- Longevity is all about extending lifespan and increasing the number of healthy years we enjoy – but how can we do that without measuring and quantifying aging, without intervening in a precise and timely fashion and without designing personalised preventative and therapeutic measures?
- Tackling aging must be both forensic and strategic, and this means arming ourselves with as much detailed information as possible; we need to understand aging organ-by-organ, person-by-person. We need to evaluate what aging pathway an individual is on and how best that can be affected.
- Longevity diagnostics offer solutions to all of these points, and are key to effecting real change in millions of lives.
As your chronological age creeps higher by the year, you may feel it is the best way to gauge healthy life left to live. But no two 68-year-olds are the same; one might be a marathon runner whilst the other smokes twenty a day.
Although an extreme comparison, it is clear from this scenario that ‘biological age’ – a reflection of how fast one is aging – is a better metric for morbidity risk than chronological age.
Research is revealing that not only do people age at different rates, but it could be that each of the organs and tissues within the body do to.
The aim of longevity diagnostics is to detect minimal fluctuations in biomarkers of aging and, in doing so, provide a more accurate representation of the health of the body.
By tracking damage that is happening intrinsically within our bodies as we age, longevity diagnostics have the potential to promote a healthier aging process.
Longevity diagnostics are hot for three reasons:
- If clinically validated, those that can give an accurate representation of biological age could provide high resolution insights that healthcare systems can use to optimize therapeutic interventions and lifestyle habits.
- Longevity diagnostics could have a central role in the longevity industry and could become a primary metric in geroscience, regenerative medicine, AgeTech, and personalised medicine. They could also serve as a major channel for the implementation of AI within the longevity industry, translational research, drug discovery and development, and clinical trials.
- Most longevity diagnostics make commercial sense even without the tick of an FDA clinical approval due to the increasing size of the wellness market, set to reach $7 trillion by 2025, according to the Global Wellness Institute.
The use of longevity diagnostics within clinical trials will lead to better interpretation and enhanced standardisation of clinical trial results, personalized application of longevity therapeutics, and therefore increased efficacy and accelerated clinical validation.
This paradigm has unlimited potential because of the enormous flow of biological data that can be continuously extracted for everyone, to inform protocols for personalized lifestyle change, appropriate drugs, and other therapeutic interventions.
The CEO of Deep Longevity, Alex Zhavoronkov, stated, “we are standing before the inflection point. If you think about the internet or personal computer or the iPhone or Facebook, these exponential technologies that took over the world – with respect to PCs we are currently in the 60s, if you compare us to the internet, you are probably in the late 80s…” (Longevity blog, 2020).
Currently, the primary target market for longevity diagnostics is the wellness industry. Worldwide, the health and wellness industry generate 5.3% of global economic output. As of 2019, the global health and wellness market was estimated at over 4.4 trillion U.S. dollars. This figure is expected to increase to over six trillion U.S. dollars by 2025 (Gough, 2021). Such large growth in the market in a relatively short time is supported by increasing consumer interest. Companies at the forefront of creating novel diagnostic tools are likely to benefit within this highly attractive market sector.
Longevity diagnostics have raised $2.2 billion in total capital to date (estimate based on data provided by Pitchbook Inc.) Interestingly, there was a lot of activity in 2021 for longevity diagnostics, corresponding to 39% of total funding to date. This interest could have been spurred by health awareness during the COVID-19 pandemic and it will be interesting to see how 2022 fares in comparison.
Longevity Diagnostic companies venture capital investment ($M). Analysis by Longevity.Technology, according to Pitchbook funding data as of 29 June 2022, based on 50 companies.
Longevity Diagnostic companies yearly deal count. Analysis by Longevity.Technology, according to Pitchbook funding data as of 29 June 2022, based on 50 companies.
Investment by location
The bulk of the longevity diagnostics market is concentrated in developed countries, with the United States (53%) and the United Kingdom (35%) dominating the market. These countries offer improved investment environment, infrastructure, and legal systems for Biological age diagnostic companies, as well as clusters of research units and staff that specialize in geroscience. In the US, there is also a concentration of aging clock and biomarker/biomarker panel biological age tests being developed.
Number of Longevity Diagnostic Companies by region. Analysis by Longevity.Technology, according to Pitchbook funding data as of 29 June 2022, based on 50 companies.
