There is a difference when AV uses caching.
Suppose that you have downloaded a malicious file a few days ago, without opening the Download folder, so you have not been infected. The file was not detected, but It could be detected today if you would try to execute it. Now, if AV uses the old cache, you can still be infected today when you will open the Download folder
without executing anything from that folder. Yes, it is possible (and happened in the wild) if malware can exploit Explorer.
This is not an issue for the home users who update Windows regularly, but does matter in organizations and Enterprises.