Approximately　20％-25％　of　adults　encounter　metabolic　syn-drome(MetS)worldwide,and　MetS　is　a　risk　factor　for　cognitive　decline(CD)development.Patients　with　MetS　have　an　11.48-fold　increased　incidence　of　CD　compared　with　those　without　MetS.1　Ataxia-telangiectasia　mutated(ATM)gene　encodes　ATM　kinase,which　belongs　to　the　phosphatidylinositol　3-hy-droxy　kinase　family.Reduced　ATM　gene　expression　creates　an　inhibitory　hippocampal　function,excitatory/inhibitory　imbalance,and　finally　CD.2　Based　on　the　China　Hainan　Centenarian　Cohort　Study(CHCCS)performed　in　18　cities　and　counties　of　Hainan,we　showed　that　the　frequency　of　CC　ge-notype　in　single　nucleotide　polymorphism(SNP)rs189037　was　significantly　higher　and　that　of　TT　genotype　was　significantly　lower　in　centenarians　with　MetS　than　in　those　without　MetS.Compared　with　CC　and　CT　genotypes,TT　genotype　was　negatively　and　significantly　associated　with　MetS　but　not　CD.This　study　demonstrated　that　mutant　SNP　rs189037　in　ATM　gene　had　a　significantly　negative　association　with　MetS　but　not　CD　in　Chinese　centenarians.