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Changes in metal ion homeostasis occur with aging which may precipitate the development of neurodegenerative diseases in susceptible individuals. Slight increases in iron content of specific brain regions, sometimes as little as two-fold, may have a devastating effect on brain function. In this current review we shall initially discuss changes that occur in brain iron homeostasis during healthy aging and longevity, and how alterations of its concentration and distribution may expedite various neurodegenerative diseases. Changes in metal ion homeostasis of other metal ions, namely copper and zinc, also occur in neurodegenerative diseases and will be discussed. Over the past five years the use of iron chelators to slow the progression of the disease and even improve clinical symptoms in some neurodegenerative diseases has been reported; clinical trials have confirmed their efficacy in specific neurodegenerative diseases, namely Friederich’s ataxia and Parkinson’s disease. The development of new chelators which are able to target specific regions of the brain, combined with drugs which are able to modulate the inflammatory processes, will further advance hope for the eradication of these debilitating neurodegenerative diseases.

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