Back Clinic Nerve Injury Team. Nerves are fragile and can be damaged by pressure, stretching, or cutting. Injury to a nerve can stop signals to and from the brain, causing muscles not to work properly and losing feeling in the injured area. The nervous system manages a great majority of the body’s functions, from regulating an individual’s breathing to controlling their muscles as well as sensing heat and cold. But, when trauma from an injury or an underlying condition causes nerve injury, an individual’s quality of life may be greatly affected. Dr. Alex Jimenez explains various concepts through his collection of archives revolving around the types of injuries and condition which can cause nerve complications as well as discuss the different form of treatments and solutions to ease nerve pain and restore the individual’s quality of life.
The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Do you have difficulty concentrating before eating a meal? Do you experience fatigue after meals? Do you feel as if you’re not getting enough rest or sleep? Do you have noticeable variations in mental speed? If so, you may have brain fog. �
What is Brain Fog?
Brain fog is a health issue that can occur due to a variety of factors. You may struggle to focus on everyday tasks, conversations, or even on the words you�re currently reading. You may also have difficulty making choices where minimal decisions can be overwhelming, you may need coffee to concentrate or snacks to stay awake and even alcohol at night to temporarily relieve the brain fog. In severe instances, you may also have headaches, vision problems, and nausea. �
What Causes Brain Fog?
Brain fog is a symptom rather than a single health issue. It can occur due to nutrient deficiency, bacterial overgrowth from consuming too much sugar, sleep disorder, depression, or even due to thyroid problems. Other common causes of brain fog can ultimately include eating too much and too often, lack of exercise or physical activity, not getting enough rest or sleep, chronic stress, and a poor diet. Below, we will discuss several of the most common causes of brain fog and brain health issues. �
Hormonal Changes
Hormonal changes, frequently caused when our body is producing too much or too little of a specific hormone, is a well-known cause of brain fog. Hormone imbalances due to thyroid health issues are associated with brain fog. This is especially true with Hashimoto�s thyroiditis, an autoimmune disease where the immune system attacks the thyroid as well as causes inflammation and affects the production of enough thyroid hormones. Low thyroid hormone production or hypothyroidism can cause decreased cognitive function and low blood sugar or glucose levels that can ultimately lead to brain fog. �
Lack of Rest or Sleep
Poor sleeping hygiene, such as an irregular sleep and wake time, getting less than seven to eight hours of sleep a night, or blue light exposure before bed, can interrupt our natural circadian rhythm or our internal body clock. This can cause brain fog in a variety of ways. In the instance of blue light exposure close to bedtime, the blue wavelengths can decrease the production of the hormone melatonin, which is essential for deep REM sleep. Both REM and non-REM sleep is necessary for optimal brain function. From 10 pm to 2 am, our body and brain detoxify the most, therefore, staying in an active state throughout this time period can ultimately interrupt our body and brain’s natural detoxification process, which can also cause brain fog. �
Nutritional Deficiencies and Food Sensitivities
Vitamin B12 contributes to the production of red blood cells as well as the maintenance of the central nervous system. A vitamin B12 deficiency can affect your energy levels and cause an overall feeling of fatigue. A vitamin D deficiency can also cause brain fog as decreased vitamin D levels are associated with impaired cognitive function. An unidentified food sensitivity can also contribute to brain fog. By way of instance, gluten sensitivities can ultimately lead to cognitive dysfunction through inflammatory pathways. Advanced blood work that analyzes nutrient levels, as well as an elimination diet or a food allergy/sensitivity test, can help determine if any of these could be contributing to your brain fog. �
How to Naturally Improve Brain Fog
Do Intermittent Fasting
Intermittent fasting can help improve brain fog. Not only can it help you lose weight, calorie restriction and going long periods of time between meals can also help promote brain health and reduce the risk of neurological diseases. Start by trying to extend the time between the last meal of the day and the first meal of the next day. Ideally, intermittent fasting requires you go 12 hours between eating the last meal of the day and the first meal of the next day. This promotes a process called ketogenesis, which can stimulate brain regeneration.� Intermittent fasting should ultimately be practiced after following the guidance of a healthcare professional, such as a health coach, who understands intermittent fasting. �
Participate in Exercise or Physical Activity
Neurological diseases, such as Alzheimer�s disease, dementia, and even moderate cognitive dysfunction, are more common in sedentary populations. Increased activity levels have been associated with sharper mental acuity, better memory, and positive mood changes. Exercise and physical activity cause the release of substances known as cytokines as well as chemicals known as endorphins. These substances and chemicals ultimately improve brain health and function. Try to engage in exercise or physical activity every day. Walking, running, or even dancing can help improve brain fog and boost your mood. �
Rest More and Sleep Better
The most common mistake people make, whether it involves dealing with school, work, or whatever looming project deadline, is that they try to maximize their time by staying up late and/or getting up early. However, this generally backfires because cognitive abilities decrease with sleep deprivation. Rest and sleep at least seven hours a night, preferably eight or even nine if possible. Your efficiency will increase while the time it takes to create quality work will likely decrease. �
Reduce Stress
Stress can cause a variety of symptoms, including brain fog. To reduce stress, you also need to learn how to flex your parasympathetic nervous system, which is engaged during rest and relaxation as well as helps to calm your body and your mind. You can help reduce stress by incorporating more meditation and yoga into your daily workout routine. �
Feed your Brain
The human brain is made up of a lot of fat and protein. Too much sugar and frozen as well as fried or processed foods are not ideally nourishing for our brain. You can follow a plant-based Paleo diet, consisting mostly of vegetables, protein, and good fats. Also, make sure to get plenty of omega-3 fatty acids, for their anti-inflammatory powers, lots of antioxidants and coenzyme Q10, essential for energy, and boost your body�s energy and regeneration with essential vitamins and minerals. �
Brain fog can make people feel as if they’re not able to focus or concentrate accordingly and it’s often accompanied by fatigue and other well-known symptoms. While brain fog is a symptoms rather than a single health issue, it can have a variety of causes, from hormonal changes to lack of rest and sleep to nutritional deficiencies or food sensitivities. Fortunately, there are several steps to help naturally improve brain fog symptoms and promote overall brain health and wellness. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
Neurotransmitter Assessment Form
The following Neurotransmitter Assessment Form can be filled out and presented to Dr. Alex Jimenez. Symptoms listed on this form are not intended to be utilized as a diagnosis of any type of disease, condition, or any other type of health issue. �
In honor of Governor Abbott’s proclamation, October is Chiropractic Health Month. Learn more about the proposal. �
Do you have difficulty concentrating? Do you experience fatigue after meals? Do you feel as if you’re not getting enough rest or sleep? Do you have noticeable variations in mental speed? As previously mentioned above, you may have brain fog. � The scope of our information is limited to chiropractic, musculoskeletal and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900 . �
Curated by Dr. Alex Jimenez �
Additional Topic Discussion: Chronic Pain
Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance.
Neural Zoomer Plus for Neurological Disease
Dr. Alex Jimenez utilizes a series of tests to help evaluate neurological diseases. The Neural ZoomerTM Plus is an array of neurological autoantibodies which offers specific antibody-to-antigen recognition. The Vibrant Neural ZoomerTM Plus is designed to assess an individual�s reactivity to 48 neurological antigens with connections to a variety of neurologically related diseases. The Vibrant Neural ZoomerTM Plus aims to reduce neurological conditions by empowering patients and physicians with a vital resource for early risk detection and an enhanced focus on personalized primary prevention. �
Formulas for Methylation Support
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.
�
For your convenience and review of the XYMOGEN products please review the following link. *XYMOGEN-Catalog-Download �
* All of the above XYMOGEN policies remain strictly in force.
Do you have low brain endurance when it comes to focus and concentration? Do you often feel like you must drink coffee or exercise to improve brain function? Have you been experiencing noticeable variation in your mental speed? How often do you pick up your smartphone and forget why? Many women commonly struggle to remember everyday tasks throughout their 40’s and 50’s. Research studies have determined that menopause is a prevalent cause of brain fog in women. �
What is Menopause Brain Fog?
