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Background: The aetiology of age-related macular degeneration (AMD) and cognitive impairment is poorly understood. A link between cognitive impairment and AMD has been proposed although only a weak association was found in population-based studies. Purpose: To assess cross-sectional associations between AMD and cognitive impairment in an older Australian population. Methods: The Blue Mountains Eye Study examined 3,509 persons aged 49+ years during 1997–2000. AMD lesions were assessed from retinal photographs using the Wisconsin System. Mini-mental state examination (MMSE), demographics, lifestyle factors and medical history were collected at interview. MMSE score was categorised as high-normal (28–30), low-normal (24–27) and impaired (Results: Prevalence rates for late and early AMD were 1.5% (n = 50) and 8.3% (n = 273), respectively. Cognitive impairment was present in 18.0% in persons with late AMD and 8.4% with early AMD, compared to 2.6% in persons without AMD. After multivariate adjustment, late AMD was associated with low normal MMSE (odds ratio (OR): 2.2, 95% confidence interval (CI): 1.1–5.0) and cognitive impairment (OR: 3.7, CI: 1.3–10.6). Using the modified MMSE, the multivariate association between late AMD and cognitive impairment remained (OR: 2.2, CI: 1.0–5.0). No significant association was found between cognitive impairment and early AMD. Conclusions: We found a significant, cross-sectional association between late AMD and cognitive impairment in a sample of older Australians that appeared to be independent of visual impairment. The association was weaker but remained significant after excluding vision-related items from the MMSE.