Stroke Caregivers at Risk for Depression

Caregivers of stroke survivors are at risk for developing depression and complications from chronic stress, according to a new study.

Researchers at Loyola University Chicago (LUC; IL, USA) evaluated 45 women (median age 55.8 years) who were caring for a family member who had experienced a stroke during the past year; participants were recruited from support groups, social networking sites, and two outpatient clinics. The average hours of care the participants provided was 50.7 hours per week. The women completed the Center for Epidemiologic Studies Depression Scale (CES-D) survey to measure perceived stress and caregiver burden, as well as social support, quality of sleep, and depressive symptoms. They also provided saliva samples to test for the stress-related hormone cortisol four times throughout the day, for a period of two days.

The results showed that the women had high levels of perceived stress and caregiver burden, and poor quality of sleep. The study also found that the burden of caring for a stroke victim increases the risk of depressive symptoms and stress. This burden can include financial strain, home confinement, changes in the relationship with the care recipient, noncompliance of the stroke survivor, demands of caring for the stroke victim, and having little personal time for oneself. In women with CES-D scores over 16, salivary cortisol levels were significantly lower across the day relative to women with CES-D scores lower than 16. The study was published in the July 2012 issue of Biological Research for Nursing.

“Stroke survivors can suffer significant and lasting disabilities that may require lifelong support from family and other caregivers,” said lead author associate professor Karen Saban, PhD, RN, of the LUC School of Nursing. “Many families struggle to provide 24-hour care for their loved ones. This burden places the caregivers at risk for depression, anxiety, and sleep disturbances, which can harm quality of life and heighten their risk for other health problems.”

Cortisol (hydrocortisone) is a steroid hormone, more specifically a glucocorticoid produced by the adrenal gland. It is released in response to stress and a low level of blood glucocorticoids, acting to restore homeostasis. Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat, protein, and carbohydrate metabolism. It also decreases bone formation.

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