This study investigated whether spouses would adopt a specialized speech register when communicating with adults with probable Alzheimer's disease. A picture description task was used so that the effectiveness of such speech accommodations could be assessed. The AD subjects did not vary the syntactic complexity, semantic complexity, or content of their descriptions when they were describing individual pictures versus directing their spouse to choose one of four pictures in a barrier task. The spouses' picture descriptions were more complex syntactically and semantically than the AD subjects' and included more highly salient elements. The spouses also varied the complexity and content of their descriptions, reducing syntactic and semantic complexity and increasing references to highly salient picture elements during the barrier task. These accommodations appeared to facilitate the AD subjects' performance on the picture description task.