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Objectives: To estimate the association between sensory impairment and cognitive decline in older Mexican Americans., Design: A prospective cohort study., Setting: The Hispanic Established Populations for Epidemiologic Studies of the Elderly from five southwestern states., Participants: The sample consisted of 2,140 noninstitutionalized Mexican Americans aged 65 and older followed from 1993/1994 until 2000/2001., Measurements: The outcome, cognitive function decline, was assessed using the Mini-Mental State Examination blind version (MMSE-blind) at baseline and at 2, 5, and 7 years of follow-up. Other variables were near vision, distance vision, hearing, demographics (age, sex, marital status, living arrangements, and education), depressive symptoms, hypertension, diabetes mellitus, stroke, heart attack, and functional status. A general linear mixed model was used to estimate cognitive decline at follow-up., Results: In a fully adjusted model, MMSE-blind scores of subjects with near vision impairment decreased 0.62 points (standard error (SE)=0.29, P=.03) over 2 years and decreased (slope of decline) 0.13 points (SE=0.07, P=.045) more per year than scores of subjects with adequate near vision. Other independent predictors of cognitive decline were baseline MMSE-blind score, age, education, marital status, depressive symptoms, and number of activity of daily living limitations., Conclusion: Near vision impairment, but not distance vision or hearing impairments, was associated with cognitive decline in older Mexican Americans.