Cognitive disability might be on the rise in the U.S., particularly among younger adults

A retrospective analysis of data from the Centers for Disease Control and Prevention’s Disability and Health Data System revealed that the prevalence of self-reported cognitive disability rose from 5.3% in 2013 to 7.4% in 2023. The increase was most pronounced among young adults, rising from 5.1% in 2013 to 9.7% in 2023 for this group. The research was published in Neurology.

Cognitive disability refers to a significant limitation in a person’s ability to think, learn, remember, or solve problems compared to what is typical for their age. It can affect skills such as reasoning, understanding language, attention, and the ability to plan or make decisions.

Some people are born with cognitive disabilities due to genetic or developmental conditions like Down syndrome or fragile X syndrome. Others may acquire them later in life through brain injury, stroke, or illnesses that damage the nervous system. Cognitive disabilities often co-occur with other challenges, such as motor or sensory impairments, but they can also exist on their own.

In the United States, more than 70 million adults are affected by some form of disability. That is 1 in 4 individuals. Among these, cognitive disability is the first or the second most reported type of disability (depending on the source of the report).

Study author Ka-Ho Wong and his colleagues wanted to explore how cognitive disability prevalence changed over the past decade in the U.S. and whether associations between cognitive disability and race, age, and other social determinants of health persist over time.

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They analyzed data from the Centers for Disease Control and Prevention’s Disability and Health Data System, which integrates nationally representative responses from US adults. They analyzed a total of 4,507,061 responses collected between 2013 and 2023.

Cognitive disability was identified using the following question: “Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions?”. Participants who answered with a “Yes” to this question were considered to have self-reported having a cognitive disability.

Participants also self-reported depression by answering the question “Have you ever been told by a doctor, nurse, or other health professional that you have a depressive disorder, including depression, major depression, dysthymia, or minor depression?” and reported various other health-related and demographic data.

The researchers excluded individuals from their analysis who had also reported ever being diagnosed with a depressive disorder. This was done to better isolate cognitive challenges not attributable to depression.

Results showed that the prevalence of self-reported cognitive disability increased steadily during the study period, rising from 5.3% in 2013 to 7.4% in 2023. Young adults, aged 18 to 39, exhibited the largest increases of any age group, with prevalence nearly doubling from 5.1% in 2013 to 9.7% in 2023.

In contrast, the prevalence among individuals aged 70 or older slightly decreased from 7.3% in 2013 to 6.6% in 2023. Examining different racial and ethnic groups, the prevalence of cognitive disability in 2023 was highest among American Indian and Alaska Native individuals (11.2%) and Hispanic individuals (9.9%). The prevalence was lowest among Asian individuals (4.8% in 2023). There were no substantial gender differences.

“The disproportionate growth in cognitive disability among younger adults seems to be the primary driver of the overall national trend. These findings warrant further investigation, given their potential long-term implications for population health, workforce productivity, and health care systems,” the study authors concluded.

The study sheds light on trends in self-reported cognitive health in the U.S. over the past decade. However, it should be noted that cognitive disability in this study was measured with a single, self-reported question, which means reporting bias could have affected the results.

The paper, “Rising Cognitive Disability as a Public Health Concern Among US Adults,” was authored by Ka-Ho Wong, Christopher D. Anderson, Cecilia Peterson, Erin Bouldin, Lauren Littig, Neeharika Krothapalli, Trieste Francis, Yvonne Kim, Giselle Cucufate, Jonathan Rosand, Kevin Navin Sheth, and Adam de Havenon.