Dr. Lisa C. Silbert, a behavioral neurologist at Oregon Health & Science University, delves into vascular cognitive impairment—often overlooked yet crucial in aging. She discusses how cerebrovascular diseases can modify dementia risk, emphasizing the need for accurate diagnosis through detailed histories and MRI scans. The conversation also highlights enlarged perivascular spaces' role in neurodegenerative conditions and the significance of cerebral amyloid angiopathy. Dr. Silbert calls for more research, especially focusing on blood-based biomarkers to enhance cognitive health.