Abstract Body: Introduction: As the US population ages, the prevalence of Alzheimer’s disease and related dementias (ADRD) is expected to increase. Cardiovascular risk factors an accelerated vascular aging increase risk for ADRD. Therefore, we examined the relationship between carotid intima-media thickness (IMT) and neurocognitive function in a longitudinal study of the effect of CV risk factors on brain health. Methods: Participants had CV risk factors (BMI, BP, Lipids, high sensitivity CRP), IMT (mean R & L, common, bulb, internal) and Rowan Digital Cancellation Tests (RDCT) collected which consists of 3 tests administered on an iPAD that varied in stimulus complexity. For Letter, participants were asked to circle the letter A on a sheet of letters where there were 16 targets (the letter ‘A’) in each of the 4 quadrants of the paper, for Symbol, they were to circle a specific symbol, and for Mixed they were to alternate between A and the symbol. A Summary outcome measure was calculated for each test condition by combining correct hits, average time between correct hits, and drawing time for correct targets. Mean values for CV risk factors, IMT and RDCT were calculated; and general linear models were constructed to determine if IMT remained associated with RDCT after adjustment for demographics, age, BP, lipids, and hsCRP. Results: Forty-nine participants had data available (mean age 60.7 + 6.3 yr, 68% female, 73% white). Higher IMT was associated with reduced neurocognitive functioning (lower RDCT) independently of CV risk factors for all 3 RDCT outcomes (TABLE). Summary: In these preliminary findings among middle-aged adults, accelerated vascular aging was associated with poorer cognitive function. Additional research with a greater number of participants with replication in populations who are older, have known mild cognitive impairment, and dementia are needed to determine the utility of IMT as a biomarker for age-related neurodegenerative disease.