The National Adult Reading Test (NART), used to estimate premorbid mental ability, involves pronunciation of irregular words. The authors demonstrate that, after controlling for age 11 IQ test scores, mean NART scores do not differ in people with and without dementia. The correlation between age 11 IQ and NART scores at about age 80 was similar in the groups with (r = 0.63, p < 0.001) and without (r = 0.60, p < 0.001) dementia. These findings validate the NART as an estimator of premorbid ability in mild to moderate dementia.