Individuals with a history of high cholesterol, hypertension, obesity, atherosclerosis, and smoking are at increased risk for developing cerebrovascular disease and changes in the structure of blood vessels inside the brain. At one end of the continuum, vascular cognitive impairment can emerge from these risk factors and manifest in subtle cognitive problems with learning and memory, attention, and/or information processing. At the other end of the spectrum, more severe cognitive dysfunction may be present, suggestive of vascular dementia, which often can evolve out of a history of large vessel strokes, isolated cerebral infarctions affecting critical brain regions, cardiac arrest (and resulting depletion of blood supply to the brain), and/or widespread small-vessel disease. Neuropsychological evaluations can provide essential information to individuals, family members, and treatment providers who are seeking clarity in terms of diagnostic considerations. In addition, formal assessment will explore emotional factors and what supports and individual has to inform appropriate referrals for treatment and ongoing management. In addition, neuropsychological evaluations are necessary to accurately monitor for changes in cognitive and functional status over time.