Cognitive impairment contributes significantly to negative health outcomes. This meta-analysis aimed to investigate the association between cognitive impairment and cardiovascular mortality in mature and older adults.

PubMed, Web of Science, and Embase databases were searched until February 10, 2024, to identify the association between cognitive impairment and cardiovascular mortality in mature and older adults (aged 50 years and older) from the general population. The adjusted risk estimates from the included studies were extracted and pooled using a random effects model.

Ten studies were included in the meta-analysis, involving 16,765 participants. The pooled hazard ratio (HR) of cardiovascular mortality was 1.75 (95 % confidence interval [CI] 1.44–2.14; I2 = 48.2 %) for individuals with cognitive impairment compared to those without, even after adjusting for common confounding factors. Subgroup analysis revealed that the prognostic value of cognitive impairment may be influenced by the assessment tools used for measuring cognition. Additionally, cognitive impairment significantly predicted cardiovascular mortality in women (HR 2.40; 95 % CI 1.54–3.74; I2 = 45.4 %) but not in men (HR 1.49; 95 % CI 0.99–2.24; I2 = 44.8 %).

Cognitive impairment is a significant predictor of cardiovascular mortality in mature and older adults from the general population. However, future studies are needed to evaluate the specific impact of cognitive impairment on different genders.