Rates of self-reported cognitive disability among U.S. adults are on the rise, with a notable increase among young adults aged 18 to 39, according to a recent study conducted by Yale University. This research, drawing on data from the U.S. Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System, highlights a growing trend that could have significant implications for public health and the workforce.
The CDC’s annual phone survey asks respondents to report how often they experience serious trouble with memory, concentration, or decision-making—conditions the CDC categorizes as “cognitive disability.” Analyzing over 4.5 million survey responses from 2013 to 2023, researchers identified a rise in the percentage of adults reporting cognitive disability from 5.3% in 2013 to 7.4% in 2023. Notably, the rate among young adults nearly doubled, from 5.1% to 9.7%, driving much of the overall increase.
Young Adults at the Forefront
The unexpected surge among young adults has drawn particular attention. “What stood out was the surprising rise among young adults,” remarked Adam de Havenon, an associate professor of neurology at the Yale School of Medicine and a lead author of the study. The research team, including experts from the University of Utah and the Mass General Brigham health system, published their findings in the journal Neurology.
While the findings are concerning, de Havenon emphasized that they do not indicate an imminent wave of dementia cases. “This isn’t a diagnosis of dementia or even of cognitive impairment,” he explained. “It’s a subjective report of people saying they’re having serious difficulty concentrating, remembering, or making decisions.” Dementia involves structural brain disease and specific pathologies, which differ from self-reported cognitive difficulties.
Implications and Future Research
The study’s results suggest a need for further investigation into the causes and potential consequences of rising cognitive problems. Growing cognitive issues among the population could impact healthcare systems and workplace productivity in the future. “It’s important to highlight that impairment in cognition is a problem in the adult population of the United States,” de Havenon noted. “It’s something that I think we’ll be paying more and more attention to in the years to come.”
However, the study is not without its limitations. Researchers excluded responses from individuals reporting depression, dementia, and other cognitive disabilities, yet self-reported data remains inherently subjective. Increased public awareness of cognitive health might also be contributing to the rise in self-reported rates. “I’d argue that we can’t answer that question, but the fact that more people are reporting this as a disability means we should be paying more attention to it,” de Havenon stated.
Demographic Disparities and Social Determinants
The study also revealed demographic disparities in cognitive disability rates. Adults identifying as American Indian, Alaska Native, and Hispanic reported the highest rates, while Asian adults reported the lowest. Additionally, lower income and educational levels were linked to higher rates of cognitive disability. Geographic differences were evident, with the South and Midwest experiencing higher rates compared to the Northeast.
Individuals with chronic health conditions, such as diabetes or high blood pressure, were more likely to report cognitive disabilities. “These are already well-known phenomena: Cognitive impairment follows social determinants of health,” said de Havenon, who specializes in vascular neurology. The study is part of his ongoing research into the epidemiology of cognitive impairment in the U.S.
Looking Ahead
De Havenon suggests that addressing vascular health at a population level could potentially improve cognitive outcomes. “A lot of work has been done in small cohorts looking at very specific disease pathology like the plaques that cause certain dementia,” he said. “My goal is to start talking about how vascular interventions at a population level could improve not only stroke and cardiovascular disease rates, but also cognition.”
As the nation grapples with these findings, the need for comprehensive strategies to address cognitive health becomes increasingly apparent. The study underscores the importance of continued research and public health initiatives aimed at understanding and mitigating the factors contributing to cognitive disability.
