Background: According to previous studies, the quality of life is usually substantially altered in patients who have suffered a subarachnoid hemorrhage of an aneurysmal origin. Some studies have attempted to find out which factors predict the deterioration in quality of life. Our study will try to describe the quality of life of these patients and discover which variables may predict it in each of its dimensions. Methods: The participants were 70 patients with aneurysmal subarachnoid hemorrhage between 15 and 85 years of age. The instrument used to measure the quality of life is the SF-36 with its eight dimensions. The predictor variables introduced into the multiple linear regressions are neurological condition on admission [World Federation of Neurological Surgeons (WFNS) scale and Hunt and Hess scale], extension of the hemorrhage (Fisher scale), sex, age, physical handicaps, and the Glasgow Outcome Scale (GOS) on release. Results: The results showed that 42.9% of the patients had a deteriorated quality of life after 4 months, and that the most affected dimension was the Physical Role (60%). The two factors that predict quality of life are sex and physical handicaps. Other factors that intervene are the GOS on release and the WFNS. Conclusions: The patients who have experienced an aneurysmal subarachnoid hemorrhage show greater difficulty in performing daily activities, and they present more depression and anxiety. The absence of handicaps and being male are predictor factors for an unaffected quality of life.

The detection of feigned cognitive impairment remains difficult and may be even more challenging in certain population groups. Studies on the use of neuropsychological tests in ethnic groups for which they were not designed have shown variations in performance associated with cultural differences. With this background, our group studied a Spanish population by applying commonly used procedures [Victoria Symptom Validity Test (VSVT), Test of Memory Malingering (TOMM), and the b test] in a group with post-concussion syndrome (PCS) (whether litigants or not) and in a group of analog malingerers (AN). These tests appeared to function adequately in this Spanish population, who showed similar performances to results published for North Americans.

Malingering detection has become a topic of increased interest in the US over the last years. However, this development has not been matched in Europe. For example, in Spain there is insufficient evidence to support the use of reliable and valid malingering tests. In this study, we tested the applicability of two malingering detection tests (Test of Memory Malingering (TOMM) and Dot Counting Test) in a Spanish sample. The sample included three groups of patients (30 non-compensation seeking, 14 compensation seeking non-suspected of malingering, and 10 suspected of malingering) and a group of analog students (n=54). Tests' results were able to discriminate between the groups of malingerers (both patients and analogs) and non-malingerers (both compensation seeking and non-compensation seeking). However, the TOMM achieved a higher overall classification rate than the Dot Counting Test. Our results encourage the use of the TOMM as an indicator of malingering with Spanish population.

Background: Early definitions of mild cognitive impairment (MCI) excluded the presence of functional impairment, with preservation of a person's ability to perform activities of daily living (ADL) as a diagnostic criterion. However, recent studies have reported varying degrees of functional impairment associated with MCI. Hence, we aimed to test the potential functional impairment associated with MCI and its predictors.Methods: Sixty-nine healthy elderly subjects, 115 amnestic single-domain MCI subjects (a-MCI), and 111 amnestic multi-domain MCI subjects (md-MCI) were assessed using a battery of neuropsychological tests including measures of attention, memory, working memory, executive functions, language, and depression. Additionally, functional ability was assessed by both qualitative (WHO-DAS II) and quantitative (CHART) instruments. Cognitive and functional performance was compared between groups, and regression analyses were performed to identify predictors of functional ability.Results: The md-MCI group was more impaired than the a-MCI group, and both were more impaired than healthy subjects in all cognitive measures, in total CHART score, CHART cognitive and mobility subscores, and WHO-DAS II communication and participation subscales. For the rest of the functional measures, the md-MCI group was more impaired than healthy controls. Prediction of functional ability by cognitive measures was limited to md-MCI subjects and was higher for the CHART than for the WHO-DAS II. The WHO-DAS II was largely influenced by depressive symptoms.Conclusions: Functional impairment is a defining feature of MCI and is partially dependent on the degree of cognitive impairment. Quantitative measures of functional ability seem more sensitive to functional impairment in MCI than qualitative measures, which seem to be more related to depression.