Abstract: This document discusses, among other things, systems, devices, and methods for detecting stroke in a patient. A system may comprise a sensor circuit for sensing in a patient at first physiological signal and a second physiological signal or a functional signal. A stroke risk circuit may establish a physiological trend from at least the first physiological signal over time, and generate a stroke risk indicator using the physiological trend and the second physiological or functional signal. Indications of behavioral or cognitive impairment may also be used in stroke risk indicator generation. The system includes an output unit that outputs the stroke risk indicator to a user or a process.