Objective: We aimed to explore the association of liver fibrosis markers with cognitive decline. Methods: In this cross-sectional study, there were 8669 participants over 60 years old from 51 Community Health Centers in the Luohu District of Shenzhen from 2017 to 2018. All participants were divided into a cognitive low-risk group (n=8202) and a cognitive high-risk group (n=467) according to their scores of mini-mental state examination and education status. Blood routine examination and liver function markers were tested from fasting blood samples. The liver fibrosis markers FIB-4 and APRI were calculated with parameters such as ALT, AST, and PLT using specific formulas. We used the t-test, Mann-Whitney test, and Chi-square test to analyze the differences in general statistical characteristics and live fibrosis markers between the two groups, and binary Logistic regression analysis was used to analyze each parameter. The association between the liver fibrosis markers and alcohol drinking habits was tested by Spearman rank correlation. Results: FIB-4 was significantly higher in the cognitive high-risk group than the cognitive low-risk group [1.40 (1.13,1.78) vs. 1.49 (1.21,1.88), Z=3.595, P<0.001] but FIB-4 was not an independent risk factor of cognitive decline [OR (95%CI): 0.718 (0.444~1.159), P=0.175]. For alcohol drinkers, FIB-4 was significantly positively correlated with the age of starting drinking (r_s=0.089, P=0.005) and frequency of drinking (r_s=0.149, P<0.001). There was a positive correlation between APRI and frequency of drinking (r_s=0.078, P=0.013) as well. For people abstaining from alcohol, FIB-4 exhibited a positive correlation with the age of abstinence (r_s=0.172, P=0.014). Conclusion: FIB-4 was elevated in people with cognitive decline, and increased frequency of drinking was correlated with raised FIB-4 and APRI, and giving up drinking as soon as possible might be beneficial to prevent the cognitive decline by liver health.