Earlier studies showed a less favorable outcome for patients with established cerebrovascular disease (CVD), defined as a history of stroke, infarctions on radiological imaging, or moderate to severe white matter lesions on a CT scan [16, 31]. Boon et al. found 52% of the patients with CVD to be improved, as opposed to 79% of those without , and Spagnoli et al. showed similar results in the long-term perspective (mean 52 months), with 49 vs. 79% improved patients . Our study included only a history of stroke, but the negative impact of CVD, in this narrower sense, regarding the proportion of improved patients in the short or long term could not be confirmed. Patients with a history of stroke performed worse with regard to the smRS score only after 3 years, but the proportion of patients still reporting “better” was not affected at any time point.