V165, (point to the window), V187 (wave goodbye), V188 (brush your teeth).

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Mini Mental State Examination (MMSE)

There are several variables to do with MMSE(Folstein, 1975) in each interview for the 5 centres. These are mmse, mmsg4 and mms01,.,mms26. In the screen interviews there is also mmsei.

mmsei_s0 and mmsei_s2

Missing values 7, 8 and 9 are recoded to the value 0. This MMSE variable is the original laptop MMSE and has been used for deciding the sample at assessment.

mmse

MMSE in CFAS publications has been coded up so that items that could not be answered due to sensory or mobility problems ('physical items' in table below) were recoded to zero whenever the question was not asked (interviewer recorded 9). If the interviewer recorded 7 (interviewee didn't know) or 8 (no answer) these were also recoded to zero. If a non-physical item was not asked or any question was skipped, then a person's MMSE score was declared invalid and they are given an impossible score of -1 to show this.

mms01 ,.,mms26

These are the appropriate questions recoded so that they are ready to be added together (if not equal to -1) to make up the MMSE score( mmse ). All are worth 1 point with the exception of mms16 which is worth a maximum of 5 points. The table below shows how these relate to the MMSE questions and where the questions are in each interview.

* 'Physical items

mmsg4

MMSE has been grouped at every interview such that:

N.B. People with a missing MMSE score can still be put in one of the first 4 MMSE groups if answers to questions that were not asked would not affect what group they would be in.

Reference

Folstein MF, Folstein SE, McHugh PR. 1975 'Mini Mental State': a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res12:189-198,

Extra variables dataset 

Angina

In CFAS (5 centres), the questions related to angina across all interviews up to year 8 were:

Prevalence screen (s0)

Q41    Have you ever suffered from angina?

Q42    Have you ever had any pain or discomfort in your chest?

Q43    Have you ever had any pressure or heaviness in your chest?

Q44    Do you get it when you walk uphill or hurry?

Q45    Do you get it when you walk at an ordinary pace on the level?

Q46    What do you do if you get it while you are walking?

Q47    If you stand still what happens to it?

Q48    How soon?

Q49    Will you show me where it was?

Incidence screen (s2)

Q41    Have you ever been diagnosed as having angina? (If yes, was that in the last two years?)

Q42    Have you, in the last two years, had any pain or discomfort in your chest?

Q43    Have you, in the last two years, had any pressure or heaviness in your chest?

Q44 - Q49     same as in prevalence screen.

First and Second annual follow ups (f1, f3), Combined screen and assessment at year 2, year 6 and year 8 (c2, c6, s6 c8)

Q257    Since we last saw you have you been diagnosed as suffering from angina?

Q258    Have you had any pain or discomfort in the centre of your chest when walking uphill or hurrying, that is relieved quite quickly when you rest (since we last saw you)? Can answer: Yes, No, or never walks uphill/hurries.

All informant interviews (h0, h2, ch2, h6, h8)

Q193     Has there ever been pain or discomfort in the chest that goes away with rest?

Answers: no, probable angina or certain angina.

The coding up and interpretation of the combined angina variables

Rose (1962) produced a questionnaire from which a diagnosis of angina can be made. The questions in this questionnaire, and relevant for diagnosing angina, were questions that featured in CFAS interviews: s0 and s2. For the people in these interviews who had not previously been diagnosed with angina by a doctor, the criteria of Rose (1962) were used to diagnose angina or no angina. Only when neither a positive diagnosis could be made (not all questions were answered) nor a negative diagnosis (not answering any question in such a way as to rule out angina) was a missing value assigned. The combined angina variables that have been coded up can be interpreted as:-

Has angina been reported or diagnosed for the first time in a CFAS interview?

If an individual has reported or been diagnosed with angina at one interview, then in all subsequent interviews they, by definition, do not report or get diagnosed for the first time in a CFAS interview. The variable definitions in full are:

angin_s0:   'ever had angina according to Rose (1962) or diagnosed by doctor'

class="MsoBodyText2"> angin_s2:   'first report of having previously been diagnosed with angina, or had angina according to Rose (1962), where did not report or get diagnosed with angina at screen (i.e. angin_s0 ¹ 1)'

angin_f1, angin_c2, angin_f3, angin_c6, angin_s6, angin_c8:   'since last seen, had angina (roughly according to Rose (1962)) or reported having previously been diagnosed, where in all previous interviews did not report or get diagnosed with angina (i.e. angin_s0 ¹ 1 ,.etc.)'

Table of newly reported/diagnosed angina incidents up to year 8

Missing values

Some people have missing values in the table above because they did not answer some questions or were not asked them in the first place, and had not previously reported or got diagnosed with angina .

