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Findings from a recent study reveal that a rising number of US adults, particularly those under 40, are reporting serious challenges with concentration, memory and decision-making.
Between 2013 to 2023, the rate of self-reported cognitive disability in the US rose from 5.3% to 7.4%. People with lower incomes and less education saw the biggest increases, while Native American and Alaska Native adults had the highest reported rates.
The researchers say their results, published in Neurology, highlight a potential public health concern. They suggest further research into which social and economic factors are driving the increase may help to provide healthcare providers with effective support.
“Challenges with memory and thinking have emerged as a leading health issue reported by US adults,” says the study’s senior author Adam de Havenon, from Yale University’s Department of Neurology.
The researchers analysed more than 4.5 million survey responses collected annually from 2013 to 2023 by the Behavioral Risk Factor Surveillance System. Due to the COVID-19 pandemic, responses from 2020 were excluded from the dataset.
Participants responded to questions like “Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions?”
If a participant answered yes to this question they were classified by the researchers as having a cognitive disability.
The researchers observed that the largest increase was among adults aged 40 and under. Over the 10-year period, cognitive disability rates almost doubled in this age bracket, rising from 5.1% in 2013 to 9.7% in 2023.
But the rate of cognitive disability dropped from 7.3% to 6.6% across the same period for adults aged 70 and older.
“Our study shows that these difficulties may be becoming more widespread, especially among younger adults, and that social and structural factors likely play a key role,” says de Havenon.
Although the survey conducted is not a measure of cognitive impairment, de Havenon acknowledges that the study still reflects an important public health trend that should not be dismissed.
“It could reflect actual changes in brain health, better awareness and willingness to report problems, or other health and social factors,” says de Havenon.
“But regardless of possible causes, the rise is real and it’s especially pronounced in people under 40.”
The researchers also found adults with household incomes below $35,000 USD ($52,900 AUD) consistently reported the highest rates of cognitive disability, rising from 8.8% to 12.6%.
While most of the participants in the study were white, the researchers found that the rates were on the rise across nearly all racial and ethnic groups,. The highest prevalence was found across Native American and Alaska Native adults, rising from 7.5% to 11.2%.
The rates of cognitive impairment from 11.1% to 14.3% among adults without a diploma rose while rates among college graduates rose 2.1% to 3.6% in the same period.
“These findings suggest we’re seeing the steepest increases in memory and thinking problems among people who already face structural disadvantages,” says de Havenon.
“We need to better understand and address the underlying social and economic factors that may be driving this trend.”
The authors acknowledge the study is limited by its broad definition of disability and reliance on self-reported data which “reflects individuals’ perceptions and may be influenced by social, cultural, and psychological factors” rather than “objectively measured cognitive impairment or clinical diagnoses”.
However, the findings provide a foundation to allow future work to dive deeper into the factors contributing to this rise.
“More research is also needed to understand what’s driving the large increase in rates among younger adults, given the potential long-term implications for health, workforce productivity and health care systems,” says de Havenon.
