Objective: This study sought to document the prevalence of cognitive impairment among a nationally representative sample of community-dwelling older adults and determine associated factors. Methods: A survey of 2943 older adults was undertaken in four parishes in Jamaica. A two-stage cluster sampling methodology was used, with the first and second cluster units being enumeration districts and households, respectively. Cognitive impairment was assessed using the Mini-Mental State Examination tool. Bivariate analyses were used to explore relationships between cognitive impairment and sociodemographic and health characteristics. Significant variables were entered into a logistic regression model and adjusted odds ratios for likelihood of cognitive impairment obtained. Results: Less than one in three persons had some level of cognitive impairment. Older age and lower levels of education independently predicted cognitive impairment (OR 1.05, 95% CI 1.04, 1.06; OR 3.00, 95% CI 2.23, 4.01). Older adults who limited their activities because of fear of falling (OR 1.35, 95% CI 1.09, 1.67), self-reported diabetes mellitus (OR 1.32, 95% CI 1.05, 1.67), screened positive for depression (OR 1.02, 95% CI 1.02, 1.03) and reported dependence in one or more activities of daily living (OR 2.47, 95% CI 1.62, 3.78) were more likely to have cognitive impairment. Conclusion: The prevalence of cognitive impairment in community-dwelling older adults is significantly higher than previously found in Jamaica, a middle-income developing country, but similar to that of populations with comparable age, education and income profile. Further exploration of risk factors may point to interventions for reducing cognitive impairment and associated morbidity.