Dementia has a significant impact on communication abilities. The profile of communication skills in dementia differ from the profiles of developmental aging and focal organic disorders. Normal elders may have some episodic memory losses and slower reaction times as aging progresses. Focal language disorders (aphasia and right hemisphere disorders) will affect specific language functions without affecting intellect and memory. Communication in the presence of dementia progresses through three stages. The first stage deficits are primarily in the content area of lexical access and subtle conversational skills. The second stage reveals increased difficulty in content areas including concept formation, lexical access diminished graphic abilities, reliance on syntactic abilities and reduced memory function. The third stage of dementia may involve all of the above to a more severe degree, with severe memory and intellectual deficits. Assessment batteries have been developed to evaluate the deficit areas frequently associated with communication in dementia. Clinical evaluation and standardized assessment can differentiate the language profile of dementia from other neurological disorders. Therapeutic intervention in communication focuses on maintaining the patient's communication and providing educational information for caregivers for more effective communication strategies.