Introduction: Cognitive impairment is an important pathology among the Aged, but few studies evaluate populations at an important geographical height. Objectives: To characterize and find the factors associated with cognitive deterioration in urban and rural populations of medium geographic height. Methodology: Analytical cross-sectional study, cognitive impairment was evaluated with the Pfeiffer Test (Cronbach's Alpha: 0.69), its results were combined versus three socio-educational variables and four comorbidities; analytical statistics were obtained. Results: Of the 400 older adults, 26.5% (106) had no cognitive impairment, 47.5% (190) had mild impairment, 25.5% (102) moderate and 0.5% (2) severe; 60% were women, the median age was 66 years (interquartile range: 63-69 years), 67% lived in rural areas. In the multivariate analysis it was found that there was more moderate / severe cognitive impairment at older age (RPa: 1.05; 95% CI: 1.02-1.08; p <0.001), among those with diabetes (RPa: 1 , 23; 95% CI: 1.17-1.29; p <0.001), arterial hypertension (RPa: 1.47; 95% CI: 1.33- 1.61; p <0.001), chronic kidney disease (RPa: 2.21, 95% CI 2.01-2.43, p <0.001) and heart failure (RPa: 2.25, 95% CI 1.92-2.64, p <0.001); On the other hand, those with a university degree had less cognitive deterioration (RPa: 0.89, 95% CI: 0.22-0.65, p <0.001); adjusted for sex and place of residence. Conclusion: Important associations of cognitive deterioration were found in an older adult population residing between 2500-3900 msnm, these results are important as they are not a highly studied population; therefore, these data should be taken for diagnosis and treatment.