Background As China undergoes a demographic transition towards an aging society, the prevalence and incidence of age-related disabilities, Alzheimer's disease, and various geriatric syndromes are steadily rising. Objective The China Healthy Aging Cohort Study (China-Aging) aims to investigate the prevalence and associated risk factors of disability and cognitive impairment, and to develop predictive models for these conditions by combining traditional risk factors with artificial intelligence-derived metrics (such as gait, speech, vision, etc.). Methods The China-Aging cohort consists of community-dwelling participants aged 60 years and older from Beijing, Hangzhou, Shenzhen, and Haikou. The baseline recruitment was from May 16, 2022 to March 19, 2025, with study participants primarily from urban areas. Follow-up assessment of the cohort will occur every 1-3 years from the baseline. Results Among 6283 participants who completed the baseline evaluation (mean age 70.6 years, SD 6.3), 3775 (60.1%) were women. The overall prevalence of disability, cognitive impairment, frailty, depression, and sarcopenia were 17.8%, 18.5%, 5.9%, 7.1%, and 5.7%, respectively. The prevalence of disability in the Beijing cohort was higher than in other cohorts (Beijing: 35.6%, Hangzhou: 6.5%, Shenzhen: 6.8%, Haikou: 10.9%) and the prevalence of cognitive impairment in the Haikou cohort was higher than in other cohorts (Beijing: 9.5%, Hangzhou: 7.9%, Shenzhen: 16.2%, Haikou: 45.5%). Conclusions The prevalence of disability and cognitive impairment is relatively high, and notable regional difference exists in China. China-Aging cohort provides crucial evidence for the precise prevention and management of disability, cognitive impairment, and other geriatric syndromes in promoting active and healthy aging.