Abstract. Full Text Article available at: https://aanddjournal.net/article/S1552-5260(18)31481-X/pdfBackground: Cognitive impairment is a prominent public health issue among older adults. Different factors are believed to be associated with different stages of cognitive impairment. Knowledge of these factors are important in programming for preventive measures and to reduce worsening of impairment to more debilitating states. The aim of this integrative review and meta-analysis was to examine the modifiable risk factors impacting at different stages of cognitive impairment trajectory and their magnitude. Methods: A systematic search of literature was conducted in 6 databases: Medline, Embase, Global Health, Food Science and Technology Abstracts (FSTA), Co- chrane Central Register of Controlled Trials (CCRCT) and CI-NAHL complete, for current studies published within 10 years by November 2017. Prospective cohort, case control and cross sectional studied were included. Results: A total of 506 items were retrieved from the databases and 57 articles met the inclu- sion criteria for this review. Six groups of modifiable factors were identified including: vascular factors, co-morbidity and medical interventions, biological and nutritional factors, genetic and environmental interaction, psychological factors, life style factors and social factors. Vascular factors, particularly history of stroke presented the highest risk of dementia compared to the rest of other exposures, with odd ratios (OR) of ¼3.80 [95%CI, 1.92, 7.51]), and MCI (OR ¼1.82 [95% CI, 1.57, 2.11]), while engaging in physical activity at least 2 or more times per week was associated with a reduced risk of dementia (OR¼0.67 [95%CI, 0.48, 0.93]). Conclusions: Despite of some of vascular factors identified in this review are clinical conditions by themselves, their preventive measures are available in the developing countries. Culturally sensitive interventions focusing on vascular factors, as well as nutritional and life style factors may have dual positive effects in preventing both vascular condition and cognitive decline among elderly.