Psychosocial Factors Outweigh Short-Term Environmental Exposures in Subjective Cognitive Difficulties: A Causal AI Study

Short-term environmental exposures have been linked to cognitive and attention-related outcomes, but the robustness of these associations remains uncertain. We linked daily weather and air-pollution exposures to repeated measures of subjective cognitive difficulties and attention-related outcomes among participants in the All of Us Research Program from 2018 to 2024. Associations were evaluated using complementary longitudinal and causal-inference approaches, including fixed-effects, lagged-exposure, and event-study analyses. Machine-learning methods were used to characterize heterogeneity and latent psychosocial structure, and findings were independently evaluated using 2024 Behavioral Risk Factor Surveillance System data. Several environmental exposure measures were associated with cognitive outcomes in pooled analyses; however, most associations attenuated substantially after accounting for within-location temporal variation. In contrast, mental-health burden, loneliness, and impaired social functioning remained consistently associated with subjective cognitive difficulty across analytical approaches. Similar patterns were observed in the validation dataset. These findings suggest that some observed environmental associations may reflect broader geographic and contextual differences rather than short-term environmental effects. Overall, psychosocial factors demonstrated more consistent associations with subjective cognitive difficulties than short-term environmental exposures across multiple analytical frameworks and independent datasets.