• The depressive symptoms of a stroke survivor and that of their caregiver are linked
• Important to focus not only on stroke survivors during their post-stroke rehabilitation, but also on monitoring their family caregivers

Professor David Matchar and Assistant Professor Rahul Malhotra, from the Health Services and Systems Research Programme at Duke-NUS, led a study that followed up with 172 stroke survivors and their respective family caregivers in Singapore over one year after the stroke. The study is the first to assess how depressive symptoms progress over time in patient-caregiver pairs, addressing an area that was lacking in past studies.

All stroke survivors were found to be at risk of depression initially, but about half could expect their depressive symptoms — which include feeling lonely, talking less than usual and having trouble focusing on routine activities — to decrease with time.

Among caregivers, seven in 10 were found to be at a low risk of depression and remained stable over time, while the remainder had a higher risk of depression initially and gradually improved.

Where one party’s depressive symptoms went up significantly, an increase was also seen for the other.
The researchers also found that the loss of functional ability in stroke survivors increases their depressive symptoms. Having a foreign domestic worker to help care for a patient reduces depressive symptoms in the caregiver.

The study, supported by the Ministry of Social and Family Development and National Research Foundation, did not cover foreign domestic workers and Prof Matchar said this is because internationally, the definition has traditionally been that of a family caregiver.

Helping only a stroke survivor or caregiver may have an indirect impact on the other, but help would be more effective if offered to both parties at the same time, said Prof Malhotra.

“Health and social care professionals caring for stroke survivors should focus not only on their patients but also make an effort to reach out to and converse with the family caregivers who are caring for their patients at home”, he added.

Although depression can hit caregivers of people with various disabilities, Prof Matchar said, “It’s especially of importance in stroke, because stroke is so commonly associated with depression.”