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Purpose: To estimate the 5-year incidence and risk factors for age-related maculopathy (ARM) in a representative older Japanese population., Methods: A population-based cohort study was conducted in 1998 on 1482 Hisayama residents aged 50 years or older, and 961 of these subjects attended the 5-year follow-up examinations in 2003. At both time points, the characteristics of ARM were determined by grading color fundus photographs according to the Wisconsin Age-Related Maculopathy Grading System. Using these cohort data, logistic regression analyses were performed to determine the risk factors for ARM. Nine possible risk factors were examined: age, sex, hypertension, diabetes, hyperlipidemia, smoking, alcohol intake, body mass index, and white blood cell count., Results: The 5-year incidence of early ARM was 8.5%, and that of late ARM was 0.8%. Men were found to have a significantly higher incidence of late ARM than did women. The incidence of both early and late ARM increased significantly with age. Multiple logistic regression analysis showed that age and smoking were significantly associated with early and late ARM., Conclusions: The results suggest that the overall 5-year incidence of early ARM is 8.0% and that of late ARM is 0.8% in the general Japanese population and that higher age and smoking are relevant risk factors for early and late ARM in the Japanese.