In order to understand the neurobiological underpinnings of epilepsy in the geriatric population, it is important to reviewcertain neuropathological events that lead to neurodegenerative disorders such as Alzheimer’s disease (AD), and how these events are distinguished from the neurobiological changes associated with normal aging that may be related to geriatric epilepsy or functional decline, such as age-associated memory impairment (AAMI). Data supporting three major onclusions regarding brain aging are discussed: (1) in AD, synaptic connections are lost as selectively vulnerable neurons die and circuits deteriorate; (2) AAMI occurs in the absence of significant neuron loss, yet may involve synaptic alteration in the same circuits; and (3) endocrine senescence (e.g., decrease in circulating estrogen) interacts with neural aging and may
impact both cognition and related neural circuits.