Over the past decade, developments in imaging acquisition and post-processing, together with the availability of high field scanners, have made it possible to use MRS to study the spinal cord in-vivo. Reductions in spinal cord total Nacetylaspartate concentrations are thought to reflect neuroaxonal injury and/or mitochondrial dysfunction in patients with multiple sclerosis, cervical spondylitic myelopathy and amyotrophic lateral sclerosis, while increases in spinal cord myo-inositol/total creatine ratios in multiple sclerosis and following brachial plexus re-implantation are likely to represent a reactive gliosis. Because metabolite concentrations reflect specific pathological processes, they could potentially become useful imaging biomarkers of the future. Serial MRS investigations in patients with neurodegenerative diseases may therefore be a useful way of monitoring progression and response to treatments. However, periodic imaging is potentially vulnerable to temporal changes in spinal cord metabolites that are associated with normal healthy aging, rather than disease progression and it is, therefore, important to understand how spinal metabolites change with age to improve interpretation of interval changes. To date no studies of the spinal cord have addressed metabolic changes associated with normal aging. In this study, which was carried out in healthy volunteers, we therefore aimed to investigate whether age was associated with changes in concentrations of commonly quantified metabolites and explore the effect of gender on metabolite concentrations. We used a single voxel MRS protocol optimised for improved SNR to permit quantification of Glx from the spinal cord. A higher SNR was achieved by employing a longer voxel and increased signal averaging compared to earlier MRS protocols. Although longer voxel lengths can be associated with worsening of B0 convergence, our other spectral quality indicators, after elimination of poor spectra, were comparable to those published by other groups. We aimed to evaluate whether age is associated with changes in metabolite concentrations of the upper cervical cord, as is seen in the brain. Using a recently optimised MRS protocol, we quantified metabolite concentrations in the cervical cords of healthy subjects aged between 23 and 65. We found that older age was strongly associated with lower concentrations of tNAA and Glx and that there were significantly lower Glx concentrations in female subjects compared to males. NAA is a non-essential amino acid which is synthesised by neuronal mitochondria and found exclusively in neurones and their processes. In the spinal cord, axonal numbers closely correlate with NAA levels quantified by immunoassay, and NAA levels decrease in the presence of inhibitors of complexes I, III, IV and V of the mitochondrial BKM120 PI3K inhibitor respiratory chain. Therefore, in MRS studies, concentrations of tNAA are commonly interpreted as reflecting neuroaxonal integrity and/or mitochondrial energy production.