BACKGROUND The brain-at-risk stage is the earliest phase of the vascular cognitive impairment continuum and includes individuals with vascular risk factors (VRF). However, there is still no clear definition of this concept. The aim of the study is to characterize the neuropsychological profile of elderly individuals by 3 levels of VRF. METHODS This is a cross-sectional analysis of the Canadian Study of Health and Aging baseline data; 577 nondemented elderly individuals > or =65 years old were divided into 3 groups: reference group (0 VRF; n = 82); intermediate brain-at-risk group (1-2 VRF; n = 360); high brain-at-risk group (> or =3 VRF; n = 135). A principal component analysis (PCA) and univariate/multivariate analyses of variance were performed to examine the relationships between the groups and various cognitive measures. RESULTS The PCA produced a 2-component solution (1) executive/psychomotor functions including measures of abstraction and (2) verbal memory. The high brain-at-risk group performed significantly worse than the reference group on the first component. CONCLUSIONS Elderly individuals presenting with > or =3 VRF are more impaired on measures of executive functions/ processing speed than participants without any VRF.