Socio-pragmatic processing is a complex feature of human communication that relies on several cognitive systems such as attention, working memory, and the ability to access semantic information in the lexicon. This chapter examines socio-pragmatic processing in the context of Alzheimer's dementia (AD). We consider (a) the characteristics of communication in dementia, (b) how cognitive limitations associated with AD interact with the ability to fully process the contextual information necessary for attending to, and comprehending, socio-pragmatic information, and (c) the implications of interacting with people with AD for neuro-typical communication partners. Consideration of qualitative studies published in the past decade in addition to the examination of data collected in an ethnographic study suggest that people with AD are often adept at managing to sustain the use of small-talk and politeness tokens in conversational dyads. However, this may be due to the nature of these particular forms of talk which allow for more paradigmatic choices than other forms of talk that contain greater propositional density.