Alzheimer's dementia (AD) is a progressive, degenerative disease that occurs in the cerebral cortex due to increased levels of glutamate, the proliferation of plaque-forming amyloid beta proteins, and reactive gliosis. Establishing behavioral indicators of the disease (e.g., impairments of episodic memory) and use of neuroimaging technology that can substantiate medial temporal lobe brain structure deficiencies demonstrates an important clinical neuroanatomic relationship needed for early evaluation of possible AD diagnosis. This bilingual/bicultural case study details the cognitive and language impairments associated with AD over the course of 1 year. Utilization of a bilingual/bicultural case study may elucidate the pattern of language and cognitive decline in this understudied population. Formal and informal measures, observations, and magnetic resonance imaging (MRI) results are provided. Insights into cultural and linguistic differences are presented.