The effects of CSVD on attention and executive functioning are best understood within a network model of cognition as revealed by functional neuroimaging. Analysis of network function in CSVD can improve characterization of disease severity and treatment effects, and it can inform theoretical models of brain function.

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Highlights 1. 50% of older adults in a case-control study with vascular risk factors had CSVD 2. Subjective complaints but not performance-based measures differentiated CSVD from controls. 3. In CSVD, preserved executive function appeared to come at the cost of reduced processing speed. 4. CSVD is associated with higher incidence of depressive symptoms.