Abstract
Dysphagia resulting from focal lesions and degenerative neurologic conditions has been widely reported. Few studies address oropharyngeal dysphagia associated with multiple strokes and vascular dementia, despite the fact that most individuals with severe dementia are eventually unable to participate in the eating process. Dysphagia management strategies used with other cognitively impaired populations would appear to have application to those with vascular dementia. Dysphagia evaluation and management strategies with the vascular dementia population are suggested, with emphasis on the role of the caregiver in dysphagia management. For patients with advanced dementia of all types, provision of nutrition by way of tube feeding is common practice. This controversial issue is explored.