Elderly people speak with a large tongue, with slurred speech, slurred speech, and change in speech speed. If accompanied by symptoms such as dizziness, slurred mouth and eyes, cognitive impairment, and limb weakness, acute cerebrovascular disease should be considered, including conditions such as cerebral infarction, acute cerebral hemorrhage, encephalitis, intracranial hematoma, and intracranial tumors. Other diseases should also be considered, such as severe pneumonia that can cause pulmonary encephalopathy, and endocrine diseases, including hypothyroidism, diabetes, hypoglycemic reaction, severe hyponatremia, etc. These systemic systemic diseases can lead to transient ischemia and hypoxia of the brain and the manifestation of speaking with a loud tongue.