Over the past decade, more adults in the US report experiencing problems with concentration, memory, and decision-making.

While adults of all ages reported these issues, researchers found that the rate of cognitive disability nearly doubled among those younger than 40.

“Challenges with memory and thinking have emerged as a leading health issue reported by US adults,” Adam de Havenon, MD, MS, Yale School of Medicine, New Haven, Connecticut, senior author, stated in a press release. “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.”

The study was published online on September 24 in Neurology.

‘The Rise is Real’

In a retrospective analysis of data from the Behavioral Risk Factor Surveillance System, researchers tracked 4,507,061 survey responses between 2013 and 2023, evaluating self-reported cognitive disability as a primary outcome.

Researchers also looked at whether other baseline characteristics, behaviors, and chronic conditions were linked to an increase in reporting cognitive disability.

Among respondents, 36.8% were aged 18-39, 26.2% were aged 40-54, 60.9% were non-Hispanic White individuals, and 87.3% had completed high school.

Respondents who answered “yes” to experiencing serious difficulty with concentration, memory, or decision-making due to a physical, mental, or emotional condition were classified as having a cognitive disability.

Data from 2020 were excluded from the analysis due to inconsistent collection at the beginning of the COVID pandemic, and researchers also excluded responses that self-reported depression.

Results showed the age-adjusted prevalence of self-reported cognitive disability was 5.3% (95% CI, 5.1-5.4%) in 2013, rising to 7.4% (95% CI, 7.2-7.6%) in 2023. The increase became statistically significant in 2016 (P < .001) and remained significant through 2023 (P < .001).

Between 2013 and 2023, self-reported cognitive disability increased among respondents aged 18-39 (5.1% and 9.7%, respectively), 40-54 (4.5% and 6.0%, respectively), and 55-69 (5.1% and 6.0%, respectively) but decreased among those aged 70 and older (7.3% and 6.6%, respectively).

Other factors associated with increased reporting of cognitive disability between 2013 and 2023 included respondents with household incomes less than $35,000 per year (8.8% in 2013 and 12.6% in 2023), those with less than a high school education (11.1% and 14.3%, respectively), and nearly all racial and ethnic groups: American Indian and Alaska Native (7.5% and 11.2%, respectively), Hispanic (6.8% and 9.9%, respectively), Black (7.3% and 8.2%, respectively), White (4.5% and 6.3%, respectively), and Asian (3.9% and 4.8%, respectively).

Factors associated with a smaller increase in self-reported cognitive disability between 2013 and 2023 included having a household income of $75,000 or more (1.8% in 2013 and 3.9% in 2023) and being a college graduate (2.1% and 3.6%, respectively).

“These findings suggest we’re seeing the steepest increases in memory and thinking problems among people who already face structural disadvantages,” de Havenon said. “We need to better understand and address the underlying social and economic factors that may be driving this trend.”

More research is needed to determine why younger adults are reporting higher rates of cognitive disability than other age groups, de Havenon said. “It could reflect actual changes in brain health, better awareness, and willingness to report problems, or other health and social factors. But regardless of possible causes, the rise is real — and it’s especially pronounced in people under 40.”

de Havenon reported receiving funding from the National Institutes of Health and National Institute of Neurological Disorders and Stroke.