During normal aging, widespread loss of nerve cells does not occur. Neuronal loss is limited to restricted regions of the nervous system and is slight (probably no more than 10%). The commonest age-related structural changes undergone by nerve cells are as follows: dendrites decrease in number and length and many dendritic spines are lost; axons decrease in number and their myelin sheaths may become less compact and undergo segmental demyelination followed by remyelination; and significant loss of synapses occurs. These changes probably make a significant contribution to the behavioral impairment and cognitive decline that often accompany normal aging.