To explore the incidence and influencing factors of cognitive dysfunction in patients with menopausal syndrome(MPS).Methods:A cross-sectional survey was conducted to collect basic information from MPS patients who visited outpatient clinics in 21 hospitals in Shanghai between January 2021 and March 2022.The Montreal Cognitive Assessment(MOCA) was used to assess cognitive dysfunction.Multivariate regression analysis was applied to explore the influencing factors of cognitive dysfunction in MPS patients，and receiver operating characteristic(ROC) curves were drawn to evaluate the effectiveness of the Logistic regression model.Results:The incidence of cognitive dysfunction in 738 MPS patients was 28.18%.Univariate analysis showed that reading habits，occupational nature，urban vs.rural residence，education level，dietary habits，income，body mass index(BMI)，age at symptom onset，weekly exercise frequency，screen time，and Kupperman score were all related to cognitive dysfunction in MPS patients(P<0.05).Multivariate regression analysis revealed that a vegetarian diet，higher BMI，older age at symptom onset，and more frequent weekly exercise were independent protective factors for cognitive dysfunction in MPS patients，while longer daily screen time and higher Kupperman scores were independent risk factors.Occupational nature，education level，and diet were also independent influencing factors.The area under the ROC curve was 0.838，indicating a good predictive model.Conclusion:Cognitive dysfunction in MPS patients is influenced by multiple factors，including occupational nature，education level，dietary habits，BMI，age at symptom onset，weekly exercise frequency，screen time，and Kupperman score.These factors significantly affect cognitive function in MPS patients.