Many women between the ages of 40 and 50 may be going through menopause or the end of their menstrual cycles.� Symptoms may vary for every woman and these can range from thinning hair to weight gain to night sweats. Many other women may also have general forgetfulness or �brain fog� which can ultimately make it hard for them to concentrate. �
During one research study, healthcare professionals found that about 60 percent of middle-aged women had trouble focusing or concentrating and other health issues associated with cognitive problems. These health issues increased in women going through perimenopause. Perimenopause is the stage before the menstrual cycle stops entirely. �
The women in the research study also reported experiencing subtle changes in memory but researchers believe that a �negative effect� may have worsened these symptoms. The researchers also found that women going through menopause generally experience negative changes in mood and other memory problems. Moreover, the research study found that brain fog may also be associated with sleep issues and other vascular symptoms associated with menopause like hot flashes. �
Another research study also found that women in the early stages of menopause may experience more noticeable cognition problems. Women during the first year of their last menstrual period scored the lowest on tests evaluating: �
attention
memory
verbal learning
working memory tasks
motor function
Memory for the women improved over time, which is the opposite of what the researchers had initially hypothesized. � Furthermore, healthcare professionals believe that midlife brain fog in women may be associated with hormonal changes. �
Estrogen, progesterone, follicle-stimulating hormone, and luteinizing hormone, are all responsible for different processes in the human body, including brain function. Perimenopause lasts an average of 4 years, during which time the hormone levels may ultimately fluctuate wildly and cause a variety of symptoms as the mind and the body adjust to these hormonal changes. �
Brain Fog and Alzheimer’s Disease in Women
Memory problems during menopause can be completely normal. You may forget where you placed your smartphone or you may have trouble remembering an old coworker’s name. However, if your cognitive problems begin to negatively affect your everyday life, it may be best for you to see your healthcare professional immediately to receive a proper diagnosis. �
Dementia is another well-known health issue that may also cause brain fog. Alzheimer�s disease is the most prevalent cause of dementia in older women. It generally starts with trouble remembering things as well as difficulty organizing thoughts. Unlike the brain fog associated with menopause, Alzheimer�s disease is a health issue that progressively worsens over time. �
Other common symptoms associated with Alzheimer�s disease and dementia include: �
trouble finding the right words to identify different objects
repeating questions or statements over and over
difficulty making decisions
difficulty performing daily tasks
changes in mood, personality, or behavior
getting lost, even in familiar places
Menopause Brain Fog Treatment
Menopause brain fog may be moderate and may go away on its own over time. Severe memory health issues may cause you to neglect your personal hygiene, forget the name of familiar objects, or even have difficulty following directions. �
Once your healthcare professional has ruled out other health issues like dementia and Alzheimer’s disease, you may explore menopausal hormone therapy (MHT). This treatment involves taking low-dose estrogen or a combination of estrogen and progestin. These hormones may help with other symptoms you may experience during menopause, not just memory loss. �
According to healthcare professionals, however, long-term use of estrogen may increase the risk of breast cancer, cardiovascular disease, and other health issues. Speak with your doctor to see if this type of treatment is right for you. �
Menopause Brain Fog Prevention
While you may not be able to prevent the brain fog associated with menopause, there are several lifestyle modifications you can do to help you ease into your symptoms as well as to help improve your memory and overall health and wellness. �
Eat a Balanced Diet
A balanced diet that�s rich in low-density lipoprotein (LDL) cholesterol and fat may be bad for both your brain and your heart. Instead, try a balanced diet that’s rich in whole foods and healthy fats. The Mediterranean diet, by way of instance, may help with brain health because it�s rich in omega-3 fatty acids and other unsaturated fats. Good food choices include: �
fresh fruits and vegetables
whole grains
beans and nuts
olive oil
fish
Exercise the Body
Getting regular exercise and/or physical activity is recommended for all people, including women going through menopause. Researchers and healthcare professionals believe that exercise may even help with brain fog and other memory problems. �
Get Enough Sleep
Your quality of sleep may affect brain fog. With sleep problems high on the list of symptoms associated with menopause, getting enough sleep can be a tall order. As a matter of fact, 61 percent of postmenopausal women report having insomnia. �
According to research studies, hormonal changes in women going through menopause can cause brain fog and other memory health issues. However, these memory as well as cognition problems associated with hormonal changes and menopause, may ultimately improve on their own over time. Several treatment and prevention options can help ease menopause brain fog. If brain fog symptoms become worse, a doctor can help rule out other health issues like Alzheimer’s disease and dementia, among others. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
Neurotransmitter Assessment Form
The following Neurotransmitter Assessment Form can be filled out and presented to Dr. Alex Jimenez. Symptoms listed on this form are not intended to be utilized as a diagnosis of any type of disease, condition, or any other type of health issue. �
In honor of Governor Abbott’s proclamation, October is Chiropractic Health Month. Learn more about the proposal. �
Do you have low brain endurance when it comes to focus and concentration? Do you often feel like you must drink coffee or exercise to improve brain function? Have you been experiencing noticeable variation in your mental speed? How often do you pick up your smartphone and forget why? Many women commonly struggle to remember everyday tasks throughout their 40’s and 50’s. Research studies have determined that menopause is a prevalent cause of brain fog in women. �
The scope of our information is limited to chiropractic, musculoskeletal and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900 . �
Curated by Dr. Alex Jimenez �
Additional Topic Discussion: Chronic Pain
Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance.
Neural Zoomer Plus for Neurological Disease
Dr. Alex Jimenez utilizes a series of tests to help evaluate neurological diseases. The Neural ZoomerTM Plus is an array of neurological autoantibodies which offers specific antibody-to-antigen recognition. The Vibrant Neural ZoomerTM Plus is designed to assess an individual�s reactivity to 48 neurological antigens with connections to a variety of neurologically related diseases. The Vibrant Neural ZoomerTM Plus aims to reduce neurological conditions by empowering patients and physicians with a vital resource for early risk detection and an enhanced focus on personalized primary prevention. �
Formulas for Methylation Support
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.
�
For your convenience and review of the XYMOGEN products please review the following link. *XYMOGEN-Catalog-Download �
* All of the above XYMOGEN policies remain strictly in force.
Do you have low brain endurance when it comes to focus and concentration? Do you often feel like you must drink coffee or exercise to improve brain function? Have you been experiencing noticeable variation in your mental speed? How often do you pick up your smartphone and forget why? Many women commonly struggle to remember everyday tasks throughout their 40’s and 50’s. Research studies have determined one prevalent cause for midlife brain fog in women: hormones. �
What is Brain Fog?
Brain fog is a health issue associated with feelings of confusion and disorientation. It can make a person feel as if they’re not thinking, understanding, and remembering things as they should. Other terms utilized to describe brain fog include memory fog, forgetfulness, fogginess, and cognitive or cognition issues. People with brain fog frequently forget names they used to know, lack the ability to remember things without writing them down, and they may not feel as sharp as they used to be. �
One research study that began analyzing women at age 35 demonstrated that many women report forgetfulness and concentration problems throughout their menopausal transition. Healthcare professionals can help regulate this process for women who are transitioning into menopause as well as allow them to know how women�s brains can be sensitive to fluctuating levels of estrogen for mood and cognitive ability. Hormones also play an important role in midlife brain fog. �
Brain Fog and Hormones
During an interview with Dr. Marcie Richardson, Women Living Better (WLB) advisor, she states, �there’s a lot of research studies which haven’t proven a definitive connection between brain fog and changing hormones, however, we do know that there are estrogen receptors found in the human brain”. She adds, “but, there is very clear scientific evidence for sleep affecting cognitive function, so if you are dealing with disrupted sleep, it is likely contributing to your cognitive problems�. �
The December 2018 New York Times article by Jane Brody cited a 2010 research study that followed women for 6-years to see whether her anxiety, depression, sleeping problems, and vasomotor symptoms, were the cause of a decline in her cognitive function right before menopause or in late perimenopause. However, it concluded these were not the causes. �
Brain Fog Remedies to Consider
It�s essential to keep in mind that research studies demonstrate that women can begin to experience brain fog early in the menopausal transition which will then resolve on its own. Many women worry that their brain fog may be a sign or symptom of dementia and Alzheimer’s disease, but these have not been associated with each other in research studies to date. While there aren�t any definitive treatments for brain fog, there are several natural remedies or coping techniques available, such as recognizing the symptom, utilizing tools like notes to self, setting alarms for reminders as well as acknowledging and accepting when a name doesn�t come back to you right away, generally when you are no longer feeling stressed out about it. Keep in mind that disrupted sleep, which comes with hormonal changes for many women, can also contribute to brain fog. �
According to Research Studies
A sample of several recent research studies associated with midlife brain fog and cognition problems in adult women has been demonstrated below. As you can see, it�s inconclusive. The research study on midlife brain fog in women suggests that: �
Many types of problems with memory are associated with lower ratings of health and depressed mood. Problems with current memory and remembering past events are associated with higher levels of reported stress, which many women commonly attribute to the increased burden of having to meet multiple role demands, among other demands.
