World Stroke Day Proclamation 2015

W orld Stroke Day is an opportunity to proclaim a compel- ling universal message about stroke.Previous proclamations have emphasized challenges and opportunities to treat, rehabilitate, and prevent stroke (2006), the importance of small strokes (2008), and a prioritized world stroke agenda (2010).1,2 On the occasion of World Stroke Day 2015, an esteemed group of international stroke experts focus our attention on joining forces to prevent stroke and potentially preventable dementias.3 Key tenets of the 2015 proclamation include the following: (1) stroke and some dementias may be prevented; (2) shared risks (eg, tobacco use, physical inactivity, and poor diet) account for leading world health problems including major dementias of later life; (3) prevention has been neglected or not optimally applied; (4) poststroke dementia should be an integral part of stroke care; (5) major dementias commonly have a vascular component and detection and management of vascular risks should be encouraged; (6) organized stroke and dementia care and rehabilitation can improve outcomes; and (7) the need to better support and inform patients with stroke and caregivers, and a call to engage the public to increase knowledge that stroke and some dementias may be preventable.3 Why is this year's proclamation about stroke and the potentially preventable dementias so timely and important?For many years, the scientific community has been fixed on Alzheimer disease (AD), and vascular cognitive disorders have received less emphasis.4 There is no doubt that AD is extremely important to our understanding of late-life cognitive impairment.However, despite the recognition in the late 1990s and early 2000s that AD and vascular cognitive disorders may have shared cardiovascular risks, the scientific community was slow to embrace the relationship.[5][6][7] Furthermore, many past cardiovascular risk reduction trials did not include comprehensive study of cognitive function, and only more recently have these trials incorporated cognitive metrics as a key outcome.8,9 Thus, missed opportunities to study cognitive function in patients with a high burden of vascular risks have been common.