APOE and early-onset autosomal dominant Alzheimer disease: A higher number of ApoE ε4 alleles, a genetic risk factor for Alzheimer disease, has been associated with faster cognitive decline after stroke.12 Higher risk for cognitive impairment has been shown after recurrent strokes than after a single stroke.29 We observed that regardless of the number of ApoE ε4 alleles or number of strokes, college-educated stroke survivors had faster decline in executive function.