Study finds doubling of dementia risk factors among young Americans as cognitive disability rises

A Yale University-led analysis of 4.5 million U.S. adults from 2013 to 2023 found self-reported cognitive disability rose 40 percent over the decade, increasing from about 5.3% to 7.4% of respondents overall.

Among adults aged 18 to 39, the prevalence nearly doubled, rising from roughly 5% in 2013 to about 10% in 2023, while rates among older adults remained stable or declined slightly.

Cognitive disability is a core signal of cognitive impairment and a pivotal stage between normal aging and dementia. The study notes that about 80% of individuals with mild cognitive impairment progress to dementia within six years, underscoring the long-term risk associated with these symptoms.

Disparities in the data were pronounced. American Indian/Alaska Native individuals saw the highest jump, from about 7.5% in 2013 to more than 11% in 2023. Black and Hispanic adults also showed higher rates than white adults, while Asian adults had the lowest prevalence. Education and income shaped risk: those with less education or lower incomes reported more cognitive difficulties, and the prevalence rose across income groups, with the lowest-income group climbing from about 9% to 12.6% over the decade.

Researchers used the Behavioral Risk Factor Surveillance System (BRFSS) survey to track trends, but data from 2020 were excluded because of pandemic disruptions, while the overall trend persisted across groups.

Long-standing health conditions were linked to higher risk. Adults who had survived a stroke were the most affected, with nearly one in five reporting significant cognitive disability in 2023. Those with high blood pressure were about 30% more likely to report cognitive difficulties than those without it, and adults with diabetes showed roughly a 50% higher prevalence.

Lead study author Dr. Adam de Havenon, a neurologist at Yale School of Medicine, said the findings point to a broader public health issue. "Challenges with memory and thinking have emerged as a leading health issue reported by U.S. adults," he said. "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."

Experts caution that cognitive disability is not a diagnosis of dementia, but the pattern raises concerns about potential long-term impacts on health, workforce productivity and health care systems. The study adds that more research is needed to determine the drivers of the rise among younger adults and to understand how to effectively address increasing cognitive health disparities.