Increasing Awareness and Screening for Cognitive Impairment in Adults Younger Than 65: A Literature Review
Dr. Tiney Ray, PhD, DNP, FNP-BC, PMHNP-BC
DOI: 10.1016/j.nurpra.2025.105673
This peer-reviewed literature review explores the growing prevalence of cognitive impairment in adults younger than 65, barriers to early detection, disparities in diagnosis, post-COVID cognitive concerns, and the critical role of nurse practitioners in advancing age-inclusive cognitive screening and care.
Abstract
Cognitive impairment in adults younger than 65 years is increasingly reported but remains underdiagnosed in primary care. This literature review synthesizes recent studies (2020–2025) on prevalence, screening recommendations, and barriers to early detection, especially in nurse practitioner-led settings. Findings show cognitive impairment in this age-group is often missed due to limited guidelines, low awareness, and diagnostic overshadowing, with misconceptions and disparities further delaying care. Nurse practitioners are well-positioned to advance screening, education, and policy advocacy.
Highlights
- Cognitive impairment younger than 65 is often missed in primary care.
- Lack of screening guidelines delays diagnosis in younger adults.
- Misconceptions about dementia hinder early recognition of symptoms.
- Disparities affect timely diagnosis and care for cognitive decline.
- Nurse practitioners are key to advancing cognitive screening access.
“There is an urgent need for age-inclusive protocols to support early detection and equitable cognitive healthcare for younger adults.”