This study examines the processing of a specific linguistic distinction, the mass/count distinction, in patients suffering from Alzheimer's disease (AD) and mild cognitive impairment (MCI). Fourteen AD and 10 MCI subjects were tested using a sentence grammaticality judgement task where grammaticality violations were caused by determiner–noun mismatches, as well as a sentence–picture matching task to assess their ability to access mass and count readings of dual nouns. Considerable heterogeneity was observed within each subject group, and performance across groups was almost identical. It is concluded that a combination of linguistic and attentional and/or learning factors are responsible for the range of impairments; specifically, a subset of subjects exhibit no linguistic nor attentional/learning impairment, another subset exhibit only an attentional and/or learning impairment but no linguistic impairment, and a third subset (comprising more than half of the subjects included in this study) exhibit a linguistic impairment. It is postulated that the latter group have difficulty processing sense extensions in metonymous nouns. It is further claimed that, at least within the limits of the study, language impairments can be of the same severity and nature across AD and MCI subjects.