Caregiver spouses of stroke survivors face a higher risk of long-term mental and physical health problems, a seven-year Swedish study published in the journal Stroke reports.
Researchers from the Sahlgrenska Academy at the University of Gothenburg followed 248 stroke survivors (all younger than 70, with an average age in the mid-60s) and their spouses, comparing them with 245 matched non-stroke control couples over seven years. The study examined how caring for a partner after an ischemic stroke affects spouses’ health-related quality of life both in the years immediately after the event and in the long term.
Key findings showed that spouses of stroke survivors reported significantly lower scores across several domains of health-related quality of life. These included increased health problems that affected daily life, reduced vitality, and poorer social functioning. These negative effects were present not only during the early post-stroke years but persisted through the seven-year follow-up. At that follow-up point, 16.5 percent of the stroke survivors had experienced a recurrent stroke.
The researchers found that the spouse’s quality of life was most strongly related to the survivor’s level of disability, cognitive impairment, and depressive symptoms. In other words, when a survivor had persistent functional limitations, memory or thinking problems, or ongoing depression, the spouse was more likely to report worse physical and mental health.
Study approach and measures
The study used validated instruments to evaluate both survivors and their spouses. Spouses’ health-related quality of life was measured with the Short Form-36 (SF-36), which assesses physical functioning, bodily pain, role limitations, vitality, social functioning, emotional role, and mental health. Stroke survivors were evaluated with standardized clinical methods, including the National Institutes of Health Stroke Scale (NIHSS) for stroke severity, the Mini-Mental State Examination (MMSE) for cognitive status, the Hospital Anxiety and Depression Scale (HADS) for mood symptoms, the Barthel Index for activities of daily living, and the modified Rankin Scale (mRS) for overall disability and dependency.
Data collection included questionnaires, telephone interviews, and face-to-face assessments. The researchers also accounted for demographic factors such as age, presence of children at home, education level, and employment status to better understand how caregiving responsibilities interacted with other life circumstances.
Why these results matter
The study highlights that caregiving after stroke can be a sustained burden, particularly in younger couples who may still be working, raising children, or managing financial responsibilities. The combination of reduced work hours, increased caregiving duties, and the emotional strain of a partner’s long-term disability can have lasting effects on a spouse’s mental and physical well-being.
These findings have implications for clinicians and policymakers: stroke care and follow-up should include attention to family members, especially spouses, who may need social support, mental health services, and resources to manage caregiving demands over time. Early identification of at-risk spouses and targeted interventions could reduce the prolonged negative impact on their quality of life.
Authors, funding and disclosures
The study authors include Josefine Persson, M.Sc., Lukas Holmegaard, M.D., Ingvar Karlberg, M.D., Ph.D., Petra Redfors, M.D., Ph.D., Katarina Jood, M.D., Ph.D., Christina Jern, M.D., Ph.D., Christian Blomstrand, M.D., Ph.D., and Gunilla Forsberg-Wärleby, Ph.D. Author disclosures and funding information are reported in the manuscript published in Stroke.
Summary facts
- Spouses who care for stroke survivors report reduced health-related quality of life both in the early years and up to seven years after the stroke.
- Lower vitality, more health problems affecting daily life, and reduced social functioning were among the main areas of impact for caregiver spouses.
- The severity of the survivor’s disability, cognitive impairment, and depressive symptoms were key factors associated with worse spouse outcomes.
Abstract summary
The long-term consequences of stroke for family members are often studied only in the short term. This seven-year follow-up from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS) assessed health-related quality of life among spouses of stroke survivors using the SF-36 and standardized clinical assessments for survivors. The authors concluded that spouses’ health-related quality of life is reduced not only during the first years after stroke but also over a prolonged period, underscoring the need for continued attention and support for caregivers.