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It isnt a sign of cognitive decline in the way that dementia is

It was also shown that TMA and TMAO levels were initially higher and the numbers of aortic lesions were increased in choline diet-fed ApoE / mice transplanted with microbiota from high TMAO-producing C57BL/6J strains than in mice transplanted with low TMAO-producing NZW/LacJ strains ( The final step in TMAO formation is the oxidation of TMA, which is mediated by the flavin-containing monooxygenase (FMO) family members FMO1 and FMO3

This is a key part of your GLP-1 diet and hydration prep

[12] CoQ10 in Food Eating a well-balanced diet that includes a variety of foods can help keep your overall CoQ10 status up