ObjectiveTo systematically analyze the prevalence of cognitive impairment in patients with COPD.MethodsAn electronic search in PubMed, Embase, CNKI, WanFang Data and VIP databases to identify studies describing the prevalence of cognitive impairment in patients with COPD from inception to 3 May 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, the meta-analysis was performed by using Stata16.0 software. ResultsA total of 40 studies involving 9, 988 patients with COPD were included. Meta-analysis showed that the total prevalence of cognitive impairment in patients with COPD was 48.26% (95%CI 42.39% to 54.20%). The results of subgroup analysis revealed that the prevalence of cognitive impairment in patients with acute exacerbation of COPD was higher than that in patients with stable-phase (58.62% vs. 49.71%). The prevalence of cognitive impairment in COPD patients was 29.07% before 2015, while the prevalence between 2015-2019 and 2020-2023 were higher, with rates of 53.06% and 48.26% respectively. The prevalence of cognitive impairment in domestic COPD patients was significantly higher than that in foreign patients (52.66% vs. 37.06%). ConclusionThe prevalence of cognitive impairment is relatively high in COPD patients, highlighting the need to strengthen the screening for cognitive impairment in COPD patients and provide early assessment and intervention.