Association between brain tissue level perfusion and cognitive decline has been previously documented. However, contribution of blood flow and artery patency in medium-to-large arteries and its relation to tissue level perfusion and cognition remain unclear. In this study, 3D-TOF, ASL, and SNAP, an MRA technique sensitive to slow blood flow, were acquired at baseline and 12-months follow-up. A vascular map construction software was used to measure changes in medium-to-large arterial features. Changes in SNAP artery length and branch number during follow-up were significantly associated with changes in cognitive function, while no such association was found with ASL tissue level perfusion.