Women in the earliest and middle stages of perimenopause, as well as those who utilize hormones, have more problems associated with memory than the previously mentioned women in late-stage menopause or perimenopause.
About 72 percent of women reported problems remembering names at least some of the time. About 50 percent have a problem remembering where they put things, recent phone numbers, things others told them or they told others, keeping up a correspondence and forgetting what they were doing. None of these are considered a serious problem.
Another research study, from 2009, concluded that �consistent with transitioning women�s perceived memory difficulties, perimenopause was associated with a decrement in cognitive performance, characterized by women not being able to learn as well as they had throughout premenopause. Improvement rebounded to premenopausal levels in postmenopause, suggesting that menopause transition-related cognitive difficulties may be time-limited, according to the research study�. �
A recent meta-analysis set out to �synthesize the existing research studies of the relationship between menopausal stage and neuropsychological performance and depression�. However, it concluded that although �the menopausal transition is a time of increased vulnerability for cognitive decline and increased risk of depressive symptoms and depressive disorders, these results from the research studies looked at can’t necessarily be generalized�. Although it�s reassuring that there was no documentable cognition decline across research studies, the weakness in these research studies is that cognition decline is generally measured as the ability to complete a test in an experimental setting, a setting with one focus and no interruptions. �
The research study doesn�t accurately emulate real-life settings or measure the type of forgetfulness midlife women report. � A fourth research study also found that cognitive function does not change linearly across perimenopause. Decreases in attention/working memory, verbal learning, verbal memory, and fine motor speed may be most evident in the first year after the final menstrual period, according to the research study. Further research studies are required to determine the association between midlife brain fog and hormone changes in perimenopause and menopause in adult women. �
Symptoms for menopause for women in their 40’s or 50’s are different for each woman, and these can commonly include anything from night sweats to weight gain to thinning hair. However, many women have also reported feeling symptoms of brain fog. According to research studies, hormonal changes in women going through menopause or perimenopause can cause brain fog. However, further research studies are required to demonstrate how hormones can ultimately cause brain fog and other mental health issues. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
Neurotransmitter Assessment Form
The following Neurotransmitter Assessment Form can be filled out and presented to Dr. Alex Jimenez. Symptoms listed on this form are not intended to be utilized as a diagnosis of any type of disease, condition, or any other type of health issue. �
In honor of Governor Abbott’s proclamation, October is Chiropractic Health Month. Learn more about the proposal. �
Do you have low brain endurance when it comes to focus and concentration? Do you often feel like you must drink coffee or exercise to improve brain function? Have you been experiencing noticeable variation in your mental speed? How often do you pick up your smartphone and forget why? Many women commonly struggle to remember everyday tasks throughout their 40’s and 50’s. Research studies have determined one prevalent cause for midlife brain fog in women: hormones. �
The scope of our information is limited to chiropractic, musculoskeletal and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900 . �
Curated by Dr. Alex Jimenez �
Additional Topic Discussion: Chronic Pain
Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance.
Neural Zoomer Plus for Neurological Disease
�
Dr. Alex Jimenez utilizes a series of tests to help evaluate neurological diseases. The Neural ZoomerTM Plus is an array of neurological autoantibodies which offers specific antibody-to-antigen recognition. The Vibrant Neural ZoomerTM Plus is designed to assess an individual�s reactivity to 48 neurological antigens with connections to a variety of neurologically related diseases. The Vibrant Neural ZoomerTM Plus aims to reduce neurological conditions by empowering patients and physicians with a vital resource for early risk detection and an enhanced focus on personalized primary prevention. �
Formulas for Methylation Support
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.
�
For your convenience and review of the XYMOGEN products please review the following link.*XYMOGEN-Catalog-Download �
* All of the above XYMOGEN policies remain strictly in force.
How often do you have a hard time remembering your appointments? Has it become harder for you to learn new things? How often do you feel you have something that must be done? Or even, how often do you feel more susceptible to pain? If it is your very first time experiencing what is commonly referred to as midlife brain fog, which involves a ditsy episode of forgetfulness, it could be frightening, especially knowing that psychological decline is mostly inevitable with age. �
Research studies reveal that the human brain begins to noticeably slow down from the time we hit 40, and around 17 percent of individuals over 65 will wind up with some type of moderate cognitive impairment, like intermittent problems concentrating, locating the proper term, focusing, or even recalling where they have set their car keys, among others. �
Stress is very prevalent in our middle age, also and the reality is that between 6 to 15 percent of people that fulfill the standards for “moderate cognitive impairment” will often go on to develop dementia and Alzheimer’s disease. However, this problem does not need to occur. New research studies indicate that brain fog can ultimately be managed accordingly. �
The brain is based on an intricate variety of compounds to maintain mood in check and also to operate correctly, but should you disturb that equilibrium, you can quickly experience mood changes, not able to sleep, and also struggle to focus properly. Moreover, if you’re eating the incorrect foods, getting inadequate sleep or exercise, overindulging in social networking and TV, stress, and too small downtime, then you will almost surely be destabilizing essential human brain compounds. �
However, you can reverse those trends and take control of your brain health in as little as two weeks if you eliminate the blocks that keep you stuck and give your mind the substances it needs to function efficiently. The purpose of the following article is to show what you can do to prevent and avoid midlife brain fog as well as improve overall health and wellness. �
BOOST BRAIN FATS
A fantastic source of healthy fats in your daily diet may help you feel better. Enjoy lots of olive oil, which is packed with anti-inflammatory chemicals, found in some research studies to help prevent Alzheimer’s disease and depression, as well as fatty fish and select organic meat. Research studies reveal that half a year of nutritional supplements is sufficient to enhance brain function. Also, make sure to pick extra virgin olive oil for salad dressings and olive oil for cooking, virgin olive oil is not safe at high temperatures. Avoid soybean oil because it is packed with unsaturated omega-6 fats which may not be so beneficial. �
AVOID SWEETENERS
Artificial sweeteners may be saving you a couple of calories but it is impossible that these aren’t giving your brain the nutrients it requires for optimum performance. Your mind requires a source of blood glucose to keep it functioning and it is deprived by artificial sweeteners. Worse, sweeteners are demonstrated to interrupt the degree of good bacteria in the intestine, so disrupting the creation of the happy hormone serotonin, a lot of which is fabricated in the gastrointestinal tract. �
TURN OFF YOUR PHONE
Scaling down on social media usage and electronic equipment will help reduce midlife brain fog. All of those lights, dings, and advertisements scrolling across the display give our brains a very small bit of dopamine, as it would for a compulsive gambler sitting in front of a slot machine. Switch off your phone or its own ringer as frequently as possible and do not leave it charging on your bedroom so that it does not disturb your sleeping, even subconsciously. Aim to have just one day of the weekend free. Dump the Kindle through the night and read novels instead. Cut back multitasking, concentrate on doing one thing at a time and provide that all of your attention. This may be a potent antidote to the onslaught of distractions of networking. �
SWITCH OFF THE TV
Engaging in leisure activities helps stimulate the mind. Research studies demonstrate that studying, playing board games and musical instruments, dance, traveling, knitting, and gardening reduce the risk of cognitive decline and guard you against midlife brain fog. But TV does exactly the contrary. Furthermore, research studies reveal that watching TV raises your risk of cognitive impairment up to 20 percent, whereas studying reduces it by 5 percent, according to the same research study. �
SPICE IT ALL UP
Turmeric includes a plant chemical called curcumin, which has significant anti-inflammatory and antioxidant properties and raises levels of a protein named BDNF (brain-derived neurotrophic factor) that is dubbed the “Miracle-Gro” for the mind. Along with making you feel better, turmeric will make you think better by increasing dopamine within the brain. �
Research studies demonstrate that for combating Alzheimer’s disease, low doses of garlic on lengthy periods of time are somewhat more powerful than very substantial doses. So instead of relying upon an occasional Indian takeaway to the turmeric fix, the goal should be to consume 1 food containing garlic using a grind of fresh black pepper (making the garlic more readily absorbed by your system ) daily. Put in a teaspoon of garlic into stews, soups and salad dressings. �
Saffron, yet another frequent ingredient in curry, may also inhibit Alzheimer’s disease, as well as the carnosic acid from the frequent herb rosemary, which can also boost your brain health (the odor alone can even help enhance memory) while rosemary was demonstrated to boost your ability to recall information. Spicing it all up can ultimately help brain fog. �
GO TO BED EARLY
In addition to fostering learning, disposition, and imagination, sleep serves as the brain “self-cleaning” cycle to stop brain fog and eliminate the plaques involving nerve cells which lead to Alzheimer’s disease. A fantastic night’s sleep may improve alertness and fortify the brain’s links, assisting you to combine the memories that you encoded during daily. Poor sleep leads to elevated levels of stress hormones, like cortisol, and enhances dopamine levels, which makes you unhappy, unmotivated and unfocused. Do anything you can to get up to eight hours of sleep each night and keep it continued throughout the week. �
ENJOY COFFEE
Contemplate drinking coffee (without sugar or milk), a healthy food that may help protect against cognitive decline and protect against depression and dementia. Drink espresso macchiato (black coffee with somewhat foamed milk) or espresso over ice with a dash of soy milk. Both without amounts under 50 calories. You can enjoy up to three cups every day. �
Is inflammation the final trip wire for Alzheimer’s disease?� Neuroinflammation is considered to be the final epigenetic trip wire for the genetic predisposition of Alzheimer’s disease . Brain fog can make thinking, understanding, and remembering basic information challenging. A variety of healthy lifestyle habits and modifications can help prevent, as well as avoid, midlife brain fog and improve overall health and wellness. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
Neurotransmitter Assessment Form
�
The following Neurotransmitter Assessment Form can be filled out and presented to Dr. Alex Jimenez. Symptoms listed on this form are not intended to be utilized as a diagnosis of any type of disease, condition, or any other type of health issue. �
In honor of Governor Abbott’s proclamation, October is Chiropractic Health Month. Learn more about the proposal. �
Have you been experiencing noticeable variations in your mental speed? Do you suffer from pain, discomfort, and inflammation? Have you been experiencing fatigue, especially after meals or exposure to chemicals, scents, or pollutants?�Brain fog can cause a variety of symptoms, including memory and concentration as well as vision problems. In the article above, midlife brain fog can be prevented and avoided by following a variety of lifestyle habits and modifications. �
The scope of our information is limited to chiropractic, musculoskeletal and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900 . �
Curated by Dr. Alex Jimenez �
Additional Topic Discussion: Chronic Pain
Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance.
