This chapter explores the background to representations of language in dementia in contemporary literary fiction and non-fiction, from a perspective which draws upon work in clinical speech and language, neurolinguistics and cognitive linguistics, and interactional discourse. The approach adopted here to literary representations of language in dementia relies on a number of cross-disciplinary methods and insights. With regard to literary models and practices of self- and other-manifestation, it is well-known that tensions emerge between narrative preoccupations that are either broadly mimetic or symbolic. In the clinical and diagnostic literature, there is growing recognition that the term is unhelpfully wide-ranging and potentially stigmatising given its literal associations with madness. In a broad sense, the task and purpose of representing language deterioration that occurs in dementia is no different to that involved in portraying non-standard language of any sort. There is general utility in representing broad spectra of language varieties for purposes of anchoring texts in particular regional, social and psychological environments.