We aimed to investigate the relationship between pesticide exposure and cognitive decline in a rural South Korean population. From July 2015 to December 2017, 200 randomly selected Korean Farmers Cohort study participants were recruited and of these, 169 participants were analyzed. Pesticide exposure was investigated using a standardized questionnaire, and the Korean-Montreal Cognitive Assessment (K-MoCA) was conducted. Cognitive decline was more frequent among those directly exposed to pesticides (P = 0.057). Pesticide exposure and cognitive decline were positively correlated in the group with direct exposure versus no exposure (crude odds ratio [OR], 2.66; 95% confidence interval [CI], 1.17–6.04); this relationship was insignificant after adjustment (adjusted OR, 1.50; 95% CI, 0.57–3.92). There was a significant difference in the K-MoCA scores for each group based on pesticide exposure (P = 0.003). When we stratified by age, differences in the K-MoCA scores depending on the degree of pesticide exposure in the those aged 60 to 69 years were identified. Overall, there was a tendency towards an association between pesticide exposure and cognitive decline in rural Korean adult farmers. In our study, chronic pesticide exposure tended to have a greater impact in certain age group (60–69 years) than in those under 60 and over 70.
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