• Self-reported cognitive disability among U.S. adults increased from 5.3% to 7.4% over the past decade.
• Rates nearly doubled for younger adults ages 18 to 39.
• The steepest increases occurred among people with lower incomes and less education.
• American Indian and Alaska Native adults reported the highest overall rates.
• Researchers urge deeper study into the social and economic causes behind these patterns.

Growing Reports of Memory and Thinking Problems

An increasing share of American adults, especially those under 40, say they are struggling with memory, focus, and decision-making, according to a new study published in Neurology, the journal of the American Academy of Neurology.

"Challenges with memory and thinking have emerged as a leading health issue reported by U.S. adults," said study author Adam de Havenon, MD, MS, of Yale School of Medicine in New Haven, Connecticut, and a Fellow of the American Academy of Neurology. "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."

Researchers examined data from more than 4.5 million annual surveys conducted between 2013 and 2023. Respondents were asked, "Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions?" Those answering "yes" were categorized as having a cognitive disability. Responses from individuals reporting depression were excluded, as was data from 2020 due to the unique impact of the COVID-19 pandemic.

Younger Adults See the Steepest Rise

Between 2013 and 2023, the percentage of adults reporting cognitive disability climbed from 5.3% to 7.4%. The upward trend began around 2016 and was most pronounced among adults under 40, where rates nearly doubled from 5.1% to 9.7%. Meanwhile, adults aged 70 and older showed a slight decline, from 7.3% to 6.6% during the same period.

Although this survey did not directly measure clinical cognitive impairment, de Havenon noted that the rising rate of self-reported difficulties among younger adults points to an emerging public health issue.

Economic and Educational Gaps in Brain Health

Income and education appeared to play a major role in cognitive health trends. Adults earning less than $35,000 annually had the highest reported rates, increasing from 8.8% to 12.6% over the decade. By comparison, adults with incomes above $75,000 saw only a modest increase, from 1.8% to 3.9%.

Education showed a similar divide: rates among adults without a high school diploma rose from 11.1% to 14.3%, while those among college graduates increased from 2.1% to 3.6%.

Racial and Ethnic Disparities

Although most respondents were white, self-reported cognitive challenges increased across nearly all racial and ethnic groups:

• American Indian and Alaska Native adults: highest prevalence, from 7.5% to 11.2%
• Hispanic adults: from 6.8% to 9.9%
• Black adults: from 7.3% to 8.2%
• White adults: from 4.5% to 6.3%
• Asian adults: from 3.9% to 4.8%

"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 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," de Havenon continued. "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."

Researchers noted that the study relied on self-reported data from telephone surveys, meaning respondents may not have recalled all details accurately. Another limitation was the broad definition used for cognitive disability, which may capture a range of experiences rather than a specific clinical diagnosis