参考答案：A

解析：

The muscles that become paralyzed in dysarthria are the same ones used for swallowing. This increases the client's risk of aspiration. Clients with Alzheimer's disease that are still ambulatory probably don't have the voluntary muscle problems that occur later in the disease. Clients that need help with ADLs or have severe arthritis shouldn't have difficulty swallowing unless it exists secondary to another problem.