Patients with dementia or Alzheimer’s disease often appear withdrawn or unresponsive, raising a crucial question — can they still hear and understand voice commands? This review examines auditory perception and emotional comprehension in neurodegenerative conditions, emphasizing how hearing and understanding diverge as cognition deteriorates. Evidence shows that while the auditory cortex remains functionally active even in moderate dementia, the language comprehension and semantic networks progressively degrade. Emotional tone and familiar voices, however, continue to evoke responses, highlighting the enduring connection between sound, memory and emotion. This non-laboratory review bridges neuroscience with compassionate caregiving to promote effective communication in advanced dementia care.
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