Patients with mild cognitive deficits experience different types of evolution. They are at increased risk of developing dementia, but they have also a chance of remaining stable in cognition or of improving. We investigated whether global brain volume, callosal size and hippocampal size are associated with the rate of cognitive change in elderly without dementia. Volumetric MR images were recorded from 39 controls and 35 patients with questionable dementia who were followed up longitudinally for a mean of 2.3 years. The outcome measure was the annual change in the test score in the Structured Interview for the Diagnosis of Alzheimer's Dementia and Multi-Infarct Dementia, which includes all items of the Mini-Mental State Examination. Global brain volume, grey matter volume and white matter volume were the only significant independent predictors of the rate of cognitive change.