To examine the extent to which levels of cognitive status influence patterns of word use in dementia evaluation reports. We utilized neuropsychological evaluation reports from 61 geriatric primary care patients referred for suspected dementia. Linguistic Inquiry Word Count analysis was utilized to examine clinician language use in patient reports and whether language use differs dependent on the diagnosis rendered. ANOVA analyses were used to analyze group differences in LIWC word counts across clinical indices of cognitive functioning: dementia diagnosis. Our analysis revealed significant differences in language use across diagnostic categories. ANOVA analyses yielded differences in broad negative emotion, (2,58) = 4.010, = .023 as well as other subgroups; anxiety-related word groups, (2,58) = 4.706, = .013; insight words, (2,58) = 3.815, = .028; causation words, (2,58) = 3.497, = .037; certainty words, (2,58) = 6.581, = .003; negation words, (2,58) = 3.165, = .05; time-related words; (2, 58) = 7.521, < .001; and human-related words, (2,58) = 6.512, = .003. The differences in clinician language use across different diagnostic groups may be reflections of implicit emotional reactions. Many of the patterns found in this study can be linked to previous research concerning word use and underlying thought processes. Awareness of language use is helpful in clinical relationships to attenuate stigma and facilitate treatment and research.© The Author(s) 2020.