In a longitudinal study of 1,664 Chinese older adults, lower albumin tertile was associated with greater risk of cognitive impairment at baseline [low, odds ratio (OR) = 2.30, 95% CI = 1.31–4.03; medium, OR = 1.59, 95% CI = 0.88–2.88] vs. high (P for trend = 0.002); and with cognitive decline in longitudinal analyses: low, OR = 1.73, 95% CI = 1.18–2.55; medium, OR = 1.32, 95% CI = 0.89–1.95, vs. high (P for trend = 0.004). Here, ALB is linked to Cognitive impairment.