Many studies present apparently conflicting results and conclusions about the effects of Alzheimer's disease (AD) on language use. This review attempts to reconcile these apparently conflicting results regarding the language impairments in AD by discussing how the slow deterioration of the semantic system at the feature level interacts with the task demands of tests used to evaluate performance. In particular, performance is impaired on tasks that require relatively complete, elaborate semantic representations but is preserved when the task requires only partial semantic representations consisting largely of shared features. The variety of language impairments reported in complex, multiword tasks are likely attributable to a combination of the deterioration of semantic representations and reduced working memory resources. The few available treatment studies for language impairments in AD suggest that treatments designed for adults with other language impairments, such as aphasia, may also be effective in AD.

One of the greatest challenges to language rehabilitation is reconciling the fact that the same therapeutic intervention, provided to different individuals with similar types of stroke-induced aphasia, may result in divergent outcomes. In this paper, the authors reviewed existing literature to identify relevant ambient factors – those outside the control of the clinician – that may potentially influence functional language recovery in aphasia and response to treatment. The goal was to develop a clinical history-taking tool to assist clinicians in gathering information germane to each individual's unique circumstances and environment, elements that may have previously been underestimated, to provide a complete inventory of potentially potent prognostic factors. First, two of the authors, speech–language pathologists experienced in aphasia rehabilitation, identified and categorized factors that seemed likely to influence aphasia outcomes. Then, a wide range of literature was reviewed in an effort to identify factors empirically found to be potent influences on aphasia recovery. Where studies relating these factors to aphasia were not found, relevant research from allied fields that examined recovery from brain injury is reported. Moreover, some factors thought to be potentially potent have yet to be examined. Finally, the ambient factors supported by evidence were categorized as facilitators or barriers to functional improvement, and the Ambient Influences on Outcome Checklist (AOC) was developed, including only those factors shown to be potent in the recovery process. It is hoped that this checklist can be used to more broadly assess potential prognostic influences in aphasia restitution, as well as spawn further research.