In order for a person to swallow safely and effectively, five bodily systems must work in coordination. Dysphagia occurs when there is a breakdown in one or more of these systems: neurological (NeuroDys), cognitive (CogDys), muscular (MuscDys), respiratory (RespDys), and gastrointestinal (GIDys). The present perspective discusses cognitive decline preceding or concurrently degrading mechanisms of the swallow. We put forth current evidence supporting the premise that cognitive decline can cause dysphagia, and that dysphagia can cause cognitive decline through the exploration of anatomy, physiology, cellular architecture, basic homeostatic mechanisms, metabolism, and nutrition. Additionally, this perspective distinguishes CogDys from NeuroDys and provides an overview of the remaining systems. These types of dysphagia comprise a bi-directional, constantly evolving relationship in which cognition can affect neurological function, and the reverse can be true. We propose literature-driven conclusions and further discussion into considerations for certified nursing assistants, medical physicians, speech-language pathologists, occupational therapists, & physical therapists in effective dysphagia management.