To examine how visual impairment affects physical and cognitive function in old age.A longitudinal population-based prospective cohort study.General practitioner offices at six study centers in Germany. They were observed every 1.5 years over four waves.Individuals aged 77-101 at follow-up Wave 2 (N = 2,394).Physical and cognitive function were assessed using an adapted scale that had been previously developed, and visual impairment was rated on a Likert scale (none, mild, severe or profound).Adjusting for sociodemographic factors and comorbidity, linear fixed-effects regression showed that the onset of severe visual impairment was associated with a decline in physical function score in the total sample (? = -0.15, P = .01) and in women (? = -.15, P = .03). Moreover, the onset of severe visual impairment was associated with decline in cognitive function score in the total sample (? = -0.38, P < .001) and in women (? = -0.38, P < .001) and men (? = -0.37, P = .001).Visual impairment affects physical and cognitive function in old age. Interventional strategies to postpone visual impairment may contribute to maintaining physical and cognitive function.