Cardiovascular risk factors have been associated with 2 common manifestation of unhealthy brain in older people, cognitive impairment and depression. The evidence for these effects is almost entirely observational, but links hypertension, smoking, hypercholesterolemia, diabetes mellitus, and hyperhomocysteinemia with cognitive impairment and depression. Unfortunately randomized trials evaluating interventions for these risk factors on the outcomes of cognition or mood have either been inconclusive or negative. However, as there are considerable other health benefits from targeting cardiovascular risk factors, these interventions should be more widely adopted, which would also probably result in positive outcomes for the brain.