ObjectivesThe prevention of cognitive impairment in the elderly is one of the public health priority areas. However, the relationship between closed-eye unipedal standing and cognitive impairment remains unclear.MethodsThis study was conducted on a group of elderly individuals from a community, using a prospective cohort study design. Participants were monitored for 7 years and were diagnosed with new-onset cognitive impairment. Logistic regression models and restricted cubic spline (RCS) were used to investigate the relationship between closed-eye unipedal standing and cognitive impairment. Stratified analysis by baseline characteristics were also performed.ResultsAt baseline, 1,652 people aged 65 years or older were enrolled. Ultimately, 880 participants completed the follow-up and 155 (17.61%) of them satisfied the diagnostic criteria for cognitive impairment at follow-up. Compared to the closed-eye unipedal standing low group as the reference, the middle (OR = 0.601, 95% CI: 0.396–0.911) and high (OR = 0.508, 95% CI: 0.329–0.785) groups had significantly lower cognitive impairment risks. RCS analysis indicated a linear relationship (Pnon − linear = 0.177), with a reduced risk of developing cognitive impairment when the duration of closed-eye unipedal standing was exceeded ~2.920 s. Stratified analysis showed that for female, aged 70 years or younger, with 3 or more years of education, without lack of exercise and without falls within 1 year subgroup, the elderly in the high group of closed-eye unipedal standing had significantly reduced cognitive impairment risks.ConclusionAmong the elderly population, closed-eye unipedal standing duration was linearly and negatively associated with the cognitive impairment risk. The closed-eye unipedal standing duration might be a predictive index for cognitive impairment in the elderly.

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