Seven-year progression of white matter hyperintensities and age-related cognitive change in healthy middle-aged and older adults

White matter hyperintensities are ubiquitous in magnetic resonance imaging scans of older adults and reflect multiple pathological causes, particularly cardiovascular and metabolic disease risk factors. Elevated white matter hyperintensity burden is a predictor of dementia, but the relationship between white matter hyperintensity progression and cognitive change in typical aging remains unclear, arguably due to the scarcity of longitudinal evidence. Here, we estimated white matter hyperintensity volume in 67 participants of the Detroit Aging Brain Study, aged 50-77 at baseline, over four occasions spanning 7 years. The white matter hyperintensity volume increased over time, especially around the frontal horns of the lateral ventricles, and accelerated with advanced age. Greater baseline white matter hyperintensity volume predicted faster progression across all regions. Men had a greater white matter hyperintensity burden than women, independent of age, but did not differ in progression rate. Of all examined cognitive abilities, only perceptual speed slowing was associated with faster white matter hyperintensity progression in parietal and occipital lobes. Thus, not only does white matter hyperintensity volume increase over time in normative aging, but the change is linked to declines in a quintessential age-sensitive cognitive skill.