and purpose: Bilingualism has been associated with slower cognitive ageing and a later onset of dementia. In this study, we aimed to determine whether bilingualism also influences cognitive outcome after stroke. Methods: We examined 608 ischemic stroke patients from a large stroke registry and studied the role of bilingualism in predicting post-stroke cognitive impairment in the absence of dementia. Results: A larger proportion of bilinguals had normal cognition compared to monolinguals (40.5 %

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... vs19.6 %, P<0.0001) while the reverse was noted in patients with cognitive impairment, including vascular dementia and vascular mild cognitive impairment (monolinguals 77.7% vs bilinguals 49.0%, P<0.0009). There were no differences in the frequency of aphasia (monolinguals 11.8% vs bilinguals 10.5%, P =0.354). Bilingualism was found to be an independent predictor of post-stroke cognitive impairment. Conclusions: Our results suggest that bilingualism leads to a better cognitive outcome following stroke, possibly by enhancing cognitive reserve.