Associations between characteristics of stroke survivors and caregiver depressive symptoms: a critical review

Background: Poststroke depression is common in stroke survivors. Evidence suggests that caregivers of stroke survivors also experience depression, at rates similar to survivors (30–40%). While much research has focused on developing better understanding of poststroke depression in stroke survivors, stroke caregiver depression has received less attention. Available research suggests that characteristics of the survivor such as age, gender, relation to caregiver, mental health, and physical or cognitive deficits correlate with and may be contributing factors for caregiver depression. Knowledge of risk factors for stroke caregiver depression could translate to better screening, management, and prevention, but further investigation is needed. Objectives: To examine the existing literature and synthesize evidence surrounding survivor characteristics and their association with poststroke depressive symptoms in caregivers. Methods: Medline, PsychInfo, and CINAHL databases were searched with variations of keywords: “stroke,” “caregiver” and “depression.” Studies analyzing associations between at least one stroke survivor characteristic and caregiver depressive symptoms were included. Results: Seventeen studies met eligibility criteria. They analyzed a wide range of survivor characteristics. Many survivor characteristics lacked convincing evidence of an association with caregiver depressive symptoms. However, a trend emerged supporting an association between survivor depressive symptoms and caregiver depressive symptoms. Conclusions: Health-care providers should be aware that depressive symptoms in one member of a stroke survivor-caregiver dyad may indicate risk for depressive symptoms in the other. Screening both individuals may lead to earlier detection and provide information to guide interventions. Knowing risk factors for stroke caregiver depression may improve prevention/management, but further investigation is needed.