<b><i>Aims:</i></b> The aim is to study the prevalence and possible relationship of apathy and leukoaraiosis in cases of cognitive impairment of varying severity in Spain. <b><i>Methods:</i></b> We conducted a cross-sectional, descriptive, multicenter study involving 109 patients with Alzheimer's disease (AD) and 59 with mild cognitive impairment (MCI). <b><i>Results:</i></b> The older group with AD had a higher prevalence of leukoaraiosis and apathy, with significant differences compared to the MCI group. <b><i>Conclusions:</i></b> To our knowledge, this is the first multicenter study in our country that jointly analyzes the presence of apathy and leukoaraiosis in the institutionalized elderly with varying degrees of cognitive impairment according to the most recent criteria for detecting apathy in dementia.