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He says he feels fine but his speech is fragmented and he says he can't remember the words he needs. He has had a lot of upheaval in the last few days with builders at his house due to a collapsed ceiling. He gets very down in such situations.

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Do you have phone numbers for your neighbor's family members? If so, I would call them and have them come and check out your neighbor. In the absence of such phone numbers I would do as Maggie suggested and call 911 but call from your neighbor's home, with him, as opposed to just calling them and having them show up at his house while he is unaware.
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Some temporary confusion MAY be natural . . . If you have concerns, call 911. Very often the paramedics can do a cursory evaluation and will attempt to transport him to the hospital.
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A collapsed ceiling would distract and upset anyone to the point of being unable to find the right words. Stress can cause that.

However, there's also the possibility that the stress of whatever caused the ceiling collapse provoked a stroke.

If you know his family, contact them and share your concerns, ASAP. Just to be on the safe side, this sudden change should be evaluated. I'd ask the family to take him to the ER. Better to be safe than sorry.

And if he's okay, it wouldn't hurt to spend some time with him, or ask his family to, while the house is undergoing reconstruction. People of any age need relief after disasters, and social support is critical.
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swisstree, my Dad will act that ways at time, he will try to talk and just can't get his words out.... it's temporary with my Dad, and later on he will be talking normal.

It could be just stress related having workmen in the house. Does your neighbor have a regular doctor that he sees? I would try to get in contact with that doctor or set up an appointment.
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