Some people have missing angina diagnoses because they never walk uphill or hurry (for angin_f1, angin_c2, angin_f3, angin_c6, angin_s6 and angin_c8) and had not previously reported or got diagnosed with angina . In s0 and s2, people who never walk uphill or hurry could receive a positive angina diagnosis but only if they can walk on the level.  

Extra points

1. Angina was not graded by severity using the answer to Q45 as in Rose (1962). This was because angina could not be graded   for people who skipped Q42-Q49 because they had previously been diagnosed with angina by a doctor (i.e. answered yes to Q41).

2. Whilst Q43 appears in Rose (1962) and also Rose et al. (1968), it does not appear in Rose et al. (1982) where the questionnaire is 'reproduced', and nor does it appear in the self-administered version of the questionnaire (Rose et al. 1977). 62 people in s0 and 25 in s2, who according to Rose (1962) had angina, answered no to Q42 but yes to Q43. These people would not have angina according Rose et al. (1982) or Rose et al. (1977). According to Rose et al. (1968) these may be categorised as having 'doubtful angina'. [The self-administered questionnaire is slightly different in other ways:- you cannot answer "never hurries/walks uphill" to Q44. You presumably answer "no" instead and get a diagnosis of no angina. Also, there is no recoding of "continue at same pace" to Q46 if on nitroglycerine.]  

References

Rose GA 1962 The Diagnosis of Ischaemic Heart Pain and Intermittent Claudication in Field Surveys. Bulletin of the World Health Organisation. 27 645-658.

Rose G, Blackburn H, Gillum RF, Prineas RJ 1982 Cardiovascular Survey Methods. Monograph Series, No.56 2^nd edition Geneva: WHO

Rose G, McCartney P, Reid DD 1977 Self-administration of a questionnaire on chest pain and intermittent claudication. British Journal of Preventive and Social Medicine. 31 42-48

Rose GA, Blackburn H, 1968 Cardiovascular Survey Methods. Monograph Series, No.56 Geneva: WHO

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Intermittent Claudication ( equivalently Peripheral Vascular Disease) 

In CFAS (5 centres), the questions related to intermittent claudication across all interviews up to year 8 were:

Prevalence screen (s0)

Q51                  Have you ever suffered from intermittent claudication?

Q52                  Do you get pain in either leg on walking?

Q53                  Does this pain ever begin when you are standing still or sitting?

Q54                  In what part of your leg do you feel it?

Q55                  Do you get it if you walk uphill or hurry?

Q56                  Do you get it if you walk at an ordinary pace on the level?

Q57                  Does the pain ever disappear while you are walking?

Q58                  What do you do if you get it when you are walking?

Q59                  What happens to it if you stand still?

Q60                  How soon?

Incidence screen (s2)

Q51                  Have you ever been diagnosed as having intermittent claudication? (If yes, was that in the last two years?)

Q52                  Have you, in the last two years, had pain in either leg on walking?

Q53 - Q60       same as in prevalence screen.

First and Second annual follow ups (f1, f3), Combined screen and assessment at year 2, year 6 and year 8 (c2, c6, s6, c8)

Q259                Since we last saw you have you been diagnosed as suffering from intermittent claudication?

Q260                Have you had pain in either calf on walking uphill or hurrying that only goes away with rest?

Can answer: Yes, No, chair/bedfast or never walks uphill/hurries.

All informant interviews (h0, h2, ch2, h6, h8)

Q187                Has there ever been pain or discomfort in the legs on walking that goes away with rest? Answers: no, probable intermittent claudication, or certain intermittent claudication.

The coding up and interpretation of the combined intermittent claudication (IC) variables

Rose (1962) produced a questionnaire from which a diagnosis of intermittent claudication can be made. The questions relevant for diagnosing IC were questions that featured in CFAS interviews: s0 and s2. For the people in these interviews who had not previously been diagnosed with IC by a doctor, the criteria of Rose (1962) were used to diagnose IC or no IC. Only when neither a positive diagnosis could be made (not all questions were answered) nor a negative diagnosis (not answering any question in such a way as to rule out IC) was a missing value assigned. The combined IC variables that have been coded up can be interpreted as:-

Has intermittent claudication been reported or diagnosed for the first time in a CFAS interview?

