Smaller premorbid brain volume is known to be related to cognitive deterioration in older adults, supporting a reserve hypothesis of brain aging. Heavy lifetime alcohol consumption (AC) may also increase the risk of cognitive impairment. The aim of this study was to examine the effects of head circumference (HC) and lifetime AC on cognitive function in the elderly. This study is part of a large, longitudinal study of men aged 60 years or older in the Korean community. We studied 1569 subjects with complete demographic, anthropometric and AC data. Cognitive function was assessed by the Korean version of Mini Mental State Examination (K-MMSE). Participants reported at the time of interview their lifetime alcohol drinking patterns. HC was also measured. We did a cross-sectional analysis the relation between two factors to cognitive function. After a multivariable adjustment, the interactive effect between HC and lifetime AC was shown to be significantly associated with cognitive function (F=2.55, p=0.038). Simple main effect analysis showed that smaller HC and a high level of lifetime AC were related with decreased cognitive function. All these findings suggest the possibility that lifetime AC and HC have synergistic effects on cognitive impairment.