Neural Zoomer Plus for Neurological Disease
�
Dr. Alex Jimenez utilizes a series of tests to help evaluate neurological diseases. The Neural ZoomerTM Plus is an array of neurological autoantibodies which offers specific antibody-to-antigen recognition. The Vibrant Neural ZoomerTM Plus is designed to assess an individual�s reactivity to 48 neurological antigens with connections to a variety of neurologically related diseases. The Vibrant Neural ZoomerTM Plus aims to reduce neurological conditions by empowering patients and physicians with a vital resource for early risk detection and an enhanced focus on personalized primary prevention. �
Formulas for Methylation Support
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.
�
For your convenience and review of the XYMOGEN products please review the following link.*XYMOGEN-Catalog-Download �
* All of the above XYMOGEN policies remain strictly in force.
How often do you have a hard time remembering your appointments? Has it become harder for you to learn new things? How often do you feel you have something that must be done? Or even, how often do you feel more susceptible to pain?�Research studies have demonstrated that brain fog may be associated with Alzheimer’s disease. In the following article, we will discuss how midlife systemic inflammatory markers have ultimately been associated with late-life brain volume. �
Midlife Systemic Inflammatory Markers are Associated with Late-life Brain Volume
Abstract
Objective: To clarify the temporal relationship between systemic inflammation and neurodegeneration, we examined whether a higher level of circulating inflammatory markers during midlife was associated with smaller brain volumes in late-life using a large biracial prospective cohort study.
Methods: Plasma levels of systemic inflammatory markers (fibrinogen, albumin, white blood cell count, von Willebrand factor, and Factor VIII) were assessed at baseline in 1,633 participants (mean age 53 [5] years, 60% female, 27% African American) enrolled in the Atherosclerosis Risk in Communities Study. Using all 5 inflammatory markers, an inflammation composite score was created for each participant. We assessed episodic memory and regional brain volumes, using 3T MRI, 24 years later.
Results: Each SD increase in midlife inflammation composite score was associated with 1,788 mm3 greater ventricular (p = 0.013), 110 mm3 smaller hippocampal (p = 0.013), 519 mm3 smaller occipital (p = 0.009), and 532 mm3 smaller Alzheimer disease signature region (p = 0.008) volumes, and reduced episodic memory (p = 0.046) 24 years later. Compared to participants with no elevated (4th quartile) midlife inflammatory markers, participants with elevations in 3 or more markers had, on average, 5% smaller hippocampal and Alzheimer disease signature region volumes. The association between midlife inflammation and late-life brain volume was modified by age and race, whereby younger participants and white participants with higher levels of systemic inflammation during midlife were more likely to show reduced brain volumes subsequently.
Conclusions: Our prospective findings provide evidence for what may be an early contributory role of systemic inflammation in neurodegeneration and cognitive aging.
Introduction
� Although elevated levels of inflammatory markers have been found in the blood,1 CSF,2 and brain parenchyma3 of individuals with cognitive impairment and Alzheimer disease (AD), it remains unclear whether this heightened inflammatory state is driving neurodegenerative changes. If low-grade systemic inflammation does play a causal role in AD and other neurodegenerative diseases, a heightened inflammatory response during midlife would be expected to increase one’s risk for pathologic brain changes much later. Although cross-sectional studies have demonstrated a link between elevated inflammatory markers and reduced brain volume in older adults,4,�7 it remains unclear whether systemic inflammation during midlife, before the onset of significant age- and disease-related neurologic changes, is associated with brain volume loss later in life. � The goal of the current study was to examine how midlife plasma markers of inflammation relate to late-life brain volume among a biracial community sample of older adults. To this end, we examined the relationship between 5 markers of systemic inflammation measured during midlife and MRI measures of regional brain volume 24 years later in the Atherosclerosis Risk in Communities (ARIC) Study cohort. We tested the hypothesis that greater midlife systemic inflammation is associated with smaller brain volumes in regions most susceptible to AD-related atrophy and reduced episodic memory in older adulthood. Based on cross-sectional evidence suggesting that race, sex, and age may modify the association between inflammatory markers and brain volume,5,8,9 the current study also examined the modifying effects of each of these demographic characteristics. �
Methods
� Study population. The ARIC study, an ongoing community-based prospective study, enrolled 15,792 middle-aged adults (45�65 years of age at baseline).10 Participants were selected by probability sampling in 4 US communities: Washington County, Maryland; Forsyth County, North Carolina; northwestern suburbs of Minneapolis, Minnesota; and Jackson, Mississippi. Following the baseline visit in 1987�1989 (visit 1), participants were seen at 3 more visits, approximately 3 years apart until 1996�1998 (visit 4), and at the fifth visit in 2011�2013 (visit 5). � At visit 5, a subset of 1,978 participants was selected to undergo brain MRI scans.11 Participants were selected to undergo a brain MRI based on previous participation in the ARIC Brain MRI Ancillary Study and standard safety exclusion criteria. In addition, all participants with evidence of cognitive impairment at visit 5 and an age-stratified random sample of participants without evidence of cognitive impairment were recruited. The participation rate among eligible individuals selected to undergo brain MRI was approximately 81%. A detailed description of the MRI sampling strategy is provided in the e-Methods at Neurology.org. We excluded participants with poor imaging quality (n = 6), neurologic disease (i.e., stroke, multiple sclerosis) (n = 80), missing inflammatory biomarker data (n = 38), missing covariates (n = 215), and race other than white or African American (n = 6). Participants who met criteria for dementia (5%, n = 83) were excluded from the primary analyses. � Standard protocol approvals, registrations, and patient consents. The ARIC study protocol has been approved by the institutional review boards at each participating center. All participants gave written informed consent at each study visit. � Inflammatory markers. Plasma levels of 4 acute-phase reactants�fibrinogen, albumin, von Willebrand factor (VWF), and Factor VIII (FVIII)�and white blood cell (WBC) count were used to measure systemic inflammation.12 Using standard protocols, study technicians drew fasting blood, centrifuged samples, and froze plasma blood samples at ?70�C until the samples were analyzed.13 Fibrinogen (mg/dL), albumin (g/dL), VWF (% of standard), and FVIII activity (% of standard) measured at visit 1 were analyzed in an ARIC research laboratory in accordance with a standardized protocol.13,14 WBC count was determined from whole anticoagulated blood using an automated particle Coulter Counter within 24 hours of venipuncture. Repeated testing revealed interassay coefficients of variation below 8% for fibrinogen, albumin, FVIII, and WBC, and 17%�19% for VWF.15,16 � Brain MRI. MRI scans were conducted using a 3T MRI scanner.11 Magnetization-prepared rapid gradient echo (MPRAGE), axial T2* gradient recalled echo, axial T2 fluid-attenuated inversion recovery, and axial diffusion tensor imaging sequences were obtained. Freesurfer (surfer.nmr.mgh.harvard.edu) was used to measure brain volume from MPRAGE sequences.17 Total brain and ventricular volume, lobar volume (frontal, temporal, parietal, occipital), AD signature region volume (i.e., the combined volume of the parahippocampal, entorhinal, inferior parietal lobules, hippocampus, and precuneus),18 hippocampal volume, and total intracranial volume were evaluated for the current study. � Episodic memory. Episodic memory was assessed at visit 5, concurrent with the brain MRI, using the delayed word recall test (DWR). DWR is a test that requires participants to learn and recall a list of 10 words following a delay period.19 Participants were scored based on the total number of words correctly recalled. � Covariates. Race, sex, years of education attained (less than high school, high school/General Equivalency Development/vocational school, or any college), cigarette smoking status (current/former/never), average weekly alcohol consumption (grams), and previous cancer diagnosis were self-reported. A random zero sphygmomanometer was used to calculate sitting diastolic and systolic blood pressure. Second and third blood pressure measurements were averaged for the current analyses. Hypertension