摘要Objective To examine the association of atherosclerotic cardiovascular disease (ASCVD) and its risk factors with cognitive impairment in older adults.Methods Six hundred and fourteen subjects,aged ≥ 65 years,from one center (2016-2018) underwent clinical,laboratory assessments and the Montreal Cognitive Assessment (MoCA).Using regression analysis,the relationship between ASCVD and its risk factors was evaluated in subjects with and without cognitive impairment (MoCA score ＜ 26).Results Older age (β =-1.3 per 5 years,95％ CI:-1.7 to-0.9,P ＜ 0.001),history of stroke (β =-1.6,95％ CI:-3.0 to-0.3,P =0.01),and myocardial infarction (MI;β =-2.2,95％ CI:-3.6 to-0.8,P =0.003) were independently associated with lower MoCA scores,whereas more education (β =1.5 per 3 years,95％ CI: 1.1 to 1.9,P ＜ 0.001),higher body mass index (BMI;β =0.5 per 3 kg/m2,95％ CI: 0.0 to 1.0,P =0.04),higher estimated glomerular filtration rate (eGFR;β =0.8 per 15 U,95％ CI: 0.1 to 1.4,P =0.03),left ventricular ejection fraction (LVEF;β =0.4 per 5％,95％ CI: 0 to 0.8,P =0.04) and statin use (β =1.3,95％ CI: 0.3 to 2.3,P =0.01) were associated with a higher MoCA score.Cognitive impairment was inde-pendently associated with older age (OR =1.51 per 5 yrs,95％ CI: 1.28 to 1.79,P ＜ 0.001),less education (OR =0.55 per 3 years,95％ CI:0.45 to 0.68,P ＜ 0.001),lower BMI (OR =0.78 per 3 kg/m2,95％ CI: 0.62 to 0.98,P =0.03) and higher levels of high sensitivity c-reactive protein (hsCRP;OR =1.08 per 1 mg/L,95％ CI: 1.02 to 1.15,P =0.01).Conclusions Beyond age,cognitive impairment was associated with prior MI/stroke,higher hsCRP,statin use,less education,lower eGFR,BMI and LVEF.