Beyond language impairments in post-stroke aphasia: A critical review

Although poststroke aphasia has traditionally been defined as a language disorder, some studies have suggested that other cognitive abilities might also be affected. The purpose of this review was to examine the extent to which impairments in domain-general abilities such as memory, attention, executive functions, and reasoning co-occur in people with aphasia (PWA) due to stroke. A search was conducted for studies that assessed both language and domain-general abilities behaviorally in people with aphasia and were published between the year range 2000-2023 in multiple databases. Synthesis of the results was organized according to the interactions between domain-general and linguistic abilities investigated by each study. We reviewed 23 studies in total. Overall, the articles included showed evidence for a significant prevalence of other cognitive deficits in post-stroke aphasia that interact with the severity of linguistic impairment, functional communication, and recovery outcomes. We highlight some methodological factors that should be considered when studying the relationship between language and domain-general impairments in the recovery of post-stroke aphasia, as well as the still unanswered questions about such interaction and the clinical implications of acknowledging that aphasia is not only a spectrum of profiles with diverse language impairments but also altered cognitive abilities.