Family Functioning Is Associated With Depressive Symptoms in Caregivers of Acute Stroke Survivors

Objective: To determine whether family functioning is uniquely associated with caregiver depressive symptoms in the immediate aftermath of stroke. Design: Cross-sectional data from the baseline assessment of an intervention study tor stroke survivors and their families. Setting: Neurology inpatient service of a large urban hospital. Participants: Stroke survivors (n=192), each with a primary caregiver. The mean age of stroke survivors was 66 years, and most, 57%, were men (n=110). The mean age of caregivers was 57 years, and 73% (n=140) of the caregivers were women. Eighty-five percent of caregivers were white. Interventions: Not applicable. Main Outcome Measures: Measures were chosen to assess caregivers' depressive symptoms (Centers for Epidemiologic Studies Depression Scale), family functioning, (Family Assessment Device), and additional factors Such as health status (Medical Outcomes Study 36-Item Short-Form Health Survey) and stroke Survivors' cognitive abilities (modified Mini-Mental State Examination) and functional impairments (FIM and Frenchay Activities Index). Results: Depressive symptoms were mild to moderate in 14% and severe in 27% of caregivers. Family functioning was assessed as unhealthy in 34% of caregiver-patient dyads. In statistical regression models, caregiver depression was associated with patients' sex, caregivers' general health, and family functioning. Conclusions: Forty-one percent of caregivers experienced prominent depressive symptoms after their family member's stroke. Higher depression severity in caregivers was associated with caring for a mail, and having worse health and poor family functioning. After stroke, the assessment of caregivers' health and family functioning may help determine which caregivers are most all risk for a depressive syndrome.