Key points
- The National Health and Nutrition Examination Survey (NHANES) has been monitoring the health and nutritional status of U.S. adults and children since 1960.
- NHANES examines about 5,000 people each year using interviews and physical exams.
- Data on cognitive performance in adults 60 years and older have been collected during the following survey cycles: 2011-2012, 2013-2014, and 2019-2020.
About NHANES
NHANES was established in 1960 to assess the health and nutritional status of U.S. adults and children. Each year, it examines a nationally representative sample of about 5,000 people.
NHANES includes both interview and physical exam components:
- Interviews include demographic, socioeconomic, dietary, and health-related questions.
- Physical exams consist of medical, dental, and physiological measurements, as well as lab tests administered by highly trained medical personnel.
NHANES has also collected cognitive performance data on adults 60 years and older during select survey cycles: 2011-2012, 2013-2014, and 2019-2020.
These data are presented below.
NHANES 2019–2020
Data on cognitive performance in adults aged 60 years and older were collected in 2019−2020. Assessments included:
- Subjective cognitive decline question. One interview question assessed self-rated worsening memory loss or confusion.
- Montreal Cognitive Assessment (MoCA). Cognitive functioning tasks were administered during the physical exam component to detect cognitive decline across several areas of cognitive functioning.
In the home interview, a self-rated question on subjective cognitive decline (SCD question) was asked:
"During the past 12 months, have you experienced confusion or memory loss that is happening more often or is getting worse?" Response categories were yes or no.
The SCD question was part of the optional cognitive decline module from the BRFSS. It was developed to determine the need for public health activities among adults residing in the community.
The Montreal Cognitive Assessment (MoCA) is a widely used measure for accurately detecting levels of cognitive decline, testing the following areas of cognitive functioning:
- Language.
- Visual-spatial abilities.
- Memory and recall and abstract thinking.
- Areas of executive function.
A survey-adapted MoCA (MoCA-SA) cognitive functioning task was administered to adults aged 60 years and older during the NHANES physical exam component. For more information, see NHANES Cognitive Functioning Data Documentation, Codebook, and Frequencies.
The cognitive functioning dataset for 2019–2020 was not released to the public. However, information about limited access data is available.
NHANES 2011–2012 and 2013–2014
In 2011-2012 and again in 2013-2014, NHANES data on cognitive performance in adults 60 years and older were collected.
The home interview included the same self-rated question on subjective cognitive decline (SCD) as the 2019-2020 survey.
The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) provided a test that measured immediate and delayed memory. Each participant read a 10-item word list (CERAD-WL) and was asked to immediately recall those 10 items.
- The Animal Fluency test measured verbal fluency and asked participants to name as many animals as possible in one minute.
- The Digit Symbol Substitution Test asked participants to match symbols to a corresponding number during a timed test. This was done as a measure of attention and processing speed.
After completing the Animal Fluency and Digit Symbol Substitution tasks, the participant was asked to list those same 10 items again, as a delayed recall (CERAD-DR) test.
NHANES cognitive performance data for 2011–2012 and 2013–2014 are publicly accessible and available at the NHANES website.
- Cognitive performance data can be found under Questionnaire Data.
- SCD data can be found in the Medical Conditions data file.
- Data from the cognitive functioning assessments can be found in the Cognitive Functioning data file.
For an example of an analysis conducted using these data and a more detailed description of NHANES and the cognitive variables, please refer to this National Health Statistics Report on cognitive performance in adults aged 60 and over (NHANES, 2011-2014).
Find out more about participants, data collection, documentation, and analyses.