During ageing, damage and injury accumulate in the blood vessels in the brain in every individual to some extent. The damage caused to blood vessels is called small vessel disease. Small vessel disease is significantly present in about 50% of individuals >65 years. Small vessel disease is a well-known cause of stroke. However, the most important symptoms of small vessel disease are cognitive impairments, which also set the link with dementia. Nevertheless, a causal relation between small vessel disease and dementia has not yet been established. In this stuyd we followed patients with small vessel disease over a 14 years and have performed neuropsychological tests and MRI scans of the brains every 5 years. We observed that patienst with the highest burden of small vessel disease have the highest risk of dementia. But maybe more interestingly, prgression of small vessel disease over the years was also associated with getting dementia.