This lecture will describe typical structural brain changes seen on imaging studies in ageing. There is considerable overlap between patterns of brain pathology in ageing and neurodegeneration. Knowledge on changes in brain ageing is indispensable as a background against which to evaluate neurodegenerative disease. The ageing brain is likely affected by an accumulation of processes, the summation of which will lead to inter-individual differences in brain ageing, with some persons showing more ‘successful ageing’ than others. There is considerable research being conducted into understanding the biological basis for these differences.