In this cross-sectional analysis of 9189 adults between 30 and 75 years of age who were free of cardiovascular disease from the Canadian Alliance for Healthy Hearts and Minds (CAHHM) and the Prospective Urban Rural Epidemiological–Mind (PURE-MIND) cohort studies, higher body fat percentage and visceral adipose tissue were associated with more cardiovascular risk factors, vascular brain injuries, and lower cognitive scores.