One proposed explanation for the decline in stroke mortality, in addition to better identification of and control of hypertension, is that the diseases with which stroke occurs at advanced ages have declined in lethality. To examine changes in the pattern of conditions with which stroke is reported on the death certificate, age, sex and race specific multiple cause mortality data were analyzed. The findings were consistent with a decline in the lethality of stroke and increases in its prevalence as an associated cause of death at advanced ages.