Zhou LW, et al. - Two hundred twenty-eight participants who underwent structured clinical interviews, targeted clinical, laboratory, and neuropsychological assessments and magnetic resonance imaging with T₁, T₂-fluid-attenuated inversion recovery and susceptibility-weighted images were assessed by experts to determine the prevalence of brain infarcts on neuroimaging and correlations with vascular risk factors and cognitive ability in a prospective study of residents residing in marginal housing. Aside from tobacco consumption, prevalence of conventional vascular risk factors in this population was reduced vs the general population. Twenty-five out of 228 individuals had brain infarcts and all of them were ischemic in nature. Those with infarcts were older vs those without infarcts. Only age endured as a significant predictor of brain infarcts in multivariable regression analysis. The presence of infarct was a marked predictor of impaired decision making on the Iowa Gambling Task of decision making, post-controlling for age and education. The prevalence of infarcts on neuroimaging in this population was much greater than expected for age and was related to impaired decision making. Furthermore, to recognize the people at highest risk who could benefit from targeted preventative strategies, more research is required.