Objective: The objective of this study was to ascertain if cognition helps to predict functional outcome in older comorbid stroke patients with severe loss of independence. Design: This is a cross-sectional study. Subjects: The subjects of this study are patients who have suffered a stroke and who rehabilitated in the nursing homes' rehabilitation units and patients (n = 160) (mean age: 77; SD: 9.5) with a mean Barthel Index of 11.02. Method: Demographic, illness-related, functional and cognitive data were selected at baseline. Main Assessment Measures: Functional abilities were tested using the Barthel Index. Cognitive functions were assessed using a wide variety of neuropsychological tests. Results: Patients faced cognitive impairments especially in executive functioning and memory. Stepwise linear regression analysis shows that executive functioning (p = 0.050) and memory (p = 0.000; confidence interval −1.255, −0.403) are significantly associated with functional outcome. Conclusion: From a clinical point of view, we suggest combining physical and cognitive training from the very early phase of recovery.