In a recent episode of “The Heart of Innovation,” Emmy Award-winning journalist Kym McNicholas and interventional cardiologist Dr. John Phillips welcomed James Maskell, co-founder of Truneura, to discuss groundbreaking approaches to Alzheimer’s and dementia treatment. Their conversation revealed the critical connection between vascular health and brain function while exploring how personalized medicine is creating new possibilities for those experiencing cognitive decline.
A Personal Journey Leads to Innovation
For James Maskell, the mission to transform cognitive health treatment began with a deeply personal experience. In December 2023, Maskell received an urgent message that his father in South Africa had suffered a catastrophic health event. Upon arriving, he found his father barely responsive, with doctors preparing the family for his death.
Based on advice from Dr. Kristine Burke, who suggested that such rapid cognitive decline is often triggered by infection or environmental toxins, Maskell investigated his father’s living conditions. He discovered extensive black mold throughout his father’s apartment, which had developed during an unusually wet spring in Cape Town.
Despite medical professionals dismissing the possibility of mold as the cause, Maskell arranged to move his father to a clean environment by the ocean. Remarkably, his father began to recover within days. Six months later, while still requiring care due to muscle loss, his father’s cognitive function had improved dramatically—he was reading several books weekly and communicating normally.
This experience led Maskell to partner with Dr. Burke to found Truneura, with a mission to help physicians identify the various drivers of cognitive decline and determine which factors are affecting each individual patient.
Beyond Beta-Amyloid: A New Understanding of Alzheimer’s
One of the most enlightening aspects of the interview was Maskell’s explanation of how Alzheimer’s research has been hampered by focusing predominantly on beta-amyloid plaques. As he explained: “For the last 20 years, all of the Alzheimer’s research has been based on a faulty hypothesis… The end point that has been solely focused on has been the beta amyloid plaque.”
Recent developments have revealed that beta-amyloid is not the cause of Alzheimer’s but rather a cofactor occurring alongside other processes. This realization has opened the door to more comprehensive approaches that consider multiple potential drivers of cognitive decline.
The Six Drivers of Cognitive Decline
According to Truneura’s research and clinical experience, cognitive decline can be attributed to six primary categories:
Metabolic inflammation - Issues with blood sugar regulation and liver function
Nutrients and mitochondrial function - Energy production and cell integrity problems
Hormonal and trophic factors - Thyroid, sex hormones, BDNF, and muscle mass issues
Cardiovascular factors - Blood vessel health, vascular inflammation, lipids, and kidney function
Biome and biotoxins - Chronic infections, mold, and mycotoxins
Chemical toxins - Environmental pollutants, pesticides, and other chemicals
What makes Truneura’s approach revolutionary is their development of software that helps physicians efficiently analyze hundreds of biomarkers across these categories. Their system scores each biomarker on a scale of 0-100, enabling doctors to quickly identify which factors are most significantly contributing to a patient’s cognitive decline.
The Vascular Connection to Brain Health
A particularly fascinating aspect of the interview was the discussion of how vascular health directly impacts brain function. Dr. Burke, who was originally a vascular specialist before turning her attention to cognitive health, recognized that the blood-brain barrier is vascular tissue.
As Maskell explained: “She started to realize as the new science started to come out that the blood-brain barrier is actually vascular tissue… being a vascular specialist is extremely helpful for the brain because it’s really just one barrier.”
This connection underscores why individuals with cardiovascular and peripheral artery disease should be particularly vigilant about cognitive health. The same processes that damage blood vessels throughout the body can compromise the critical barrier protecting the brain.
Prevention: Starting Decades Before Symptoms Appear
Perhaps most alarming was Maskell’s revelation that “the research shows that the underlying pathology that leads to cognitive decline can start 30 years before you have symptoms.” This timeline emphasizes the importance of early detection and intervention, even for those in their 40s who show no signs of cognitive issues.
Newer testing options, such as the blood-based biomarker PTAU217, now make it possible to determine how far along someone might be on the journey toward developing dementia, providing opportunities for earlier intervention.
Hope Through Personalized Approaches
What sets Truneura’s approach apart is the focus on creating personalized treatment plans based on each individual’s specific drivers of cognitive decline. This precision medicine approach has shown remarkable results, with Dr. Burke’s practice documenting significant improvements in cognitive function—enough for some patients to regain their driver’s licenses.
As Maskell noted, traditional treatments for Alzheimer’s only slow the progression of decline, while precision medicine approaches have demonstrated the ability to actually reverse some cognitive impairment.
Moving Forward: The Alzheimer’s Summit
For those interested in learning more about these innovative approaches to cognitive health, the Alzheimer’s Summit (available at drtalks.com/summit/alzheimers) will feature 30 leaders in the field discussing everything from lifestyle interventions to addressing the root causes of cognitive decline.
The summit aims to provide attendees with practical, actionable information they can use to protect their brain health and support loved ones dealing with cognitive issues.
A New Era of Hope
The conversation with James Maskell highlighted that we’re entering a new era in the understanding and treatment of cognitive decline. By moving beyond single-factor explanations and embracing a comprehensive approach that considers multiple potential drivers, personalized medicine offers new hope for preventing, slowing, and even reversing cognitive decline.
For those concerned about brain health—whether for themselves or loved ones—this interview underscores the importance of comprehensive testing, early intervention, and working with practitioners who understand the complex interplay of factors that can impact cognitive function.
As our population ages, these innovative approaches to cognitive health will become increasingly vital in addressing one of our most significant health challenges.
Watch the full interview with James Maskell above to learn more about Truneura’s revolutionary approach to cognitive health.
