Spectral analysis using non-negative least squares in intravoxel incoherent motion enables estimation of an intermediate component in the diffusion spectrum between parenchymal diffusion and microvascular pseudodiffusion. However, the precise source of the intermediate component remains unknown. By studying the relation of the intermediate component with vascular (i.e. WMH volume) and neurodegenerative (i.e. hippocampal atrophy) biomarkers, the current study aimed to gain more knowledge about the interpretation of the intermediate peak in relation to cognitive status and its underlying pathology. The intermediate peak seems to be a promising imaging biomarker for microvascular and neurodegenerative pathology in Alzheimer’s disease and its prestages.