was defined as systolic blood pressure >140 mm Hg, diastolic blood pressure >90 mm Hg or use of hypertensive medication. Body mass index was calculated using recorded height and weight (kg/m2). Coronary heart disease was defined as self-reported coronary bypass, balloon angioplasty, angioplasty of one or more coronary artery, or myocardial infarction. Medications used in the previous 2 weeks were recorded. The presence of chronic inflammatory conditions (e.g., arthritis, lupus, gout) was assessed by patient self-report of physician diagnosis at visit 4. History of regular anti-inflammatory medication use (e.g., nonsteroidal anti-inflammatory drug, arthritis medication) was assessed at visit 5. All other variables were assessed at visit 1. Dementia diagnosis was adjudicated at visit 5 by an expert committee using cognitive, imaging, and functional data.20 � Total cholesterol and triglycerides were measured using enzymatic methods,21,22 and low-density lipoprotein using the Friedewald equation.23 Serum glucose was measured using the hexokinase method. Diabetes was defined as a fasting glucose ?126 mg/dL or a nonfasting glucose ?200 mg/dL, current use of diabetes medication or insulin, or participant report of physician-diagnosed diabetes. APOE genotype (0, 1, or 2 ?4 alleles) was assessed using the TaqMan assay (Applied Biosystems, Foster City, CA). � Statistical analysis. We examined systemic inflammation as both a continuous and categorical exposure measure. A continuous inflammation composite Z score was created using the 5 inflammatory markers. WBC count was log-transformed to correct for skewness. Each inflammatory biomarker was converted to a standardized Z score such that the group mean was zero with an SD of 1. The mean of the 5 Z scores was calculated to generate an inflammation composite Z score. Because albumin decreases in response to inflammation, albumin values were multiplied by ?1 before being included in the composite Z score. With few exceptions, the intercorrelations between inflammatory markers were within an optimal range, between 0.2 and 0.4; composite score item�test correlations, principal component factor loadings, and Cronbach ? (0.61) were satisfactory for our purposes (table e-1). For each participant, we also created a categorical measure of systemic inflammation by computing the number of inflammatory marker Z scores in the highest quartile (?75%tile) and trichotomizing this number (0, 1�2, or 3�5). � Participant characteristics were compared using an analysis of variance or ?2 tests. Multivariable linear regression was used to assess the association between continuous and categorical inflammation variables and measures of brain volume and episodic memory. Brain volume analyses were adjusted for total intracranial volume, and all analyses included the covariates described in the previous section. Interaction terms or stratification were used to evaluate the modifying effects of age, race, and sex. � Sensitivity analyses were performed excluding participants who reported regular anti-inflammatory medication use during follow-up and including participants who met criteria for dementia. For all analyses, sampling weights were incorporated to account for the ARIC brain MRI sampling strategy. Thus, all results represent estimates for the entire ARIC visit 5 study population. Because the associations between inflammation markers and specific regions of interest (ROIs) are correlated, we did not adjust for multiple comparisons. A 2-sided p-value <0.05 designated statistical significance. All analyses were conducted using Stata Version 14 (StataCorp, College Station, TX). �
Results
� Study population characteristics. A total of 1,633 participants (baseline mean age 52.8 [5.3] years, 27% African American, 60% women, 46% college or professional degree) were included in the study sample. The time between baseline assessment and follow-up MRI scan was 24 (1) years; the average age at follow-up was 76.5 (5.4) years. As shown in table 1, a higher inflammation composite score at baseline was associated with older age, female sex, African American race, and increased levels of a number of cardiovascular risk factors. � Inflammatory markers and brain volume. Each SD increase in inflammation composite score at baseline was associated with a 532 mm3 smaller AD signature region volume (95% confidence interval [CI] ?922 to ?141), a 519 mm3 smaller occipital lobe volume (CI ?906 to ?132), a 110 mm3 smaller hippocampal volume (CI ?196 to ?24), and a 1,788 mm3 larger ventricular volume (CI 371 to 3,205) at follow-up (table 2). We found the estimated effect of a 1 SD increase in inflammation composite score during midlife on occipital lobe, ventricular, and hippocampal volume to be similar to the effect associated with possession of a single APOE ?4 allele in our multivariable regression analyses. No association was found for the total brain, frontal lobe, temporal lobe, or parietal lobe volume (ps > 0.071). Our findings did not change meaningfully after excluding participants who regularly used anti-inflammatory medication during the follow-up period (table e-2) and after including participants who met the criteria for dementia at visit 5 (table e-3). For descriptive purposes, associations between individual inflammatory markers and AD signature region volume are provided in a table e-4. � An assessment of linear trend revealed that compared to individuals with 0 elevated (?75th %tile) inflammatory biomarkers at baseline (reference), those with 1�2 and 3�5 elevated biomarkers had lower AD signature region (p trend = 0.001), occipital lobe (p trend = 0.007), and hippocampal volume (p trend = 0.041) 24 years later (figure 1). Compared to the reference group, participants with 3 or more elevated markers demonstrated 5.3% smaller AD signature region volumes, 5.7% smaller occipital lobe volumes, and 4.6% smaller hippocampal volumes, on average. However, this pattern was not statistically supported for the total brain, ventricular, frontal lobe, temporal lobe, and parietal lobe volume (p trends >0.072). The modifying effects of age, race, and sex. A significant age-by-inflammation composite score interaction was found for the AD signature region, occipital lobe, and hippocampal volume (table 2). Because a reversal of association was observed at age 60 (figures 2, e-1, and e-2), we stratified the sample into young-midlife and old-midlife subgroups (<60/? 60). As displayed in table 2, the associations between higher midlife inflammation composite score and lower AD signature region, occipital lobe, and hippocampal volume at follow-up were significantly stronger among participants who were 60 or younger at baseline compared to those who were older than 60. A marginal race-by-inflammation composite score interaction was found for occipital lobe volume, whereby a higher midlife inflammation composite score was associated with lower occipital lobe volume among white, but not African American, participants (table 3). No interactions with sex were found (table e-5). � Inflammatory markers and episodic memory. Late-life episodic memory, which was associated with hippocampal and AD signature region volume after controlling for age (partial rs > 0.21, ps < 0.001), was reduced among participants with higher levels of the inflammation composite score. Each SD increase in inflammation composite score was associated with a ?0.08 SD performance decrement on the DWR after adjusting for covariates (CI ?0.15 to 0.00; p = 0.046). Similarly, a higher number of elevated inflammatory biomarkers at baseline was associated with reduced DWR performance (p trend = 0.009; figure 1). �
Discussion
� Using a large community sample, we demonstrated that a higher level of systemic inflammatory markers measured during midlife is independently associated with lower regional brain volume and reduced episodic memory 24 years later among older adults without dementia. Similarly, participants who had elevations in a larger number of 5 inflammatory markers during midlife were found to have lower regional brain volumes and reduced episodic memory in late-life in a dose-response manner. For several brain regions, including the hippocampus, the effect of a 1 SD increase in midlife inflammation composite score was comparable to that of possessing a single APOE ?4 allele during late life. Whereas age and race were found to modestly modify the relationship between midlife inflammation and late-life regional brain volume, the previously reported modifying effect of sex was supported. � Although cross-sectional evidence from the Framingham5 study and several other population-based8,9 studies suggests an association between brain volume and inflammation in older adults, the temporal relationship between inflammation and brain volume loss is still not well-understood. As a result, whether heightened systemic inflammation constitutes a potential cause or consequence of neurodegeneration and brain atrophy remains unclear. Because the pathophysiologic processes driving neurodegeneration and brain volume loss