Exposure to toxic metals and excessive amount of trace elements is a risk factor of cognitive decline. Continuous monitoring of these elements by the use of metabolically inactive tissues such as fingernails may help in taking preventive measures to delay the cognitive decline process. In this study, the cognitive function of 54 elderlies (60-72 years old) from FELDA Sungai Tengi, Selangor, was evaluated using the Malay version of Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The levels of arsenic (As), cadmium (Cd), copper (Cu), manganese (Mn), lead (Pb), and zinc (Zn) in fingernail were detected using Inductively Coupled Plasma-Mass Spectrometry. Results showed that (92.6 %) our population was cognitively impaired based on the MoCA with mean score of 18.07 ± 5.11. The mean level of elements in fingernails for As, Cd, Cu, Mn, Pb, and Zn were 16.68 ± 3.52, 4.26 ± 0.91, 4.81 ± 1.16, 1.00 ± 0.23, 1.83 ± 0.47, and 40.86 ± 10.81 μg/g, respectively. Significant inverse correlations were observed between MoCA with age (r = -0.543, p