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's disease. * Ability to obtain a Motor Threshold, determined during the screening process. * With an adequately stable condition and living environment to enable attendance at scheduled clinic visits. * If on a prescription medication for cognition that medication dose will be stable for at least 4 weeks prior to randomization into the study and participant will be willing to remain on a stable regimen during the acute treatment phase. * Able to read, verbalize understanding, and voluntarily sign the Informed Consent Form to be signed by the participant, or a designated legal representative when the participant 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, from medications 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 patient report or chart review. * Active current suicidal intent or plan as determined by patient report or chart review. * Current or Prior history of a seizure disorder as determined by patient report or chart 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 for seizure. * Not fluent in English or a hearing impairment severe enough to impair comprehension