begin decades before the onset of frank cognitive decline,24 it is essential to determine how biological processes that take place during middle adulthood relate to neurologic outcomes later in life. By demonstrating that an elevation in plasma inflammatory markers during midlife is independently associated with smaller regional brain volumes, larger ventricular volume, and reduced episodic memory in late life, the current findings provide support for a potential causal, rather than associative, role of systemic inflammation in late-life neurodegeneration (i.e., atrophy) and resulting cognitive decline. The current findings align closely with those from the neurocardiovascular literature, which have found associations between midlife blood pressure,25 cholesterol,26 and diabetes27 and adverse neurologic and cognitive outcomes in older adulthood. The contributing role of systemic inflammation to subsequent neurodegenerative processes has been demonstrated previously by animal studies,28 but had not yet been supported by a large prospective MRI study. � The current results suggest that several demographic factors modify the relationship between midlife inflammation and late-life brain volume. Younger individuals with elevated levels of inflammation (particularly participants in their 40s) were more likely to display lower brain volumes decades later, supporting the idea that elevated systemic inflammation earlier in life may make individuals especially vulnerable to neurodegenerative brain changes as they age. Although we expected stronger effects would emerge within the African American group, given the greater burden of systemic disease29 and dementia,30 the associations between inflammation and brain volume were generally weaker among African Americans. A previous study that examined the moderating effects of race found similar results in a cross-sectional analysis of older adults without dementia.8 � Circulating levels of acute-phase reactants, such as those used in the current study, change in parallel with an inflammatory response as a result of signaling from inflammatory cytokines such as interleukin-6 and tumor necrosis factor-?.12 Cytokines in the periphery have the potential to induce a pro-inflammatory neurotoxic state within the CNS through multiple routes, including activation of endothelial cells of the blood-brain barrier,31 activation of macrophage in circumventricular organs,32 and signaling of the afferent vagus nerve.33 In addition to providing support for a pathogenic role of systemic inflammation in neurodegenerative disease, the present findings indicate that elevations in commonly assayed inflammatory proteins may serve as markers of risk for future neurodegenerative changes and cognitive decline. Although we did not examine all brain regions in our analysis, our assessment of 7 representative ROIs suggests that brain regions vulnerable to atrophy, amyloid deposition, and metabolic abnormalities in the earliest phases of AD may be more vulnerable to volume loss associated with heightened midlife inflammation. This pattern of neuroanatomic specificity has been supported by previous cross-sectional studies of older adults without dementia.4,7,�9,34 � In the context of the current findings, several alternative explanations should be considered. First, it remains possible that elevated systemic inflammation may simply serve as a marker of another pathologic process linked to neurodegeneration (e.g., oxidative stress). Second, it is possible that the biological processes causing brain atrophy to trigger a protective neuroimmune response, which increases peripheral inflammation. Third, the associations found here may be an effect of residual or unmeasured confounding. Despite these caveats, the contributory role of systemic inflammation has been supported by a sizable body of literature implicating peripheral inflammatory signaling in neurodegenerative processes such as neural apoptosis,35 ?-amyloid formation,36 and neuronal tau phosphorylation.37 � Strengths of the current study include the prospective study design, length of follow-up, detailed assessment of potentially confounding variables, large sample size, and the inclusion of a large African American sample. However, the current findings should be interpreted within the context of several limitations. Although the acute-phase reactants used in the present study represent components of the innate immune system, several of these proteins are implicated in another closely related physiologic process, such as hemostasis, which may also influence brain volume. Evaluating inflammatory biomarkers that have greater biological specificity in future prospective studies will allow for stronger inferences about the contributing role of systemic inflammation. Interpretation of the current findings is also limited by the measurement of inflammatory markers at a single time point, as it is unclear whether a single measurement can adequately capture inflammation chronicity. The relatively high interassay variability of VWF also increases the likelihood of exposure misclassification; however, this possibility is mitigated by the use of the inflammation composite score. We found that participants who dropped out and participants who died before visit 5 had significantly higher levels of midlife inflammation, were older, had greater levels of medical comorbidity at baseline, and were more likely to be African American38 (table e-6). As a result, selective attrition may have biased results in the direction of the null hypothesis, particularly for African American and older participants. Finally, our interpretation of the contributory role of inflammation in neurodegeneration rests on the assumption that brain volume loss occurred after inflammatory markers were assessed. Although evidence suggests that this is likely the case (brain volume loss accelerates after age 60 years39), this cannot be confirmed without the assessment of change over time. � Despite these limitations, the current study provides insights into the connection between midlife systemic inflammation and late-life brain volume loss. These findings provide support for inflammation’s early pathogenic role in the development of neurodegenerative brain changes associated with late-life cognitive decline, AD, and other forms of dementia. �
Is inflammation the final trip wire for Alzheimer’s disease?� Research studies have demonstrated that neuroinflammation is considered to be the main epigenetic trip wire for the genetic predisposition of Alzheimer’s disease or AD. Moreover, patients with inflammation can also develop a variety of symptoms, including brain fog which can make thinking, understanding, and remembering basic information challenging. Neuroinflammation can cause brain fog and other other well-known health issues, including Alzheimer’s disease and other neurological diseases. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
Neurotransmitter Assessment Form
The following Neurotransmitter Assessment Form can be filled out and presented to Dr. Alex Jimenez. Symptoms listed on this form are not intended to be utilized as a diagnosis of any type of disease, condition, or any other type of health issue. �
� In honor of Governor Abbott’s proclamation, October is Chiropractic Health Month. Learn more about the proposal. � Have you been experiencing noticeable variations in your mental speed? Do you suffer from pain, discomfort, and inflammation? Have you been experiencing fatigue, especially after meals or exposure to chemicals, scents, or pollutants?�Brain fog can cause a variety of symptoms, including memory and concentration as well as vision problems. According to the research study above, midlife inflammation and brain fog may be associated with Alzheimer’s disease. � The following article has been referenced from the National Center for Biotechnology Information (NCBI). The scope of our information is limited to chiropractic, musculoskeletal and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900 . �
Curated by Dr. Alex Jimenez �
Additional Topic Discussion: Chronic Pain
� Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance.
Neural Zoomer Plus for Neurological Disease
� Dr. Alex Jimenez utilizes a series of tests to help evaluate neurological diseases. The Neural ZoomerTM Plus is an array of neurological autoantibodies which offers specific antibody-to-antigen recognition. The Vibrant Neural ZoomerTM Plus is designed to assess an individual�s reactivity to 48 neurological antigens with connections to a variety of neurologically related diseases. The Vibrant Neural ZoomerTM Plus aims to reduce neurological conditions by empowering patients and physicians with a vital resource for early risk detection and an enhanced focus on personalized primary prevention. �
Formulas for Methylation Support
�
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.
�
� For your convenience and review of the XYMOGEN products please review the following link.*XYMOGEN-Catalog-Download �
* All of the above XYMOGEN policies remain strictly in force.
