Abstract:Abstract: Objective This study aims to investigate the relationship between calf circumference and cognitive impairment and to study the mediating role of the hypersensitive C-reactive protein (hs-CRP)/albumin ratio (HCAR). Methods Data in the 2014 CLHLS database were analyzed, and 1 784 study participants were finally included in this study. Cognitive function was assessed by the Chinese version of the brief mental state examination (cMMSE). Data were processed and analysed using R software, and mediating effects were verified using Bootstrap sampling. Results After correcting for multiple factors, calf circumference was significantly negatively associated with cognitive impairment (OR= 0.951, 95% CI: 0.933-0.970), in which HCAR played a mediating role (mediating effect ratio 0.022, 95% CI: 0.002-0.060). Conclusion There is a negative association between calf circumference and cognitive impairment, in with HCAR plays a mediating role. This finding has important implications for the prevention and intervention of cognitive impairment.