Objective Describing the prevalence and incidence of cognitive impairment in older adults, considering the isolated and combined presence of leisure-time physical activities, hypertension, and obesity. Methods An observational, analytical, cohort study was conducted based on the data records of baseline (2008-2009) and follow-up (2016-2017) from the Campinas FIBRA Study. Screening for dementia and self-report measures concerning the number of weekly hours of low and moderate levels of leisure-time physical activities, hypertension, and nutritional status based on the body mass index (BMI) were applied. Results There were 394 aged participants; 71.8% were female and 74.4% had less than four years of formal education. The mean age at the baseline was 72.8±5.3 years old, and at follow-up was 81.4±4.8. At baseline, the most prevalent concurrent conditions were physical inactivity and hypertension (21.5%), and the least prevalent were physical inactivity, obesity, hypertension and cognitive deficit (0.6%). Associations were observed between physical inactivity at follow-up, or for both measurement periods, and cognitive impairment at follow-up. Inactive participants at the baseline showed a higher incidence ratio of cognitive impairment at follow-up, adjusted for sex, age, education, nutritional status and hypertension (RI=2.27; 95%CI: 1.49-3.45; p<0.001). Conclusion Prevalence and incidence of cognitive deficit mostly reflected the influence of low levels of leisure-time physical activity at baseline and follow-up.