The presence of calcification in the coronary arteries from the outset was linked to dementia. The value of coronary artery calcium (CAC) progression in dementia prediction, on the other hand, was unknown. The Multi-Ethnic Study of Atherosclerosis was used to investigate the link between CAC development and dementia. The Multi-Ethnic Study of Atherosclerosis was a prospective study that enrolled 6,814 people aged 45 to 84 who were free of overt cardiovascular disease at the start. The study comprised a total of 5,570 patients who had baseline and follow-up CAC scans about 2.5 years apart. Approximately 10 years following the baseline CAC scan, 4,173 of these subjects completed cognitive testing with the Cognitive Abilities Screening Instrument (CASI). Hospitalizations, death certificates, and drugs intended to treat dementia were utilized to identify dementia diagnoses using the International Classification of Diseases codes. CAC progression was measured using the absolute difference between baseline and follow-up CAC. The link between CAC progression with incident dementia and CASI score was investigated using Cox proportional hazards and multivariable linear regression models. About 350 patients experienced incident dementia over a median follow-up of 13.2 years (interquartile range: 11.2 to 15.3). After adjusting for age, gender, race/ethnicity, vascular risk factors, and baseline CAC score, there was no link between CAC advancement and dementia risk. In every modified model, there was no link between CAC progression and CASI score. After adjusting for demographic characteristics, vascular risk factors, and baseline CAC, advancement of CAC over about 2.5 years was not related to an increased risk of dementia.