Evaluating The Risk of Cognitive Decline from Socio-Demographic, Behavioral, and Social Factors

Cognitive decline is a growing concern in the US and other aging populations. Cognitive decline begins with typical age-related changes and can advance to subjective cognitive impairment, mild cognitive impairment, and eventually lead to more serious conditions like Alzheimer's disease and other forms of dementia. Using data from the 2023 Behavioral Risk Factor Surveillance System (BRFSS), which is weighted to be nationally representative, this study assessed the prevalence of difficulties with thinking or memory that were happening more often or were getting worse over the past 12 months and associated socio-demographic, behavioral, and social risk factors among adults aged 45 and older in the US. We hypothesized that: [1] sex differences in cognitive decline would be mitigated when accounting for these other factors and [2] physical inactivity would be associated with more prevalent difficulty in thinking or memory that occurs more often or gets worse over the past 12 months. Three central findings emerged from our study. First, after adjusting for socio-demographic, behavioral, and health-related risk factors, the odds of experiencing difficulties with thinking or memory that were happening more often or were getting worse over the past 12 months were higher for males than for females (adjusted odds ratio [aOR] = 1.04; 95% confidence interval [CI]: 1.00 to 1.08). Second, the odds of experiencing difficulties with thinking or memory that were happening more often or were getting worse over the past 12 months were lower for individuals earning $100,000 or more per year compared to those earning between $50,000 and <$100,000 per year (aOR = 0.80; 95% CI: 0.75 to 0.85). Third, physical inactivity was also associated with higher odds of difficulty with thinking or memory (aOR = 1.28; 95% CI: 1.22 to 1.35). These results emphasize the importance of addressing social and behavioral risk factors to potentially delay or reduce the onset of cognitive decline among the elderly.