We have a mission to help seniors extend their healthy lifespan by an average of 5 years. We believe we can initially do this by focusing on the reversion of Frailty, a silent epidemic that affects 49% of seniors and is the leading indicator of dependency.
Rosita aims to provide an answer to the problem that the aging process is poorly managed or not managed at all.
Life expectancy in Western countries is about 85, with Spain amongst their leaders with 84. However Healthy Life Expectancy is only 65. Seniors are expected to live with pain or a disease that in most cases could be preventable. Amongst the different causes for aging, we find genetic and epigenetic causes. Contrary to common beliefs, epigenetics - environmental and lifestyle choices - are responsible for the 80% of probability of developing age-related conditions, versus genetics. This has a very relevant consequence: we can act on the aging process without the need of fancy biotech solutions.
When we look at pain - 70% of seniors suffer chronic pain like osteoarthritis 365 days a year -, it is the starting point of a particular degenerative process: pain will often lead to sedentarism, which leads to loss of muscle, loss of equilibrium, bad fallings, prosthesis, long rehabs, further loss of muscle mass, sarcopenia, and eventual dependency. 49% of seniors are at risk of frailty and hence dependency. This degenerative process is what is known medically as Frailty, that is commonly defined as a “common clinical syndrome in older adults that carries an increased risk for poor health outcomes including falls, incident disability, hospitalization, and mortality”. All these figures are expected to increase worldwide during the next years and decades.
Frailty by itself is estimated to have a $10,000 surplus health cost per year over the cost of a person the same age without frailty. This figure excludes the social cost of dependency, the cost of nursery homes for families, etc. But the different health systems will not treat pre-frailty or prevent frailty comprehensively.
But Frailty can be not only delayed, but also reversed. Unfortunately health systems are not built to deal with a long term chronic disease in non-pharmacological form, which leads to the treatment of osteoarthritis and other degenerative diseases that lead to frailty with painkillers, effectively covering the problem until it is too late.
While most people look at Life Expectancy as a metric of industrialization, HLE is probably a better metric in most cases, as it shows the extension of youth, as opposed to the extension of death and the effectiveness of health systems to keep us alive. As an example from the table below, Spain is currently 5th in Life Expectancy but only average in the ratio of HLE/LE, whereas Singapore has the most success in extension of youth and US is the bad outlier where their seniors suffer more than 40% of the rest of their lives with bad health, with the implications to health systems, social systems, partners and families. The mere fact that this wild difference between varied countries exists suggests the answer is not genetic, and that we can do something proactive and significant about our aging process.
Aging is not traditionally considered a disease, despite age-related comorbidities, age being the most important risk factor for nearly all fatal diseases, and existing evidence on factors that prevent the adverse effects of the process. This consideration has a profound impact on the organization of related social and health systems.
In turn, this causes systems in most countries to deal with aging in a non-comprehensive way. Spain is a good example.
On the health systems side, pathologies related to aging are treated rather than preventing their causes, when in many cases it is too late. System's organization revolves around single specialties and illnesses, and is good or great in treating acute problems (and Spain has one of the best systems in the world in this regard), but it is ineffective in managing chronicity, both in terms of health outcomes and costs. Aging leads to multiple chronic diseases, and can be described as a chronic disease itself. The solutions offered by the system are mainly palliative of the consequences (pharmacology) and rarely address the causes. Early diagnoses exist, but always at the secondary level: ie, early diagnosis of coronary heart disease. We do not work at the primary level - prevent this coronary disease - and always with a culture of minimums - people of 75 years should be able, at least, to lift 2 kilos -, without the existence of average or excellence ranks. Prevention and health promotion are permanently pending issues in most health systems and this situation is not expected to change drastically in the short term. While there is wide experience in generating preventive medicine programs, there is little success in carrying them out, massively to the general public, or to segments of the same such as seniors, with a remarkable degree of acceptance, adherence and effectiveness in its results.
On the social systems side, all resources are dedicated to people who are already dependent, tackling the impact of aging on people who are already very old, and again without trying to prevent the causes of dependency.
The poor efficiency of the system results in the individuals to be the sole responsible of managing their aging process, endowed with little support, training and tools. General recommendations are about minimums, information on what is good and bad is confusing, knowledge is not up-to-date, and motivational factors are not adequately addressed. Humans are not good at anticipating future problems, due to various cognitive biases, which contributes to the failure of many personal strategies of adopting healthy habits or eliminating negative habits (smoking, sedentary lifestyle, nutrition). Offline substitutes exist for healthy lifestyle intervention, but are mostly based on offline coaching and specialized training, expensive, mainly oriented to elites and difficult to scale as-is.
The effects derived from mismanagement of longevity are multiple and can be summarized in the reduction of life expectancy in good health.
