Neurological aspects of aging

This chapter outlines brain and nervous system aging from structural, molecular, neurochemical and functional viewpoints. There is evidence of generalised cerebral atrophy with aging. At the microstructural level, there are changes in neuronal structure and function. Neuronal loss increases with age, but neuronal plasticity is preserved. Functional imaging of the brain demonstrates age-related declines in cerebral activation. There are age-related declines in neurotransmitter levels, particularly in acetylcholine and dopamine. There is considerable variation in the trajectory of cognitive performance with aging. Whilst aging of the nervous system is inevitable, function is usually preserved. Nonetheless, impact may be assessed via systematic history and examination.