The Cardiovascular-Cognitive Health Initiative

Inclusion Criteria: Main Study: * Age ≥ 21 years. * Able and willing (or via legally acceptable representative, LAR, where appropriate) to provide informed consent. RCT Sub-Study (Mild cognitive impairment (MCI) arm): * Meets main study criteria. * Mild cognitive impairment defined by: (i) Montreal cognitive assessment (MoCA) \<26 but ≥21; and/or (ii) impairment in at least one domain on standardized neuropsychological testing and/or (iii) MMSE \<28 but ≥24. Exclusion Criteria: * Neurodegenerative disorders or major psychiatric illnesses that substantially impair cognition. * Terminal illness or advanced major organ disease limiting participation with expected survival of less than 1 year. * Severe depression, anxiety, or stress where participation may be inappropriate. * Any condition which, in the investigator's opinion, would compromise safety or study integrity. Note: Pregnant and breast-feeding women may not take part in this study.