Christopher Chen, BA, BMBCh, MRCP, FAMS, FRCPE, National University of Singapore, Singapore, provides an insight into predicting the likelihood of cognitive impairment and dementia onset in patients with cerebral small vessel disease. Most evidence has shown that a greater burden of white matter damage is associated with a higher likelihood of progression. In addition to using longitudinal markers, baseline markers may also be used, such as measuring WM volume or atrophy. Prof. Chen is hopeful for continued advancement in this field, including the development of novel blood biomarkers for cerebrovascular disease. This interview took place at the European Stroke Organisation Conference (ESOC), 2021.