Stanford-led THRIVE coalition secures up to $34.5m from ARPA-H to build FDA-grade intrinsic capacity score predicting 20-year outcomes.
The Advanced Research Projects Agency for Health continues to place deliberate bets on the infrastructure of aging science. In its latest move under the PROSPR program, a Stanford-led coalition has secured up to $34.5 million to develop what it describes as the first FDA-grade Intrinsic Capacity score – a composite measure designed to predict long-term health outcomes including mortality, multimorbidity, hospitalization and loss of functional ability up to 20 years in advance.
The initiative, known as THRIVE – Transforming Health: Reclaiming Intrinsic Vitality for Everyone – brings together the Center for Genomics and Personalized Medicine at Stanford University, the Buck Institute for Research on Aging, the Methuselah Foundation and a network of implementation partners including Whoop, YMCA and OpenCures. The ambition is precise: to translate the World Health Organization’s concept of intrinsic capacity into a validated, scalable and affordable assessment tool, with an at-home price point below $100. As we noted in our recent coverage of ARPA-H’s healthspan-focused human trials, the agency is not simply funding molecules; it is attempting to retool the operating system of aging research itself.
The endpoint dilemma
Intrinsic capacity – defined by the WHO as the composite of physical and mental abilities that enable independence – has long been recognized as a meaningful lens on aging. Yet recognition has not equated to measurement. Clinical trials still default to disease-specific endpoints, while functional decline unfolds across years or decades; the result is a mismatch between the biology of aging and the architecture of regulation.
THRIVE proposes to close that gap by integrating health surveys, functional assessments, continuous wearable data and blood-based biomarkers drawn from large longitudinal datasets spanning millions of datapoints. The resulting PROSPR Intrinsic Capacity score is intended to function as a surrogate for age-related decline – responsive enough to detect change over shorter time horizons, yet predictive of longer-term outcomes.
Two introductory paragraphs in, the scale of the ambition becomes clear. The question is whether aging can finally be rendered legible to regulators.
Longevity.Technology: For all the billions invested in longevity biotech, the field has been circling the same structural problem: we still lack a regulatory-grade way to measure aging itself. Disease endpoints are too narrow and lifespan studies too long; what sits in between – a validated, predictive measure of functional decline – has remained frustratingly out of reach. If THRIVE succeeds in translating the WHO’s concept of intrinsic capacity into an FDA-credible, 20-year predictive score, it will mark a decisive shift where aging stops being an abstraction and becomes a quantifiable trajectory. In that sense, this is less about a new metric and more about building the measurement infrastructure that geroscience has been missing – the scaffolding upon which serious, scalable healthspan trials can finally stand.
There is, of course, ambition bordering on audacity – wearables, blood biomarkers, surveys and functional testing distilled into a sub-$100 at-home score that claims to forecast resilience decades ahead. Validation will be everything; the history of aging clocks is littered with elegant correlations that wilt under regulatory scrutiny. Yet the direction of travel feels right. By anchoring intrinsic capacity in decentralized trials and community settings rather than boutique longevity clinics, PROSPR is nudging the sector away from lifespan theatre and toward capacity span – the measurable preservation of function, agency and independence. If aging is to become an intervenable condition rather than an inevitable decline, it will be because we learned how to measure what actually matters.
From concept to computation
Dr Michael Snyder, Director of the Center for Genomics and Personalized Medicine at Stanford and leader of the coalition, frames the challenge in quantitative terms: “We lack quantitative measures for resilience and health. Our team will build quantitative science-based measures that predict long-term outcomes with the ultimate goal of keeping people healthy.”
The effort will draw on continuous physiological data captured by Whoop wearables, structured surveys and functional tests, alongside molecular biomarkers. The inclusion of continuous monitoring is pivotal to the 20-year predictive ambition. It moves the science away from the annual physical – a static, isolated “snapshot” – and toward a view of health that is more “cinematic.”
By capturing daily fluctuations in autonomic balance and sleep architecture, THRIVE aims to identify the subtle micro-drifts in resilience long before they consolidate into functional decline. This isn’t just about adding data; it’s a shift toward modeling aging as a multi-dimensional system rather than chasing a single-parameter proxy.
To validate the score, THRIVE plans a series of decentralized observational and lifestyle intervention trials involving more than 1,000 participants in partnership with the YMCA, and using OpenCures as the clinical trial platform. Diet, exercise, sleep, stress management and social engagement will be examined not as abstract lifestyle advice but as measurable inputs capable of shifting intrinsic capacity over time.
Dr Andrew Brack, ARPA-H Program Manager and architect of PROSPR, is explicit about the regulatory intent: “With PROSPR, we’re enabling the first-ever clinical trials that truly target aging. To avoid decades-long studies, we must identify a short-term, reliable and intervenable surrogate that predicts longer-term changes in health, and that’s why THRIVE is an essential key to the program’s success.”
Building an operating system
For advocates within the longevity sector, the absence of accepted endpoints has often been described as a bottleneck. Dane Gobel, Co-Founder of the Methuselah Foundation, characterizes PROSPR in infrastructural terms: “The longevity sector has been paralyzed by a lack of FDA-grade endpoints. With the PROSPR platform, we are building the diagnostic infrastructure to prove that aging is quantifiable and treatable. We aren’t just running a study – we are building the operating system for the future of human health.”
That framing – aging as a quantifiable and therefore treatable condition – remains contested in regulatory circles. Yet the logic is increasingly difficult to ignore; without measurable surrogates, preventive interventions struggle to clear evidentiary thresholds, and investment gravitates toward late-stage disease.
At the Buck Institute, Professor David Furman situates the project at the intersection of gerontology and computational biology: “This moonshot program integrates, for the first time, molecular biomarkers with functional features of aging at scale to predict long-term health outcomes. It is built on the recognition that decline in intrinsic capacity is a disease-relevant condition. By converging gerontology and geroscience, we’re bringing together three highly experienced bio-computational teams, a dedicated software engineering group and an experienced clinical team to generate next-generation predictors and therapeutics for functional aging decline. This is likely one of the most impactful federally funded efforts to extend the healthspan of all of us. I couldn’t be more excited to get this started.”
Dr Brianna Stubbs, Clinical Lead at the Buck Institute, emphasizes translation beyond academic centers: “PROSPR is redefining how we measure and protect the capacity that truly matters as we age. We’re building the scientific foundation to measure intrinsic capacity with the same rigor we measure blood pressure or cholesterol – because what we can measure, we can improve. Through decentralized clinical trials and YMCA-based lifestyle interventions, we’re moving aging science out of the ivory tower and into communities, creating scalable strategies to preserve resilience and extend healthspan.”
Capacity as currency
If successful, the PROSPR Intrinsic Capacity score would offer something aging research has long lacked: a common currency linking biology, behavior and long-term outcomes. Not lifespan, not disease incidence, but the maintenance of function across time. In a policy environment grappling with demographic shift and rising multimorbidity, that shift in emphasis may prove as significant as any single therapeutic advance.
