목적: Emerging evidence highlights the vestibular system's role in cognitive function, but mechanisms linking vestibular dysfunction to cognitive decline remain unclear, requiring further large-scale studies. This study examines the relationship between balance and cognitive function in the elderly. 방법:We assessed the impact of vestibular function on cognitive performance in rural adults aged 60+ (N = 479) using data from the 2024 Taizhou Imaging Study Cohort. Vestibular function was measured using the modified Romberg test and a self-designed balance questionnaire, while cognitive function was assessed with MMSE and MoCA. Correlation analyses and multivariable logistic regression evaluated the relationship between vestibular function and cognitive performance. 결과:The average age was 67.73 years (SD = 3.9). The dementia prevalence was 7.5%, and mild cognitive impairment was 26.7%. Vestibular dysfunction prevalence was 11.4% (modified Romberg test) and 19% (balance questionnaire). Dizziness was more common in females (24%) than males (12.7%) (P=0.003). Correlation analysis showed a negative correlation between vestibular and cognitive function (MoCA: r = -0.16, P<.05 MMSE: r = -0.19, P<.05). Logistic regression showed vestibular dysfunction was not a significant factor for dementia prevalence, while education level and hearing status were protective for cognitive function. 결론:Our study reveals a high prevalence of both vestibular dysfunction and cognitive impairment among the elderly in rural China. While there is a significant correlation between vestibular function and cognitive performance, multivariable analysis did not identify vestibular dysfunction as an independent risk factor for dementia. This suggests that vestibular function may influence overall cognitive abilities but does not directly impact the onset of dementia. Future research should further explore the mechanisms linking vestibular function to cognitive decline.