Highlights An analysis of the medical and demographic situation in the Russian Federation during the covid years (2020–2021) showed that the mortality rate in the studied population increased by 39.1%, the primary morbidity rate – by 26.3%, the incidence of COVID-19 increased by 135.6% and amounted to 10,304.1. The results of the study should be taken into account in the development of management decisions on the health of the elderly population at the federal, regional and municipal levels, as well as for planning dispensary work and preventive care for this population. Aim. To conduct an analysis of medical and demographic indicators and mortality rate in the population older than working age to develop management solutions regarding the health of older adults in the context of pension reforms.Methods. The study analyzed statistical data from the Federal State Statistics Service and the Central Scientific Research Institute of Public Health of the Russian Ministry of Health for period from 2012 to 2021.Results. The mortality rate in the population older than working age in the Russian Federation in 2021 amounted to 5 102.3‰oo. In the federal districts, the fluctuations in indicators were 1.3-fold: from 4 091.6‰oo in the North Caucasian Federal District to 5 374.6 in the Siberian Federal District. In the constituent entities of the Russian Federation, the difference between indicators was significant (2.9-fold): from 2 066.6‰oo in the Republic of Ingushetia to 5 974.6 in the Novgorod region. In 2021, the primary morbidity rate in the population older than working age in the Russian Federation was 66 183.5, in the Federal District the difference between indicators was 1.25-fold, the highest values were noted in the Siberian Federal District – 73 257.0‰oo, the lowest in the Central Federal District – 58 462.2. In other constituent entities of the Russian Federation, the difference was significant as well (2.3-fold): the Oryol region showed 91 162.7‰oo, in the Kursk region - 39 282.9. In 2021, the following diseases had high morbidity rate in the Russian Federation: respiratory diseases – 21 391.3‰oo (32.3%), COVID-19 – 10 304.1 (15.6%), injury, poisoning and certain other consequences of external causes – 6 528.1‰oo (9.9%), and diseases of the circulatory system amounted to 6 191.7‰oo (9.4%). Regarding this class of diseases, the highest morbidity rates were associated with high blood pressure – 29.9%, cerebrovascular diseases – 28.4%, and hypertension– 25.4%. In federal subjects of the Russian Federation, the difference in the incidence of COVID-19 in the studied population was almost 6-fold in 2021: from 3463.4‰oo in the Chechen Republic to 20 481.6‰oo in the Altai Republic, indicating the ambiguity of COVID-19. During the year of the analysis (2020–2021), the mortality rates in the studied population increased from 4 408.1 to 5 102.9‰oo (by 39.1%), the primary incidence increased from 57 041.4 to 60 183.5‰oo (by 26. 3%), the incidence of COVID-19 increased from 4 373.9 to 10 304.1 COVID-19 (by 135.6%).Conclusion. The results of the study should be taken into account at the federal, regional and municipal levels during planning dispensary and preventive work for the health protection of the older generation.