Increasing sensitivity of clinical proverb tests for diagnosis of dementiaCases of dementia worldwide are estimated to double, if not triple, by 2050. 1 Since there is no cure for dementia, prevention, early diagnosis and interventions that slow down cognitive decline are critical. However, early diagnosis of dementia remains a challenge. Chakrabarty et al. 2 propose that certain cognitive tests, such as those targeting pragmatic skills, may facilitate early detection of cognitive decline in dementia. The authors argue that disruption to pragmatic processing may precede a deficit in episodic memory, which is considered a hallmark of unfolding Alzheimer's disease (AD), 3 and that the hippocampus, which is a locus of early neurodegenerative changes in AD, 4 also supports pragmatic processing.The idea that comprehension of figurative language may provide a window into cognitive decline is not new. Since the early 20th century, psychologists, psychiatrists, and neuropsychologists have used proverbs for evaluative and diagnostic purposes. 5 Proverbs are fixed