The brain is highly dependent on aerobic metabolism. Normal mitochondrial function is therefore likely to play a critical role in neuronal function and integrity. Defects in the mitochondrial oxidative phosphorylation pathway (OXPHOS) have been demonstrated in aging human tissue including brain. It is not clear whether underlying mitochondrial DNA mutations are responsible for the observed functional defects. The previously reported OXPHOS defects, in particular reduced cytochrome c oxidase activity, in Alzheimer s disease (AD) are not likely to be due to specific enzyme dysfunction. The falloff in cytochrome c oxidase activity in AD brains is more likely to be related to a global decline in mitochondrial activity manifested by downregulation in mitochondrial number. It is not definitely established where the observed mitochondrial changes are placed in the AD cascade. A number of factors might contribute to the observed changes in OXPHOS function including mitochondrial transport through axonal and dendritic processes, compromised regulatory feedback mechanisms responsible for individual complex-subunit synthesis, and complex assembly.