Magnetic resonance imaging white matter changes are a common observation in the elderly. The prognostic significance of such abnormalities is incompletely understood. Correlative studies which are reviewed here, suggested a predictive potential of white matter abnormalities for ischemic stroke, intracerebral hemorrhage, cognitive decline or even dementia. According to current review of literature the most compelling evidence for such a relationship exists for intellectual dysfunction. So far, there exist only preliminary data on the rate of WMH progression, but these demonstrate, at least some increase in number or extent within relatively short observational periods.