Aging is a highly complex, multiparametric process with a personal component and its relevant context, so its effects are diverse. The path of frailty begins with a degenerative physical process that results in chronic pain, which leads to sedentary lifestyle, which leads to frailty, which in turn is a main cause of dependency. This same process can also be the cause of metabolic syndrome (diabetes, cardiovascular disease, etc.), dementia and other eventually fatal chronic diseases. This process affects sleep hygiene, cognitive health, emotional health and psychosocial factors, especially the problem of loneliness. At the end of these chains of effects, we’ll find worse quality of life in people's late years, the social, family and personal costs and finally early death.
From the extensive list of effects related to mismanagement of the aging process, Rosita aspires to provide solutions where it can have a direct impact using scalable technologies.
The most direct effect we work on is to improve physical condition and prevent pain associated with poor condition, to prevent degeneration, comorbidity and subsequent dependence, the route in which we can have a more direct impact on our ultimate goal. to increase life expectancy in good health.
Rosita's success will come not only from creating comprehensive and adapted programs that we detect as non-existent or inefficient, but also from ensuring that the people who follow them are successful in their execution.
Rosita aims to help seniors (60-80 yrs) increase their healthy life expectancy by providing them with their own Longevity Plan. The service is delivered with the help of a Mobile App that includes activity content, mostly in video format and the help of a virtual longevity coach.
A Longevity Plan helps people understand where they are today - using a set of 1st party and 3rd party diagnostics -, where they should be in 10 years and set up an action plan of how to get there, with personalized treatments that take into consideration their pathologies and contraindications.
Rosita’s Longevity Strategy starts with the reduction of chronic pain related to poor physical condition, which is a precursor of many other diseases and has the biggest impact in the aging degenerative process. It continues with primary prevention of mortal diseases, secondary prevention of diseases that are more likely to happen, and tertiary prevention of diseases the senior already suffers. Only then will the longevity strategy aim to optimize longevity with supplements and advanced diagnostics.
Rosita’s current focus revolves around solving the first stage of the longevity strategy, by delivering personalized physical condition and pain management plans. From an impact perspective, we aim not only to delay but reverse the frailty cycle. This has been proven to be possible by our scientific advisor and renowned longevity Professor Viña within his research group and as part of international research initiatives. Reversion of frailty by a few points in the frailty scale will literally increase years of healthy life expectancy to those seniors. We are taking this methodology online.
More generally, Rosita aims to help people reach the 90th percentile of where they should be at any specific age, creating the ranges of excellence for the relevant indicators to enjoy a healthy longevity.
We can make a significant impact that public health systems are simply not offering. As we become your longevity coach, your guide with a large number of touch points per week (what requires chronic pain management and physical condition to avoid frailty), we also become your health trusted partner for everything else.
It is possible to reverse frailty from home autonomously, without the oversight of a professional.
It is possible to maintain a coaching relationship remotely or virtually in the long term.
Efficient diagnostic measurements can be made autonomously by users.
It is possible to make lifestyle changes with the support of mobile technologies remotely.
Social reinforcement helps motivate people to change their healthy habits, and we can leverage it through mobile applications.
Improving some habits does not make others worse.
Chronic musculoskeletal pain is a suitable entry strategy for creating lasting habits among our novice users.
Healthy life expectancy can be predicted with physiological biomarkers.
The treating physicians will eventually use the biomarkers, ranks of excellence, and will prescribe Rosita to users with chronic pain, even as an alternative to pharmacological solutions.
Through prevention and the exercises recommended in the app, it is possible to increase the healthy quality of life of the elderly.
We are capable of designing technological services and products that older people know and can use autonomously.
We aim to increase healthy lifespan for our users, by helping them proactively plan their aging process. We use continuous diagnosis, treatment and monitoring to help them be at the best condition they can given their age and context. This helps reduce risks of developing age-related conditions, such as frailty, metabolic syndrome, respiratory conditions and others that have a direct impact on their healthy lifespan and can result in early death.
We aim to help 1 million seniors reduce the risk of frailty and extend healthspan. However measuring extra years of healthy life is difficult, so we need proxies.
These are the proxies we are currently tracking:
- Number of seniors doing more than 50 minutes of physical activity with us per week: While the WHO recommends 150 minutes of physical activity per week for seniors, the reality is that most seniors barely do anything. The biggest challenge is taking them from 0 to 50, which is equivalent to 2 full classes with us per week. A minimum of 50 is what we aim for to consider that we are having an impact. We also know that people who do 50 minutes of physical activity with us are also starting to feel better and doing more activities outside of the app.
- Pain reduction: Chronic musculoeskeletal pain leads to sedentarism which can lead to loss of muscle and eventual frailty. Chronic pain can only be reduced pharmacologically (with increasing dose over time) and with physical exercise, which is our long term bet. That is why long term motivation is critical. By measuring the pain of our users we can track how well we are helping them live the lives they want.
- Healthspan biomarker based on Frailty metrics: We are creating our own home-based biomarkers to create proxies for well known biomarkers like Frailty Index. Validation of these proxies will give us the closest metric of extension of healthspan.
Ship2B Ventures has granted Rosita with the Impact Business distinction thanks to our impact management system and solid business fundamentals.