Is your attention span decreasing? How often do you walk into rooms and forget why? How often do you feel you are not getting enough sleep or rest? If you answered yes to any of the previous questions, you may be experiencing brain fog. Brain fog is a symptom rather than a single condition and it can actually be caused by a very common factor: too much screen time. �
Many people today spend a significant amount of time staring at a screen than ever before. According to the American Optometric Association (AOA), an average office worker in the United States spends a minimum of seven hours a day sitting in front of a computer screen. While other recent research studies have shown that an average American adult spends as much as 11 hours a day looking at some type of screen of some kind, including mobile devices like smartphones. �
In light of this “digital revolution”, however, more and more healthy people in their 20’s, 30’s, and even in their 40’s have started experiencing brain fog, short-term memory loss, and insomnia as well as vision problems, headaches, and migraines. Although there isn’t an abundance of evidence, several research studies have begun to demonstrate the effects of too much screen time on our overall health and wellness. We will discuss why screen time causes brain fog, among other health issues. �
How Screen Time Changes the Brain
Sitting in front of a computer screen or looking at any other type of screen for extended periods of time can ultimately cause brain fog and vision problems, among other health issues because it changes the brain, both behaviorally and structurally. A research study of students in 10 countries showed that many of them feel acute distress if they go without their phones for 24 hours. Also, most people check their phones a minimum of 150 times a day, sending about 100 or more text messages. �
This excessive use of smartphones has been associated with stress, anxiety, and even depression. Neuroscientists have referred to this health issue as “digital dementia,” which ultimately affects important right-brain functions, such as short-term memory, attention, and concentration, in ways that may or may not be reversible if they are not treated properly. �
People who are perceived as having an online game addiction show significant gray matter atrophy in a variety of regions in the brain, including the right orbitofrontal cortex, the bilateral insula, and the right supplementary motor area, when they were evaluated using brain MRI research studies. The regions where volume loss was shown are ultimately in charge of essential cognitive functions, such as planning, prioritizing, organizing, impulse control, and reward pathways. These are also involved in our development of empathy and compassion as well as the translation of physical signals into emotion. �
Several research studies have also shown that too much screen time can also cause long-term vision problems and other eye health issues. According to the American Optometric Association, computer vision syndrome or CVS, also known as digital eye strain, is a complex vision problem associated with tasks and activities that stress the near vision and those that are experienced in relation, or during, the use of the computer, tablet, e-reader, and smartphone. The symptoms include eye strain and ache, dryness, irritation, redness, double or blurred vision, burning, and even neck and shoulder pain. �
Moreover, in 2014, a Harvard Medical School group investigated the biological effects of reading an e-book on a light-emitting device with reading a printed book in the hours before bedtime. The researchers ultimately reported that people who read on the e-book took longer to fall asleep, had less evening sleepiness, decreased melatonin secretion, later timing of their circadian rhythm, and lower next-morning alertness than when reading a printed book. Much of this likely has to do with the fact that e-books and other digital screens emit blue light, which has been shown to interfere with the production of melatonin or the “sleep hormone” which also helps regulate other hormones as well as our circadian rhythms. �
While research studies demonstrating the connection between mood and digital device addiction is still emerging, some recent research studies are starting to associate prolific social media use with the increased risk of anxiety and depression. Many patients report feeling stress, anxiety, and depression caused by spending too much time scrolling through social media, such as Instagram, Facebook, and Twitter feeds. Some even report that “social media detoxes,” where they delete these apps from their smartphones for a few days or weeks, tremendously improved their overall health and wellness. �
How to Prevent Brain Fog from Screen Time
If you find yourself experiencing symptoms such as brain fog, short-term memory loss, vision problems, insomnia, anxiety, depression, headaches, or migraines, make sure to see a healthcare professional for an evaluation first, but then try limiting screen time to six hours per day, avoiding all screens at least one hour before bed and taking the weekends “off” from social media. If you immediately feel better, you have a clear indication of how too much screen time is affecting your brain. �
Several other precautions you can take to prevent the previously mentioned symptoms can include: loading up on nutrients that have been shown to combat brain fog and vision problems like the carotenoid antioxidants zeaxanthin, lutein, and astaxanthin, found in green vegetables and a variety of colorful plant foods similar to these. If you can’t avoid using a computer or other digital device before bed, consider wearing a pair of blue-light-blocking glasses in the evenings, in which several research studies have shown that these can ultimately help restore melatonin production and improve sleep. �
Brain fog can make thinking, understanding, and even remembering basic information challenging. Brain fog is a symptom, rather than a single disorder, commonly associated with vision problems and other health issues like insomnia, anxiety, and even depression. Researchers and healthcare professionals have demonstrated that too much screen time, due to sitting in front of a computer screen or staring at a mobile device for extended periods of time, can ultimately change the brain, causing brain fog and vision problems, among other well-known symptoms. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
Neurotransmitter Assessment Form
The following Neurotransmitter Assessment Form can be filled out and presented to Dr. Alex Jimenez. Symptoms listed on this form are not intended to be utilized as a diagnosis of any type of disease, condition, or any other type of health issue. �
In honor of Governor Abbott’s proclamation, October is Chiropractic Health Month. Learn more about the proposal. �
Have you been experiencing noticeable variations in your mental speed? Do you suffer from pain, discomfort, and inflammation? Have you been experiencing fatigue, especially after meals or exposure to chemicals, scents, or pollutants?�Brain fog is a symptom that can affect many brain functions, including memory and concentration. It can also be accompanied by other symptoms like vision problems. Too much screen time can cause brain fog and other health issues. � The scope of our information is limited to chiropractic, musculoskeletal and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900 . �
Curated by Dr. Alex Jimenez �
References: �
Sissons, Claire. �Brain Fog: Multiple Sclerosis and Other Causes.� Medical News Today, MediLexicon International, 12 June 2019, www.medicalnewstoday.com/articles/320111.php#1.
Orenstein, Beth W. �When Chronic Fatigue Syndrome Harms Vision.� EverydayHealth.com, Everyday Health, 4 March 2010, www.everydayhealth.com/chronic-fatigue-syndrome/vision-problems.aspx.
Additional Topic Discussion: Chronic Pain
Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance.
Neural Zoomer Plus for Neurological Disease
�
Dr. Alex Jimenez utilizes a series of tests to help evaluate neurological diseases. The Neural ZoomerTM Plus is an array of neurological autoantibodies which offers specific antibody-to-antigen recognition. The Vibrant Neural ZoomerTM Plus is designed to assess an individual�s reactivity to 48 neurological antigens with connections to a variety of neurologically related diseases. The Vibrant Neural ZoomerTM Plus aims to reduce neurological conditions by empowering patients and physicians with a vital resource for early risk detection and an enhanced focus on personalized primary prevention. �
Formulas for Methylation Support
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.
�
For your convenience and review of the XYMOGEN products please review the following link.*XYMOGEN-Catalog-Download �
* All of the above XYMOGEN policies remain strictly in force.
Have you been experiencing noticeable variations in your mental speed? Do you suffer from pain, discomfort, and inflammation? Have you been experiencing fatigue, especially after meals or exposure to chemicals, scents, or pollutants? If you answered yes to any of the previous questions, you may be experiencing brain fog, unclear thoughts or concentration. �
Brain fog is a well-known symptom associated with a variety of health issues. It can affect many brain functions, including memory and concentration. It can occur as a result of poor lifestyle habits, including stress, an unhealthy diet, and lack of sleep, or due to other health issues, including multiple sclerosis and chronic fatigue syndrome. Moreover, brain fog can be accompanied by other symptoms like vision problems. In the following article, we will discuss brain fog and vision problems. �
What is Brain Fog?
