100Cognitive Impairment in Stroke Patients Five Years Post-Stroke is Associated with Anxious and Depressive Symptoms in Family Members

Abstract

Background and Aims: Cognitive impairment is common post-stroke, and is associated with increased levels of disability and dependency, leading to a greater burden on family members. The aim of this study was to explore associations between cognitive impairment in stroke survivors and anxious or depressive symptoms in family members five years post-stroke. Method: As part of a five-year follow-up of the Action on Rehabilitation and Secondary Prevention Interventions in Stroke (ASPIRE-S) cohort of stroke patients, family members completed a self-report questionnaire. Symptoms of anxiety and depression were assessed using the HADS-A and CES-D. Cognitive impairment in stroke survivors was assessed using the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE score >3.3). Results: 77 family members participated, of whom 71 completed the HADS-A, and 51 the CES-D. Family members were spouses/partners of stroke patients (n=49, 63.6%), adult children (n=22, 38.6%) or siblings (n=6, 7.8%). The majority was female (n=62, 80.5%). Depressive symptoms were evident in 25.5% of family members, with 19.7% reporting symptoms of anxiety. Twenty-two stroke patients (29.0%) were identified as having evidence of cognitive impairment. Family members of stroke patients with cognitive impairment were significantly more likely to report depressive [OR (95% CI): 8.00 (1.99, 32.14)] or anxious symptoms [OR (95% CI): 7.00 (2.05, 23.87)]. Conclusion: Cognitive impairment in stroke patients is significantly associated with depressive and anxious symptoms in family members. Family members play a key role in the care and rehabilitation of stroke patients. Enhancing their psychological wellbeing and identifying possible ways to decrease burden is thus essential.