Objective To investigate the cognitive function and apolipoprotein E (ApoE) genotype and risk factors of cognitive impairment in the long-lived individuals in Zhongxiang, Hubei Province. Methods From January 2013 to March 2019, we visited the long-lived individuals, conducting face-to-face questionnaire survey, performing physical examination and ApoE genotype detection, and evaluating cognitive function with the mini-mental state examination. Mann-Whitney U test, Pearson chi-square test or Fisher′s exact test were used to compare cognitive normal group and cognition-impaired group. Logistic regression analysis was used to explore risk factors of cognitive impairment. Results A total of 320 long-lived individuals (median age, 94.0 years; 104 males, and 216 females) were enrolled in the analysis. Their ApoE genotype was ε2ε2 (0.6%), ε2ε3 (15.3%), ε3ε3 (66.2%), ε2ε4 (1.3%), ε3ε4 (16.3%), ε4ε4 (0.3%). Cognitive impairment was found in 65.6%(210/320) of the long-lived individuals. Multivariate logistic regression and analysis indicated that male (aOR=0.495,95%CI 0.260-0.940; P=0.032), being educated (aOR=0.365,95%CI 0.183-0.726, P=0.004), carrying ε2 allele (aOR=0.501,95%CI 0.252-0.996; P=0.049), and ε2ε2 or ε2ε3 (aOR=0.472,95%CI 0.231-0.964; P=0.039) were the protective factors of cognitive impairment; and that visual impairment (aOR=3.769, 95%CI 1.887-7.528; P＜0.001) and hearing impairment (aOR=2.691,95%CI 1.435-5.043; P=0.002) were the risk factors of cognitive impairment. However, age, history of smoking, history of drinking alcohol, carrying ε4 allele, and ε2ε4, ε3ε4 or ε4ε4 relative to ε3ε3 were not significantly associated with cognitive impairment (P＞0.05). Conclusion The ApoE genotype was mainly ε3ε3 in the long-live individuals in Zhongxiang, Hubei Province. Cognitive impairment was associated with female, being uneducated, visual impairment, hearing impairment, and non-ε2 allele carrier. Compared with ε3ε3 genotype, ε2ε2 or ε2ε3 significantly reduces the risk of cognitive impairment but ε2ε4, ε3ε4 or ε4ε4 don′t significantly increase the risk.