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INTRODUCTION: It is unclear whether aggregated plasma protein risk scores (PPRS) could be useful to predict the risks of mild cognitive impairment (MCI) and Alzheimer’s disease (AD). METHODS: The Cox proportional hazard model with the LASSO penalty was used to build the PPRS for MCI and AD in 1,515 Framingham Heart Study Generation2 with 1,128 proteins measured in plasma at exam 5 [cognitive normal (CN)=1,258, MCI=129, AD=128]. RESULTS: MCI PPRS had a hazard ratio (HR) of 6.97[5.34,9.12], with a discriminating power (C-index=82.52%). AD PPRS had an HR of 5.74[4.67,7.05] (C-index=88.15%). Both PPRSs were also significantly associated with cognitive changes, brain-atrophy, and plasma AD biomarkers. Proteins in the MCI and AD PPRSs were enriched in several pathways related to leukocyte, chemotaxis, immunity, inflammation, and cellular migration. DISCUSSION: This study suggests that PPRS serve well to predict the risk of developing MCI and AD as well as cognitive changes and AD related pathogenesis in the brain.