Clinical neurology is evolving in response to major changes in demography and prevalence rates of diseases associated with advanced age. Neurologic conditions, especially dementia, stroke and parkinsonian syndromes, are leading causes of disability and institutionalization in the elderly. The aging nervous system offers challenges in terms of placing disease and treatment in the context of predicted aging changes. However, these and other conditions are readily identified in current clinical practice. This article will include the diagnosis of dementia, stroke, parkinsonian syndrome, vertigo and headache including giant cell arteritis and trigeminal neuralgia. It should be stressed that the treatment should be selected based on the understanding of the changes associated with aging with regard to behavioral consequences, functional demands and social settings of individual patients.