Epidemiological studies on the association between diet and cognitive function suggested a possible role of dietary fatty acids in cognitive decline. The aim of the present study was to examine whether intake of different types of fatty acids is associated with cognitive status. A cohort of 304 (127 men and 177 women) institutionalized elderly people, with a mean age of 75.3 +/- 6.7 years, were studied. Subjects were evaluated for global cognitive functions (Mini-Mental State Examination [MMSE], Spanish version). Fatty acid intake was assessed with a semi-quantitative food frequency questionnaire. Intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were found to be predictors of cognitive impairment as they were negatively associated with the MMSE score. In accordance with this, fish intake was inversely associated with cognitive impairment. On the contrary, the n-6/n-3 polyunsaturated fatty acid ratio was positively related to the MMSE score. These results could not be explained by differences in age, sex, education, smoking behaviour, inactivity, alcohol, institution or energy intake. We suggest that consumption of EPA and DHA should be encouraged for reducing the risk of cognitive impairment and subsequently disability in elderly people.