Clinical correlations of the neurobiological changes of aging

Increasing age is associated with increased risk of developing both dementia and depression; both conditions appear to be associated with structural changes in the cerebral cortex. In depression, there was evidence for regional alterations in cortical neurons either as a result of the disease or its treatment. In Alzheimer's disease, a key change is likely to be either shrinkage or loss of corticocortical pyramidal neurones which probably use glutamate as their transmitter. The putative pathogenic role of glutamate and energy metabolism, as well as an approach to treatment of symptoms are outlined.