March 18, 2026--Worse financial well-being in midlife and older age —and especially declines over time—are associated with lower memory scores and faster cognitive decline, reports a new study at Columbia University Mailman School of Public Health. The population experiencing significant financial deterioration showed memory decline equivalent to roughly five additional months of aging per year.
The study is among the first to examine the cognitive consequences of poor financial well-being. The findings are published in the American Journal of Epidemiology .
Lower average financial well-being and worsening financial conditions were consistently linked to poorer memory function and accelerated decline. Associations were strongest among adults aged 65 and older and findings were robust to sensitivity analyses addressing potential reverse causation and attrition.
"Financial well-being is an emerging economic determinant of health that may be associated with cognitive aging," said Adina Zeki Al Hazzouri, PhD associate professor of Epidemiology at Columbia Mailman School of Public Health (MSPH), and senior author. "Prolonged financial strain may overwhelm mental bandwidth and contribute to negative cognitive outcomes."
Researchers analyzed data from 7,676 adults aged 50+ in the Health and Retirement Study (2010–2020), assessing how both average financial status and four-year changes in financial well-being relate to memory performance over the subsequent four years.
To measure financial well-being, researchers developed and validated an eight-item index using existing survey data. The index captures both psychosocial strain -- such as financial dissatisfaction and stress -- and material hardship including difficulty paying bills, low income, and reduced access to basic needs. It was validated against the Consumer Financial Protection Bureau's Financial Well-Being Scale.
Each one-point worsening in financial well-being was associated with lower memory scores and faster decline. In contrast, improvements in financial well-being were not consistently associated with better cognitive outcomes.
"Our index was designed to capture poor financial well-being as a multidimensional exposure encompassing both a lack of psychosocial resources -- for example, perceived financial dissatisfaction and strain -- alongside material constraints such as difficulty meeting basic needs and low income," said Katrina Kezios, PhD, assistant professor of Epidemiology at Boston University School of Public Health and former post-doctoral scholar at Columbia Mailman School and first author. "We validated our index against the Consumer Financial Protection Bureau's Financial Well-Being scale, which was first introduced in the HRS in 2020."
The authors suggest that older adults may be particularly vulnerable due to limited financial recovery options and reliance on fixed incomes, such as Social Security and pensions. Financial strain may harm cognitive health through chronic stress, reduced access to healthcare and nutrition, and constrained social engagement.
"Our findings also point to potential policy implications," observed Zeki Al Hazzouri. "Income supports and financial assistance in later life may help protect cognitive health and reduce dementia risk, particularly for those experiencing financial decline."
Overall, the study supports the hypothesis that worsening financial well-being in midlife and later life may contribute to accelerated cognitive aging.
Co-authors are Jordan Vo, Northwestern University; Zihan Chen, Columbia Mailman School of Public Health; and Sarah Weber, Boston University School of Public Health; and Allison E. Aiello, (James S. Jackson Healthy Longevity Professor of Epidemiology, Columbia Mailman School and interim director, Columbia Butler Aging Center,
The study was supported by National Institute on Aging grant numbers K99AG084769 and R00AG084769, R01AG075719.
The authors report no financial conflicts of interest.
Columbia University Mailman School of Public Health
