Longevity, as far as startups are concerned, tends to be a moonshot-y space where technologies like biotech and AI are experimentally applied in a sort of modern day alchemical quest — and the great hope is to (somehow) ‘hack’ biology and substantially extend the human lifespan. Or even end death altogether.
Coming considerably closer to Earth is Spanish startup Hearts Radiant, which says it’s in the “longevity tech” business but is taking a far more grounded and practical approach to addressing ageing. In short it believes it’s nailed a formula for helping people live to a ripe old age.
And — here’s the key — to do so healthily.
So its moonshot isn’t to help people get to a biblical 150 or even 120. It’s about supporting seniors to live well, up to a ‘good innings’ like 95, while (hopefully) retaining their independence and vitality through the application of technology that creates a structured and engaging lifestyle routine which works to combat age-related conditions such as frailty and social isolation.
Gently does it
The startup is coming out of stealth today to disclose a first tranche of pre-seed funding and chat to TechCrunch about its dream of supporting seniors to live a more active, fulfilling and independent life.
The €450k pre-seed round, which is led by JME.vc with participation from Kfund, Seedcamp and NextVentures, will be used for research and continued development of its Rosita Longevity digital coach. The app has been in beta testing in a limited form since January — currently only for Android devices, given seniors tend to have their relatives’ hand-me-down smartphone hardware (but iOS is on the roadmap) — offering livestreamed and on-demand video classes like cardio flamenco and age-appropriate yoga for its target 60+ year-olds.
Rosita’s co-founders are husband and wife team, Juan Cartagena (CEO) and Clara Fernández (CCO), along with CTO David Gil. Their premise is that what humans really need, as they age, is guidance and motivation to stay as active as they can, for as long as they can — and that a digital platform is the best way to make personalized, ‘healthy habit’ forming therapy for seniors widely accessible.
“We believe that we have to be a habit engine,” says Cartagena, offering “health longevity” as another descriptor for the scope of what they’re aiming to achieve.
Fernández is drawing directly on her years of experience as CEO of Balneario de Cofrentes, a family business in Valencia, which she describes as a “longevity school” or camp for seniors — and which the website suggests is a combination of spa/hotel, physical therapy/rehabilitation and education center. There she’s been responsible for overseeing activity and education programs tailored to seniors, offering guided exercise and advice on things like disease avoidance and good nutrition.
“Over the last ten years we have developed a very comprehensive strategy on how to educate, how to create habits in the senior community so that they can increase their healthy lifespan,” she explains. “We have a specific methodology. We start with teaching seniors how to manage their current health situation and we progressively start educating them with lifestyle, prevention of the main diseases, and also education about the latest discoveries in the field of science.”
“I realized that the main way to expand this was taking it online,” she adds on the decision to package the program into a digital coaching app — “where a bigger percentage of the senior population could benefit”.
Lifestyle is a key part of the proposition. But they’re most comfortable with the badge of ‘longevity tech’.
“We are trying not to play in fitness for many reasons,” adds Cartagena. “It’s limited in scope. And we are trying to go beyond that — it’s just the starting point [for reducing frailty] and the issues related to that, including the final ‘disease’ which would be dependence.”
Since the premise underlying the Rosita app hinges on the proven health benefits of regular, moderate exercise as a means of combating a range of age-related conditions — such as muscle mass loss and reduced bone density leading to frailty (which in turn can lead to a fall, a broken hip, and a senior who’s suddenly dependent on personal care) — or, beyond that, as a general bolster for mental and brain health — they are squatting on established (rather than moonshotty) science.
Although they do still need to demonstrate that digitally delivered, personalized programs of lifestyle coaching — featuring familiar but still sometimes clunky technologies like AI and chatbots — can actually help reverse frailty (in the first instance) for seniors participating remotely, with no human physiotherapists on hand to help.
Hence some of the funding will go on researching how their bricks-and-mortar ‘longevity school’ program translates to a digital platform. And, more specifically, whether personalised digital coaching for 60+ year olds will yield tangible reductions in frailty (and thus gains in active years) in the same way that in-person group exercises have already been shown to. (One area that certainly merits close study is whether social human contact derived from a purely digital experience vs in-person group therapy makes a difference to treatment outcomes.)
It’s true that no smartphone in the world can transform a bog-standard bathroom into a full on luxury spa. But other elements of the Balneario’s program simply need digitizing and structuring to serve up similar benefits, is the thinking.
The sorts of digital activity programs they’re devising for the app are designed to be fun for seniors as well as beneficial and appropriate for a particular frailty level. Examples of classes currently offered include reduced mobility dance, burpee-free ‘cross fit’, and osteoarthritis-safe karate.
The onboarding process involves an assessment to determine a senior’s frailty level in order that users are offered content at an activity level that’s appropriate for their physical condition.
Long is the road
Cartagena notes they’re working with Dr. José Viña, a professor at the University of Valencia, who is renowned in the longevity field. “He has proven he can revert frailty in the earliest stages by applying a certain methodology to specific muscles with a treatment of exercise-fusion — with some lifestyle habits. Now what has not been proven is whether that is applicable to a remote environment where people do it on their own,” he adds. “And this what we are doing right now. This pre-seed round is basically to take that uncertainty, put that in front of a few thousand [app] users, take that research… and see if in the next 12 months we improve [their frailty level].”
The actual Balneario is closed at the moment, in this health-stricken year of the novel coronavirus, but the plan is to reopen in March 2021 — and then introduce the annual intake to Rosita — garnering ongoing feedback on whether or not it’s steering them toward health-supporting habits.
