my grandmaws '08 Accord has always made a loud noise on cold starts, mostly the first start of the day, then its fine afterwards. I always attributed it to the starter. Changed her spark plugs yesterday and after starting and verifying everything was fine, I finally decided to look into the noise. There are many posts online about it being a VCT actuator, my question is, does this absolutely have to be changed and if not, will it eventually cause major engine damage? My grandmaw is 76, the car has 130k miles, she plans on this being her last vehicle, so I want to maintain it as best as I can.