The Framingham Heart Study (FHS) was established in 1948 and is the longest, ongoing prospective cohort study studying cardiovascular diseases and stroke. Initially, the FHS was primarily focused on cardiovascular diseases; however, over recent decades data from the FHS have found that lifetime exposure to major cardiovascular risk factors such as hypertension, diabetes mellitus, arterial stiffness, and pressure pulsatility adversely impact neuropsychological functioning particularly in older individuals contributing to the onset of dementia including Alzheimer’s disease. Research from the FHS suggest that appropriate management of cardiovascular risk factors as well as healthy lifestyle practices that include regular blood pressure monitoring, not smoking, and eating a choline-rich diet appear to minimize neuropsychological decline as well as dementia onset.