Brain fog can make a person feel as if the processes of thinking, understanding, and remembering are not working as they should. It can affect memory, the ability to process and understand information, visual and spatial skills, the ability to calculate and solve problems as well as executive functioning. If these essential brain functions don’t work efficiently, it can become challenging to understand, focus, and even remember simple things. It can ultimately lead to stress and fatigue. �
A variety of health issues can lead to brain fog. People with multiple sclerosis (MS) may experience changes in their ability to make decisions as well as to process and recall information. These changes are generally mild or moderate and they do not affect a person’s ability to live independently. However, they can be frustrating and these can make it difficult to complete regular tasks. Fibromyalgia can also affect a person’s concentration and memory. Chronic fatigue syndrome (CFS) is another chronic, or long-term, health issue that can result in brain fog, fatigue, and other symptoms, such as vision problems. �
Changes to a person’s hormone levels can also affect brain function, especially during pregnancy or menopause. A 2013 research study found that hormonal changes throughout a woman’s menopausal transition made it difficult for women to learn or retain new information and to focus on challenging everyday tasks. Hypothyroidism and Hashimoto’s disease can cause hormone imbalances. Memory and thinking problems similar to brain fog are also common in thyroid disorders. �
Depression is a mood disorder that affects how a person thinks and feels. Problems with memory, focus, and decision-making can contribute to brain fog. There may also be problems with sleeping and a lack of energy, which can make concentrating and completing everyday tasks much more challenging. Stress and anxiety can also make it difficult to think clearly. �
Vision Problems and Brain Fog
Many people with brain fog due to multiple sclerosis (MS) or chronic fatigue syndrome (CFS) also experience vision problems. Healthcare professionals believe that vision problems associated with CFS and other health issues are caused due to brain dysfunction rather than eye dysfunction. Our brain constantly transmits signals into our eyes which allows us to know where we are as well as what it is that you�re seeing. The brain is also in charge of controlling the eye reflexes, including pupil dilation due to light and dark changes. However, these brain and eye functions may not work properly with brain fog. �
Most frequently, patients with brain fog experience vision problems where their environment appears to be blurry or it seems to be foggy. According to Dr. Peter Rowe, director of the Chronic Fatigue Clinic at Johns Hopkins Children�s Center in Baltimore, these vision problems most frequently occur when standing up, making the patients also feel lightheaded. �
Furthermore, other vision problems that CFS and MS patients commonly experience with brain fog, ultimately include: �
Difficulty when focusing on objects, generally those which are close up
Inability to see objects in peripheral vision, as though they have tunnel vision
Dizziness and being unable to look at moving objects without feeling dizzy
Seeing an excess amount of “floaters” and/or “flashes of light” in their vision
Intolerant to light or feeling discomfort in bright rooms and outdoors in the sunshine
Feeling as though the eyes are dry or as though they’re itchy, gritty, or burning
Proper Health Care with Brain Fog and Vision Problems
People with brain fog and vision problems associated with CFS, MS, or any other health issue will commonly visit an optometrist or ophthalmologist. However, an eye exam will generally return as “normal�. In addition, prescription lenses may not help because of rapid vision changes. If you do wear glasses, tints may ultimately help reduce sensitivity to light. �
Because blurred or foggy vision is the most common problem associated with brain fog, researchers and healthcare professionals believe that improving blood flow to the brain can help improve symptoms. Treating any underlying health issues and/or practicing proper lifestyle habits, such as eating a healthy diet, engaging in exercise or physical activity, and sleeping properly can help promote proper blood flow to the brain and ultimately improve brain fog and vision problems. �
Blurry or foggy vision, among other vision problems, are frequently believed to be a temporary symptom and are more associated with lightheadedness and blood flow to the brain. You may need to see a cardiologist or a neurologist to treat lightheadedness or dizziness. If you have chronic fatigue syndrome (CFS), multiple sclerosis (MS), or any other health issue where you find that you can�t tolerate bright light, you should wear sunglasses when you�re outdoors in the sunshine. �
Brain fog commonly includes feelings of confusion and disorientation, where it can make a person have difficulty thinking, understanding, and even remembering basic information. Brain fog is a symptom, rather than a single disorder, associated with vision problems and other health issues like CFS and MS. Researchers and healthcare professionals believe that because brain fog can ultimately affect brain function, it can also affect essential eye reflexes responsible for these well-known vision problems, among other symptoms, including fatigue. – Dr. Alex Jimenez D.C., C.C.S.T. Insight
Neurotransmitter Assessment Form
The following Neurotransmitter Assessment Form can be filled out and presented to Dr. Alex Jimenez. Symptoms listed on this form are not intended to be utilized as a diagnosis of any type of disease, condition, or any other type of health issue. �
In honor of Governor Abbott’s proclamation, October is Chiropractic Health Month. Learn more about the proposal. �
Have you been experiencing noticeable variations in your mental speed? Do you suffer from pain, discomfort, and inflammation? Have you been experiencing fatigue, especially after meals or exposure to chemicals, scents, or pollutants?�Brain fog is a symptom that can affect many brain functions, including memory and concentration. It can also be accompanied by other symptoms like vision problems. In the article above, we discussed brain fog and vision problems. � The scope of our information is limited to chiropractic, musculoskeletal and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez �
References: �
Sissons, Claire. �Brain Fog: Multiple Sclerosis and Other Causes.� Medical News Today, MediLexicon International, 12 June 2019, www.medicalnewstoday.com/articles/320111.php#1.
Orenstein, Beth W. �When Chronic Fatigue Syndrome Harms Vision.� EverydayHealth.com, Everyday Health, 4 March 2010, www.everydayhealth.com/chronic-fatigue-syndrome/vision-problems.aspx.
Additional Topic Discussion: Chronic Pain
Sudden pain is a natural response of the nervous system which helps to demonstrate possible injury. By way of instance, pain signals travel from an injured region through the nerves and spinal cord to the brain. Pain is generally less severe as the injury heals, however, chronic pain is different than the average type of pain. With chronic pain, the human body will continue sending pain signals to the brain, regardless if the injury has healed. Chronic pain can last for several weeks to even several years. Chronic pain can tremendously affect a patient’s mobility and it can reduce flexibility, strength, and endurance.
Neural Zoomer Plus for Neurological Disease
�
Dr. Alex Jimenez utilizes a series of tests to help evaluate neurological diseases. The Neural ZoomerTM Plus is an array of neurological autoantibodies which offers specific antibody-to-antigen recognition. The Vibrant Neural ZoomerTM Plus is designed to assess an individual�s reactivity to 48 neurological antigens with connections to a variety of neurologically related diseases. The Vibrant Neural ZoomerTM Plus aims to reduce neurological conditions by empowering patients and physicians with a vital resource for early risk detection and an enhanced focus on personalized primary prevention. �
Formulas for Methylation Support
XYMOGEN�s Exclusive Professional Formulas are available through select licensed health care professionals. The internet sale and discounting of XYMOGEN formulas are strictly prohibited.
Proudly,�Dr. Alexander Jimenez makes XYMOGEN formulas available only to patients under our care.
Please call our office in order for us to assign a doctor consultation for immediate access.
If you are a patient of Injury Medical & Chiropractic�Clinic, you may inquire about XYMOGEN by calling 915-850-0900.
�
For your convenience and review of the XYMOGEN products please review the following link.*XYMOGEN-Catalog-Download �
* All of the above XYMOGEN policies remain strictly in force.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
Inflammatory markers and brain volume. Each SD increase in inflammation composite score at baseline was associated with a 532 mm3 smaller AD signature region volume (95% confidence interval [CI] ?922 to ?141), a 519 mm3 smaller occipital lobe volume (CI ?906 to ?132), a 110 mm3 smaller hippocampal volume (CI ?196 to ?24), and a 1,788 mm3 larger ventricular volume (CI 371 to 3,205) at follow-up (table 2). We found the estimated effect of a 1 SD increase in inflammation composite score during midlife on occipital lobe, ventricular, and hippocampal volume to be similar to the effect associated with possession of a single APOE ?4 allele in our multivariable regression analyses. No association was found for the total brain, frontal lobe, temporal lobe, or parietal lobe volume (ps > 0.071). Our findings did not change meaningfully after excluding participants who regularly used anti-inflammatory medication during the follow-up period (table e-2) and after including participants who met the criteria for dementia at visit 5 (table e-3). For descriptive purposes, associations between individual inflammatory markers and AD signature region volume are provided in a table e-4. � 
An assessment of linear trend revealed that compared to individuals with 0 elevated (?75th %tile) inflammatory biomarkers at baseline (reference), those with 1�2 and 3�5 elevated biomarkers had lower AD signature region (p trend = 0.001), occipital lobe (p trend = 0.007), and hippocampal volume (p trend = 0.041) 24 years later (figure 1). Compared to the reference group, participants with 3 or more elevated markers demonstrated 5.3% smaller AD signature region volumes, 5.7% smaller occipital lobe volumes, and 4.6% smaller hippocampal volumes, on average. However, this pattern was not statistically supported for the total brain, ventricular, frontal lobe, temporal lobe, and parietal lobe volume (p trends >0.072). 
The modifying effects of age, race, and sex. A significant age-by-inflammation composite score interaction was found for the AD signature region, occipital lobe, and hippocampal volume (table 2). Because a reversal of association was observed at age 60 (figures 2, e-1, and e-2), we stratified the sample into young-midlife and old-midlife subgroups (<60/? 60). As displayed in table 2, the associations between higher midlife inflammation composite score and lower AD signature region, occipital lobe, and hippocampal volume at follow-up were significantly stronger among participants who were 60 or younger at baseline compared to those who were older than 60. A marginal race-by-inflammation composite score interaction was found for occipital lobe volume, whereby a higher midlife inflammation composite score was associated with lower occipital lobe volume among white, but not African American, participants (table 3). No interactions with sex were found (table e-5). � 
Inflammatory markers and episodic memory. Late-life episodic memory, which was associated with hippocampal and AD signature region volume after controlling for age (partial rs > 0.21, ps < 0.001), was reduced among participants with higher levels of the inflammation composite score. Each SD increase in inflammation composite score was associated with a ?0.08 SD performance decrement on the DWR after adjusting for covariates (CI ?0.15 to 0.00; p = 0.046). Similarly, a higher number of elevated inflammatory biomarkers at baseline was associated with reduced DWR performance (p trend = 0.009; figure 1). �
