Abstract: Objectives: There is widespread concern about the potential impact on services of the ageing population and long-term health conditions, such as dementia and other cognitive impairments. To effectively plan services, it is important to understand current need and use of services, and identify gaps in provision. We investigated the relationship between health and care service use and cognitive impairment in later life. Methods: Using data from the Cognitive Function and Ageing Study Wales (CFAS Wales), we modelled the relationship between the use of a variety of health and care services, and cognition. CFAS Wales is a longitudinal cohort study of people aged 65 years and over, who were randomly drawn from primary care lists in two areas in Wales, over-sampling those aged 75 years and over. Participants (n=3593) answered a wide range of health and lifestyle questions, and completed a variety of assessments including tests of cognitive function. Data from over 3000 people from wave 1 were analysed, including over 700 people with dementia or other cognitive impairments (defined as MMSE <26). Results: We anticipated that people with dementia or other cognitive impairments might be greater users of health and care services, as was the case for some, such as use of day centres. However, compared to people of the same age, we found lower reported uptake of vision checks and seeing a dentist. People with dementia or other cognitive impairments were around 30% less likely to report seeing a dentist in the year preceding interview than the rest of the sample, controlling for a number of demographic, environmental, and activities of daily living variables. In contrast, we did not find a difference in reported uptake of hearing checks. Conclusions: Striking differences in the uptake of services such as vision and dental checks suggest that there are needs of people with dementia and other cognitive impairments not being met; this may exacerbate existing conditions and have further downstream negative consequences for health and well-being.