Magnetic resonance imaging (MRI) abnormalities attributed to small-vessel disease, such as lacunar infarction and extent of white matter hyperintensities (WMH), have been associated with decreased brain volume,1 cognitive impairment2- 4 and cognitive decline,5,6 and an increased risk of dementia.7 Epidemiologic studies have shown that risk factors for vascular disease, including hypertension and d