Types of longevity diagnostics
Longevity Diagnostic Companies by Category. Analysis by Longevity.Technology, according to Longevity.Technology data as of of 29 June 2022, based on 50 companies.
There are three main categories that are forming in longevity diagnostics.
- Biological age tests: Researchers are now developing tools to accurately interpret biomarkers of aging known as “deep aging clocks” for applications in personalised medicine. These methods translate various interpretations of biological age based on the measurement of a single molecular process or “-omics” signature that changes in a specific, predictable pattern with age.
- Health assessments: These are assessments of the general health of the body based on biomarkers or biomarker panels. Many companies in this area provide an assessment of health derived from the results of genetic, microbiome, or aging biomarker testing and then present forward advice based on the results to aid healthier aging.
- Digital health assessments: This is a new type of preventative health diagnostic, which is making headway due to the convergence of information technology with the abundance of data collected through either healthcare systems or at-home testing and health devices. The aim of digital diagnostics can either be to offer a more holistic picture of the patient in a healthcare setting, or to enable consumers to have a more holistic picture of their health and aging trajectory at home.
Traditionally, longevity diagnostics were mostly based on health assessments, however, there was a huge increase in biological age diagnostic company start-ups post 2013, following publication of Steve Horvath’s ground-breaking paper on his epigenetic clock that could address many fundamental health questions in developmental biology, cancer and aging research.
There are several factors that influence the ultimate efficacy of a longevity diagnostic including the nature of the biomarker of aging measured, big data used to develop the tool, the aspects of aging it captures and in which tissues, ease of use, cost, among other factors.
In regard to big data, diagnostic tools that are trained solely on predicting chronological age are inferior to those technologies that are trained on risk factors, morbidity, and mortality data.
The longevity diagnostics’ market is wide open as each technology has its own strengths and weaknesses. Current strategies to assess systemic biological age carry significant limitations as individual parameters to accurately reflect organismal aging that can be reliably applied on an individual level has proven elusive.
As a wellness device
Recent research by McKinsey & Company revealed that consumers care about their wellness. In their recent survey of 7,500 consumers across Brazil, China, Germany, Japan, the United Kingdom, and the United States, 79% said wellness was important to them and 42% said it is their top priority (Callaghan, 2021). This point is further supported by the increasing popularity and usage of wearable devices such as fitness bands and watches, that allow people to monitor their health (GlobalNewsWire, 2021).
As a clinically validated diagnostic test
Better diagnostic tools could offset the increasing demand faced by the healthcare industry because of increasing aging populations. Longevity diagnostics look at early-stage damage that occurs in the body that results in age-related disease at an older age. If Longevity diagnostics can become validated diagnostics of these end diseases, or even predictions of onset of morbidity, they could provide cost-effective solutions and allow better health predictions and detection of disease at a much earlier stage (Liu, 2017).
Other target markets for Biological Age diagnostics include Longevity clinics and life and health insurance companies.
Venture capital has tended to approach diagnostic companies with caution, in part because their development does not follow the same, more predictable, pathway of pharmaceuticals.
Clinical diagnostics have been described as too capital intensive, too slow to commercialise, consequently generating lower returns. However, in the period 2014-2017, money invested in clinical diagnostics increased significantly and startups in this area soared.
This was mostly due to the development and promise of Next Generation Sequencing (NGS), which can decipher huge amounts of biological information quickly and cheaply. This meant improved returns on investment for NGS companies and, of a dozen well-funded NGS companies, seven exited and returned, on average, 4.4 times invested capital within seven years (Winter, 2017).
We believe that venture investors should take a good look at the longevity diagnostics area, which could follow a similar pattern to NGS tests. NGS tests presented a wealth of knowledge as a diagnostic to many inherited disease areas, such as cancer predisposition and prenatal knowledge of chromosome abnormalities.
Longevity diagnostics could promise a similar wealth of knowledge of the diseases of aging. Investment at this point in the longevity diagnostics market, especially those focused on biological age diagnostics, currently still offers relatively early-stage exposure to an exciting, opportunity-rich sector, which has potential to influence every aspect of humanity’s health and wellness, and to offer transformational returns from expected exponential growth.