Objective  To investigate the relationship between living arrangement and cognitive impairment in community elderly.

  Methods  Using cross-sectional design and systematic sampling, we investigated a total of 1 818 elderly in four communities in Wuchang district of Wuhan city, Hubei province from August 2014 through August 2016. The score of Montreal Cognitive Assessment (MoCA) was adopted to evaluate cognitive function of the elderly. Chi-square test, F test, Student-Neuman-Keulls (SNK) test, and multivariate logistic regression model were adopted to analyze the data collected.

  Results  Living with spouse only (odds ratio OR = 0.57, 95% confidence interval 95%CI: 0.41 – 0.79) and living with spouse and children (OR = 0.66, 95%CI: 0.45 – 0.98) were protective factors for cognitive function of the elderly. After adjusting for confounding factors such as age, gender, education level, occupation, physical exercise, smoking, alcohol drinking, and social networks (size, complexity), living with spouse only and living with spouse and children were still protective factors against cognitive impairment among the elderly, with the OR (95%CI) of 0.62 (0.45 – 0.88) and 0.73 (0.46 – 0.98), respectively.

  Conclusion  Living arrangement is related to cognitive decline and living with spouse is an protective factor for cognitive impairment among community elderly.