for policymakers, healthcare providers, and researchers alike. Italy stands at the forefront of this demographic transition, with one of the world's oldest populations. This makes the study of QoL in elderly Italians not only a national priority but also a valuable case study for other aging societies. The analyses presented in this article draw on the findings of an empirical study conducted on a statistically significant sample of 1,631 respondents residing in three different Italian regions. Data were collected through a structured questionnaire designed to measure perceived quality of life across a set of variables related to the characteristics of urban space.The findings presented were operationalized to inform the design of urban welfare policies aimed at promoting age-friendly cities and territories.