A recent study, published on September 24, 2025, in Neurology®, the medical journal of the American Academy of Neurology, has revealed a troubling rise in self-reported cognitive problems among adults in the United States. The findings indicate that an increasing number of people—particularly those under the age of forty—are experiencing severe difficulties with memory, concentration, and decision-making. This large-scale study, which analysed over 4.5 million survey responses collected annually between 2013 and 2023, suggests that cognitive challenges are not confined to older populations, as is often assumed, but are spreading more rapidly among younger generations. The data point to a concerning public health trend that may reflect not only biological or lifestyle changes but also deep social and economic inequalities influencing brain health in modern America.
Dr Adam de Havenon, MD, MS, of Yale School of Medicine and a Fellow of the American Academy of Neurology, led the research and described the findings as an emerging national health issue. “Challenges with memory and thinking have emerged as a leading health issue reported by U.S. adults,” he stated. “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.” His remarks highlight the dual dimensions of this problem: while some of the increase may stem from genuine shifts in neurological health, much of it appears to be intertwined with the pressures and inequities of modern living. Stress, economic hardship, inadequate health care, and educational disparities all seem to converge in ways that affect mental and cognitive functioning across the population.
The research drew on data from the Behavioural Risk Factor Surveillance System, a long-running annual survey conducted across the United States. Respondents were asked whether, because of a physical, mental, or emotional condition, they had serious difficulty concentrating, remembering, or making decisions. Those who answered “yes” were classified as having a cognitive disability. The researchers deliberately excluded data from 2020, when the COVID-19 pandemic profoundly altered patterns of mental and physical health, as well as responses from individuals reporting depression, to avoid overlapping psychological factors. Even with these exclusions, the results demonstrated a striking rise in reported difficulties. From 2013 to 2023, the national rate of cognitive disability increased from 5.3% to 7.4%, with the first noticeable uptick occurring in 2016.
Younger adults were the group most affected by this change. For people under forty, the rate of reported cognitive disability nearly doubled, climbing from 5.1% in 2013 to 9.7% in 2023. In contrast, rates among adults aged seventy and older declined slightly, from 7.3% to 6.6%. This generational divide is particularly noteworthy, as it suggests that factors unique to younger adults—such as increased stress from financial instability, digital overstimulation, long working hours, and sleep deprivation—could be influencing cognitive function. Dr de Havenon cautioned that while the survey does not directly measure clinical impairment, the rising prevalence of self-reported memory and concentration problems among younger adults signals an urgent need to investigate environmental, behavioural, and societal contributors to cognitive decline.
The study also exposed deep socioeconomic and educational disparities in cognitive health. Adults with household incomes below $35,000 consistently reported the highest rates of difficulty, increasing from 8.8% to 12.6% over the ten years. By contrast, those with incomes exceeding $75,000 had significantly lower rates, although these rates still increased modestly, from 1.8% to 3.9%. Similarly, people without a high school diploma reported a significant rise—from 11.1% to 14.3%—compared with college graduates, whose rates climbed from 2.1% to 3.6%. These findings highlight how economic and educational disadvantage can exacerbate cognitive challenges, possibly through mechanisms such as chronic stress, limited access to health care, poor nutrition, and restricted opportunities for cognitive engagement. The consistent pattern across income and education levels implies that cognitive difficulties are as much a social issue as a medical one.
Racial and ethnic disparities further complicate the picture. Although the majority of survey respondents were white, increases in cognitive disability were observed across nearly every demographic group. American Indian and Alaska Native adults exhibited the highest prevalence, rising from 7.5% to 11.2%, while Hispanic adults saw an increase from 6.8% to 9.9%. Black adults experienced a smaller increase, from 7.3% to 8.2%, whereas white adults rose from 4.5% to 6.3%. Asian adults, though reporting the lowest overall rates, still showed an increase from 3.9% to 4.8%. Dr de Havenon pointed to these disparities as further evidence that structural inequities—such as access to education, health care, and employment—shape not only physical but also cognitive well-being. “We’re seeing the steepest increases in memory and thinking problems among people who already face structural disadvantages,” he said. “We need to understand better and address the underlying social and economic factors that may be driving this trend.”
Despite the scale and robustness of the dataset, the study has limitations. The researchers acknowledged that data were gathered through telephone surveys, meaning responses depended on individuals’ recollections and subjective perceptions of their difficulties. This method introduces potential inaccuracies, as participants might misinterpret the question, overstate their symptoms, or underreport due to stigma. Moreover, the definition of “cognitive disability” was broad, encompassing a wide range of difficulties that might not equate to measurable cognitive impairment. Nevertheless, the consistent upward trend across demographics and income levels gives the findings significant credibility. Dr de Havenon called for more research into the causes of this shift, particularly among younger adults, given its long-term implications for health, productivity, and the health care system. Whether the rise reflects genuine neurological changes, increased awareness, or a greater willingness to report symptoms, the results indicate a real and troubling phenomenon that warrants urgent public health attention.
In conclusion, the study paints a sobering portrait of cognitive health in contemporary America. The data suggest that memory and thinking problems are no longer confined to the elderly but are increasingly affecting younger and economically disadvantaged populations. If these patterns persist, the long-term consequences could be profound, affecting not only the individual’s quality of life but also national productivity and social stability. As the researchers note, urgent interdisciplinary action is required—combining medical, social, and policy-based approaches—to identify the causes of these trends and mitigate their impact. In the meantime, the growing prevalence of self-reported cognitive difficulties among Americans under forty stands as a warning sign: one that demands attention not only from neurologists and psychologists but from society as a whole.
More information: Adam de Havenon et al, Rising Cognitive Disability as a Public Health Concern Among US Adults Trends From the Behavioral Risk Factor Surveillance System, 2013–2023, Neurology. DOI: 10.1212/WNL.0000000000214226
Journal information: Neurology Provided by American Academy of Neurology