“It’s all about understanding the customer so well and that’s where the competitive advantage of this company really comes from,” argues Cartagena. “By having 15,000 seniors per year coming to the school, every year we understand the customer very well, their habits, what they do, what they don’t. They come every year so we can ask them what did you do last year?
“That will be for us the way to have a massive focus group — let’s say a sliding window of focus group that we can see for ten days using the product — and we can iterate much faster by seeing not people just through our analytics but people who are using the product in front of us. One hundred or 500 people a day in our resort. And I think that will be a fundamental way in which we can actually build something that people really need and use and care about.”
The current version of the app doesn’t yet include AI-powered personalized coaching. But that’s again where the pre-seed funding comes in. “The initial coach for education and frailty itineraries should be ready in three weeks (together with our iOS app),” says Cartagena. “This solves a pressing problem our users have today.
“The personalized coach (pathologies, followups, context, atomization of exercises, etc) has a lot of logic behind and testing this properly will take more time. We will release that intelligence slowly and we should feel ‘proud’ by Christmas. That will become our Habits Engine. Together with our geroscience research plan, those are the uncertainties to get right with our current funding.”
Targeting chronic pain is another key aim for the app, although he concedes there may be some types of pain they won’t be able to address. The co-founders add that the app is intended to supplement not replace traditional healthcare — pointing out it’s being designed to be more forward-looking; aka that prevention of age-related problems is exactly the strategy to live better for longer.
“Telehealth is more about managing a disease — we’re more about preventing,” adds Fernández. “We’re more about discovering what are the indicators and the tools to make sure that the senior population… understand what it happening to their body, what is going to happen over the next ten years and start to slowly develop those habits so that they can minimize, reduce the evolution, the natural ageing process.”
Cartagena notes they are also working with researchers on developing sensor hardware that could go alongside the app to enhance their ability to predict frailty — suggesting it will allow them to define a wider/more nuanced range of user categories (the first version of the app has three categories but he says they want to be able to offer nine).
Smartphone and sensor hardware combined with AI technology has, for some years now, been enabling a new generation of guided physical therapy apps that seek to offer an alternative to pharmaceutical-based management for chronic pain — such as Kaia Health and Hinge Health, to name two. And of course mindfulness/guided mediation has become a huge app business. While the broader concept of ‘digital health’ has, over the past half decade or so, seen CBT-style therapy programs packaged up to be put on tap in people’s pockets. So there’s nothing inherently strange or exotic about the idea of a longevity coach for seniors.
Albeit, getting the user experience right could well be the biggest challenge. Cartagena says the app’s tone is important — talking in terms of not wanting to be “patronizing” or make seniors feel like Rosita is giving them “homework” — so they really click with the virtual coach and stay engaged.
Fernández too emphasizes the goal is to sustain good habits. Ergo, this is a (gentle) marathon not a sprint.
If they can design a safe and engaging experience that seniors don’t find off-putting, tedious or confusing the potential to expand access to therapies, activities and information that can improve people’s quality of life looks huge. Frailty is also only the team’s first focus. As they develop the product and grow usage they want to be able to support their users to form healthy habits that could help stave off neurodegenerative conditions like dementia, for example. Combating loneliness and social isolation is another goal. So there’s a whole range of health plans they’re hoping Rosita will be able to deliver.
“What we’re doing right now is focused especially on frailty — we’re developing the personalized AI coach on top of that — and what we’re going to do is start adding the layers of all the different health plans that we’re going to be establishing off the longevity coach,” says Fernández. “Nutrition, cognitive stimulation, relaxation and breathing, and on top of that we will put all the prevention strategies — and all the classes that we’re preparing for longevity.
“One of the things that we have tested in the clinic that is very important is to educate the user. Not just on what they need to do today — but on what is happening to their ageing process, what is happening to their metabolism, what is happening to their musculoskeletal system. How and why your body is ageing is fundamental so you can make small decisions. By empowering users through education they can understand and relate to why this specific thing that you’re telling them today is useful in the long run.”
“One of the most successful strategies that we have built is creating this whole course on longevity which is what is happening to your body — what science knows today about the field of longevity,” she adds. “And how you can minimize those symptoms. And those things we’re translating completely into the [app].”
Cartagena also points to the risk of a COVID-19 ‘4th wave’ of deaths that could result from seniors becoming more frail than they otherwise would after being forced into a more sedentary existence as a result of lockdown measures and concerns about their risk of exposure to the coronavirus.
Or, in other words, sitting at home on the sofa might help seniors stay free of virus but if abrupt inactivity risks their vitality that too could cut short a healthy lifespan. So tools to help older people stay active are looking more important than ever. And to that end he says the app will remain free throughout the pandemic — envisaging that could stretch into 2022.
The plan for the business model is b2c, likely focused on selling premium content — such as connecting users directly with a therapist to chat through their progress. In the meanwhile they’re relying on VC to get their digital “motivation engine” to market.
Right now they have 5,000 “pre-registrations” for the app and 1,000 seniors actively testing the product (all aged 60 to 80, in Spain). They’ve also just pushed out an update, moving the software out of the ‘early access’ phase — as they progress toward launching their “personalized AI coach for longevity.”
And while Rosita’s coaching is currently only available in Spanish — with the team having recorded “hundreds” of videos so far for different levels and chronic pathologies — the aim is to scale up in Europe (and perhaps beyond), starting with the U.K. market. Which makes English the next natural language for them to build out content.