Rising Cognitive Disability as a Public Health Concern Among US Adults: Trends From the Behavioral Risk Factor...

Area of Science:

• Public Health
• Epidemiology
• Gerontology

Background:

• Cognitive disability, defined as serious difficulty concentrating, remembering, or making decisions, is the most reported disability in US adults.
• Previous research indicated disparities by race, age, and socioeconomic status, but recent trends remain under-examined.

Purpose of the Study:

• To analyze national trends in self-reported cognitive disability from 2013 to 2023.
• To investigate differences in cognitive disability prevalence across age groups, racial/ethnic populations, and social determinants of health.

Main Methods:

• Retrospective analysis of nationally representative US adult data (≥18 years) from the Behavioral Risk Factor Surveillance System (BRFSS), 2013-2023 (excluding 2020).
• Exclusion of participants reporting depression to focus on non-psychiatric cognitive impairment.
• Survey-weighted logistic regression used to model prevalence trends and associations with demographic/socioeconomic factors.

Main Results:

• Age-adjusted cognitive disability prevalence rose from 5.3% in 2013 to 7.4% in 2023.
• The prevalence among younger adults (18-39 years) nearly doubled, from 5.1% to 9.7%, becoming the main driver of the national increase.
• Statistically significant increases in cognitive disability were observed starting in 2016.

Conclusions:

• The disproportionate rise in cognitive disability among younger adults is the primary driver of the overall national trend.
• These findings necessitate further investigation due to potential long-term impacts on population health, workforce, and healthcare systems.