Repetitive Transcranial Magnetic Stimulation for Dementia

Inclusion Criteria:

• Veterans aged 55 years or older

• Diagnosed with Mild Cognitive Impairment (MCI) or dementia likely due to Alzheimer'sdisease.

• Ability to obtain a Motor Threshold, determined during the screening process.

• With an adequately stable condition and living environment to enable attendance atscheduled clinic visits.

• If on a prescription medication for cognition that medication dose will be stablefor at least 4 weeks prior to randomization into the study and participant will bewilling to remain on a stable regimen during the acute treatment phase.

• Able to read, verbalize understanding, and voluntarily sign the Informed ConsentForm to be signed by the participant, or a designated legal representative when theparticipant lacks decision making capacity prior to participating in any study-specific procedures or assessments.

Exclusion Criteria:

• Patients with prior exposure to rTMS or electroconvulsive therapy (ECT).

• Unable to safely withdraw, at least two weeks prior to treatment commencement, frommedications that substantially increase the risk of having seizures.

• Have a cardiac pacemaker or a cochlear implant.

• Have an implanted device deep brain stimulation or metal in the brain

• Current substance abuse not including caffeine or nicotine as determined by patientreport or chart review.

• Active current suicidal intent or plan as determined by patient report or chartreview.

• Current or Prior history of a seizure disorder as determined by patient report orchart review

• Traumatic brain injury within the last two months

• Participation in another concurrent interventional clinical trial

• Known current psychosis as determined by patient report or chart review.

• Current or prior history of a mass lesion, cerebral infarct or other non-cognitive,active central nervous system (CNS) disease that would increase the risk forseizure.

• Not fluent in English or a hearing impairment severe enough to impair comprehension