Back

Generational gains in memory capacity and stability may account for declining dementia incidence rates in Europe and the United States

Fjell, A. M. M.; Grodem, E. O. S. O. S.; Lunansky, G.; Vidal-Pineiro, D.; Rogeberg, O. J.; Walhovd, K. B.

2026-04-15 neurology
10.64898/2026.04.14.26350835 medRxiv
Show abstract

Dementia incidence has been declining in Western societies for decades, but whether this reflects higher cognitive capacity entering old age, slower cognitive decline, or both remains unresolved. Analysing ~783,000 episodic memory assessments from ~219,000 individuals across five longitudinal cohorts, we find that later-born cohorts benefit from a double dividend: higher memory levels entering old age and slower rates of decline. The projected 20-year cohort advantage at age 80 is of sufficient magnitude to plausibly account for the observed 13% per-decade decline in dementia incidence reported in meta-analyses. Generational gains are disproportionately concentrated among the fastest-declining individuals, and are reflected in lower hippocampal atrophy rates in an independent sample. A formal bounding analysis shows that the double dividend is robust across a range of plausible period assumptions, consistent with environmental conditions operating across the lifespan having reshaped the architecture of human cognitive aging.

Matching journals

The top 5 journals account for 50% of the predicted probability mass.