Objective Growing evidence suggests that patients with rheumatoid arthritis (RA) have increased risk for dementia. We assessed risk factors for incident dementia in an inception cohort of RA. Methods This retrospective population-based cohort study included residents of eight counties in Minnesota who were ≥50 years when they met 1987 ACR criteria for incident RA between 1980-2014 and were followed until death/migration or 12/31/2019. Patients with dementia before RA incidence were excluded. Incident dementia was defined as two relevant ICD-9/ICD-10 codes at least 30 days apart. Data on socio-demographics, disease characteristics, cardiovascular/cerebrovascular disease (CVD) risk factors and comorbidities were abstracted from medical records. Results The study included 886 patients with RA (mean age=65 years, 65% females). During the follow-up period (median=8.5 years), 103 patients developed dementia. After adjusting for age, sex and calendar year of RA incidence, older age at RA incidence (Hazard Ratio (HR):1.14 per 1 year increase, confidence interval (CI):1.12-1.17), rheumatoid nodules (HR:1.76,CI:1.05- 2.95), hypertension (HR:1.84,CI:1.19-2.85), presence of large joint swelling (HR:2.03,CI:1.14-3.60), any CVD (HR:2.25,CI:1.38-3.66), particularly ischemic stroke (HR:3.16,CI:1.84-5.43) and heart failure (HR:1.82,CI:1.10-3.00), anxiety (HR:1.86,CI:1.16-2.97), and depression (HR:2.63,CI:1.76-3.93) were associated with increased risk of dementia. After adjusting for CVD risk factors and any CVD, all covariates listed above were still significantly associated with risk of dementia. Conclusion Apart from age, hypertension, depression, and anxiety, which are universally recognized risk factors for dementia, clinically active RA and presence of CVD were associated with an elevated risk of dementia incidence among RA patients.