Objective:We investigated the frequency of Aβ positivity in the nine groups classified according to a combination of three different cognition states and three distinct levels of white matter hyperintensities (WMH) (minimal, moderate, and severe). We also aimed to determine which factors were associated with Aβ after controlling for WMH, and vice versa.Methods:A total of 1047 individuals with subjective cognitive decline (SCD, n=294), mild cognitive impairment (MCI, n=237), or dementia (n=516) who underwent Aβ positron emission tomography scans were recruited from the memory clinic at Samsung Medical Center in Seoul, Korea. We investigated the following: 1) Aβ positivity in the 9 groups, 2) the relationship between Aβ positivity and the WMH severity, and 3) clinical and genetic factors independently associated with Aβ or WMH.Results:Aβ positivity increased as the severity of cognitive impairment increased [SCD (15.7%), MCI (43.5%), and dementia (76.2%)], whereas it decreased as the severity of WMH increased [minimal (54.5%), moderate (53.9%), and severe (41.0%)] or the number of lacunes [0 (59.0%), 1-3 (42.0%), and >3 (23.4%)] increased. Aβ positivity was associated with higher education, absence of diabetes mellitus, and presence of APOE e4 after controlling for cognitive and WMH status.Conclusion:Our analysis of Aβ positivity involving a large sample classified according to the stratified cognitive states and WMH severity indicates that Alzheimer’s and cerebral small vessel diseases lie on a continuum. Our results offer clinicians insightful information about the association between Aβ, WMH, and cognition.