Blake Jason A, Long D Leann, Knight Amy J, Goodin Burel R, Crowe Michael, Judd Suzanne E, Rhodes J David, Clay Olivio J
Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Biostatistics & Data Science, Wake Forest University, Winston-Salem, North Carolina, USA.
Int J Geriatr Psychiatry. 2025 Jan;40(1):e70046. doi: 10.1002/gps.70046.
Caring for an individual with cognitive impairment carries a physical, mental, and emotional toll. This manuscript examines the relationship between caregiver psychosocial measures and longitudinal cognitive outcomes of stroke survivors, as well as analyzing the psychosocial factors as moderators of stroke severity and cognition.
This analysis was conducted on caregiver and stroke survivor dyads (n = 157) that participated in the Caring for Adults Recovering from the Effects of Stroke (CARES) project, an ancillary study of the REasons for Geographic and Racial Differences in Stroke (REGARDS) national cohort study. Stroke severity at hospitalization discharge was included as the primary predictor of cognitive outcomes and caregiver psychosocial factors were included as additional predictors. Cognition was assessed biennially and measured the domains of learning, memory, and executive functioning. Individual mixed-effect models included each psychosocial factor and were covariate-adjusted for pre-stroke cognitive scores and demographic variables. Caregiver psychosocial factors included caregiver strain, depressive symptoms, life and leisure time satisfaction, and overall quality of life.
Decreased caregiver strain (b = -0.230, 95% CI: -0.39 to -0.07; p = 0.006) and increased leisure time satisfaction (b = 0.045, 95% CI: 0.01 to 0.08; p = 0.005) were both found to be significant predictors, alongside stroke severity (b = -0.137, 95% CI: -0.22 to -0.05; p = 0.002), of better stroke survivor cognition overall. No variables were found to be moderating factors of the relationship between stroke severity and cognition.
Understanding the caregiver psychosocial factors that predict stroke outcomes will help clinicians to identify stroke survivor and caregiver dyads at higher risk for worst longitudinal cognitive outcomes following stroke.
照顾认知障碍患者会给照顾者带来身体、心理和情感上的负担。本文探讨照顾者心理社会指标与中风幸存者纵向认知结果之间的关系，并分析心理社会因素作为中风严重程度和认知的调节因素。
本分析针对参与“照顾中风后康复成人”（CARES）项目的照顾者与中风幸存者二元组（n = 157）进行，该项目是“中风地理和种族差异原因”（REGARDS）全国队列研究的一项辅助研究。出院时的中风严重程度作为认知结果的主要预测因素，照顾者心理社会因素作为额外预测因素。每两年评估一次认知，测量学习、记忆和执行功能等领域。个体混合效应模型纳入每个心理社会因素，并针对中风前认知分数和人口统计学变量进行协变量调整。照顾者心理社会因素包括照顾者压力、抑郁症状、生活和休闲时间满意度以及总体生活质量。
照顾者压力降低（b = -0.230，95%置信区间：-0.39至-0.07；p = 0.006）和休闲时间满意度提高（b = 0.045，95%置信区间：0.01至0.08；p = 0.005）均被发现是总体中风幸存者认知改善的显著预测因素，与中风严重程度（b = -0.137，95%置信区间：-0.22至-0.05；p = 着002）一样。未发现任何变量是中风严重程度与认知之间关系的调节因素。
了解预测中风结果 的照顾者心理社会因素将有助于临床医生识别中风后纵向认知结果最差风险较高的中风幸存者和照顾者二元组。
