Rabin JS, et al. - In this longitudinal observational study, the researchers ascertained if vascular risk and β-amyloid (Aβ) burden act additively or synergistically to promote cognitive decline in clinically normal older adults as well as to assess the unique influence of vascular risk on prospective cognitive decline beyond that of commonly used imaging biomarkers, including Aβ burden, hippocampal volume, fludeoxyglucose F18–labeled (FDG) positron emission tomography (PET), and white matter hyperintensities, a marker of cerebrovascular disease. Findings revealed that vascular risk was linked with a prospective cognitive decline in clinically normal older adults, both alone and synergistically with Aβ burden. They suggested that vascular risk could complement imaging biomarkers in evaluating the risk of prospective cognitive decline in preclinical Alzheimer disease.