title: Determinants of quality of life in stroke survivors and their informal caregivers.
abstract: OBJECTIVE
  We examined longitudinal changes of quality of life (QOL) covering physical and mental factors in an unselected group of stroke patients and their informal caregivers. Our hypothesis was that informal caregivers would have better QOL than patients at both follow-ups, and that changes, if any, would be related to the patients' status.
  
  
  METHODS
  QOL of 304 consecutive stroke patients and their 234 informal caregivers from the population-based Lund Stroke Register was assessed 4 months after stroke onset with the Short Form 36 (SF-36) questionnaire. SF-36 was repeated for both groups after 16 months together with Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-20) for patients.
  
  
  RESULTS
  The patients' mean QOL scores improved between 4 and 16 months after stroke in the socio-emotional and mental SF-36 domains and decreased in the domain physical function. Multivariate analyses showed that the patients' most important determinants of QOL after 16 months were GDS-20 score, functional status, age, and gender. Informal caregivers had better QOL than patients except for the domain role emotional and the mental component summary. The caregivers' most important determinants of QOL were their own age and the patients' functional status.
  
  
  CONCLUSIONS
  Our study highlights depressive symptoms in determining QOL of stroke patients. Despite self-perceived deterioration in physical function over time, several other components of QOL improved, suggesting internal adaptation to changes in their life situations. Informal caregivers of stroke patients may be under considerable strain as suggested by their lower emotional-mental scores.
authors.affiliation: Department of Clinical Neuroscience, Division of Neurology, University Hospital, S-221 85 Lund, Sweden. ann-cathrin.jonsson@skane.se
authors.forename: Ann-Cathrin
authors.initials: AC
authors.lastname: Jönsson
authors.forename: Ingrid
authors.initials: I
authors.lastname: Lindgren
authors.forename: Björn
authors.initials: B
authors.lastname: Hallström
authors.forename: Bo
authors.initials: B
authors.lastname: Norrving
authors.forename: Arne
authors.initials: A
authors.lastname: Lindgren
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003863:Depression; D005190:Family; D005260:Female; D006304:Health Status; D006701:Home Nursing; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D012044:Regression Analysis; D012944:Social Support; D020521:Stroke / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome