The Longitudinal Cohort of Cerebral Small Vessel Disease in Ruijin Hospital

Inclusion Criteria: 1. Age ≥18 years. 2. Evidence of cerebral small vessel disease (CSVD) on brain MRI, meeting at least one of the following imaging criteria: * White matter hyperintensities (WMH) with a total Fazekas score ≥2; * Fazekas score =1 with at least two vascular risk factors (hypertension, hyperlipidemia, diabetes mellitus, obesity, current smoking, or a history of vascular events other than stroke); * Fazekas score =1 accompanied by the presence of lacunes; * Imaging evidence of a recent subcortical lacunar infarction. 3. Independent in activities of daily living (modified Rankin Scale \[mRS\] ≤2). 4. Able and willing to provide written informed consent. Exclusion Criteria: 1. Acute ischemic stroke with a diffusion-weighted imaging (DWI) lesion \>20 mm in diameter. 2. Acute intracerebral hemorrhage. 3. Acute subarachnoid hemorrhage, a history of aneurysmal subarachnoid hemorrhage or cerebrovascular malformation, or the presence of an untreated intracranial aneurysm \>3 mm in diameter. 4. Previously diagnosed neurodegenerative disorders, such as Alzheimer's disease (AD) or Parkinson's disease (PD). 5. Definite non-vascular white matter diseases, including multiple sclerosis, adult-onset leukodystrophy, metabolic encephalopathy, or other non-vascular white matter disorders. 6. Major psychiatric disorders diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). 7. Contraindications to MRI (e.g., severe claustrophobia or MRI-incompatible implants). 8. Severe systemic diseases (e.g., active malignancy) with an expected life expectancy of less than 5 years. 9. Inability to complete scheduled follow-up because of geographic, logistical, or other reasons. 10. Concurrent participation in another interventional clinical trial.