If an individual has reported or been diagnosed with IC at one interview, then in all subsequent interviews they, by definition, do not report or get diagnosed for the first time in a CFAS interview. The variable definitions in full are:

intcl_s0:   'ever had IC according to Rose (1962) or diagnosed by doctor'

intcl_s2:   'first report of having previously been diagnosed with IC, or had IC according to Rose (1962), where did not report or get diagnosed with IC at screen (i.e. intcl_s0¹ 1)'

intcl_f1, intcl_c2, intcl_f3, intcl_c6, intcl_s6, intcl_c8:   ' since last seen, had IC (roughly according to Rose (1962)) or reported having previously been diagnosed, where in all previous interviews did not report or get diagnosed with IC (i.e. intcl_s0¹ 1 ,.etc.)'

Missing values

Some people have missing values in the table above because they did not answer some questions or were not asked, and had not previously reported or got diagnosed with IC.

Some people have missing IC diagnoses (for intcl_f1, intcl_c2, intcl_f3, intcl_c6, intcl_s6 and intcl_c8) because they never walk uphill or hurry or were chair/bedfast, and had not previously reported or got diagnosed with IC. In s0 and s2, people who never walk uphill or hurry could receive a positive IC diagnosis but only if they can walk on the level.

People who were chair/bedfast (intcl_??=9) could not be diagnosed by Rose (1962) and these people, if they had not reported having previously been diagnosed with IC, were separated from the missing category (intcl_??=-1).

Extra points

1. Intermittent claudication was not graded by severity (using the answer to Q56) as in Rose (1962). This was because intermittent claudication could not be graded for people who skipped Q52-Q60 because they had previously been diagnosed with intermittent claudication by a doctor (i.e. answered yes to Q51).

2. In the self-administered version of the Rose questionnaire (Rose et al. 1977) you cannot answer "never hurries/walks uphill" to Q55. You presumably answer "no" instead and get a diagnosis of no intermittent claudication. This is the only difference between the interviewer administered and the self-administered version of the questionnaire. 

References

Rose GA 1962 The Diagnosis of Ischaemic Heart Pain and Intermittent Claudication in Field Surveys. Bulletin of the World Health Organisation. 27 645-658.

Rose G, McCartney P, Reid DD 1977 Self-administration of a questionnaire on chest pain and intermittent claudication. British Journal of Preventive and Social Medicine. 31 42-48  

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EMSE (Extended Mental State Exam)

At the 2 screening interviews, subjects were asked a range of questions relating to cognitive function.   These include the Mini-Mental State Exam (MMSE) (Folstein et al., 1975) which has a maximum score of 30, and a selection of additional questions from the MRC Alzheimer's Disease Workshop (1987), also with an additional maximum score of 30.   The additional items combined with the MMSE comprise the Extended Mental State Exam (EMSE).

Questions that may have been missed due to sensory or motor impairment were recoded to 0 (i.e. treated as not able to answer the question correctly).   Such questions include those involving writing or drawing, or those involving picture or object recognition.   Furthermore, in the MRC additional items, subjects are asked to recall an address that they have previously been asked to write.   If the subject was physically unable to write the address, it should have been repeated twice by the interviewer and then the subject would be asked to recall the address.   However, as evidenced by the large number of missing values for these items, it is suspected that some interviewers may have skipped eliciting this recall because of the subject's physical limitations.   Therefore, the recall of the written address was categorized as a physical item and missing values were recoded to 0.   For those questions that were not physical, missing items were left coded as missing. A small number of people were just missing 1 or 2 items and these have been recoded to 0 so that they may have a EMSE score.

The items making up the EMSE were the MMSE questions plus:

Q168    Naming - keys

Q169    Naming - envelope

Q170    Number of animals named (Score 0 if name 0, 1 if name 1-9, 2 if name 10-14, 3 if name 15-19, 4 if name 20-24, 5 if name 25+)

Q172a Recent recall - pencil

Q172b Recent recall - wristwatch

Q172c Recent recall - keys

Q172d Recent recall - envelope

Q173 Prime Minister

Q174    US President

Q175    Union Jack colours

Q176    Neville Chamberlain

Q177    Guy Burgess

Q185    Write address (Score 2 if correct, 1 if poor but acceptable)

Q189    Similar - fruit (Score 2 if abstract response, 1 if a concrete response)

Q190    Similar - transport (Score 2 if abstract response, 1 if a concrete response,)

Q191a Recall - first name

Q191b Recall - surname

Q191c Recall - no. of street

Q191d Recall - street

Q191e Recall - county

Q192a Picture recognition - shoe

Q192b Picture recognition - glasses

Q192c Picture recognition - pipe

References

Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician.J Psychiatr Res. 1975 Nov; 12(3): 189-98.

Report from the MRC Alzheimer's Disease Workshop (1987), Medical Research Council

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The Cambridge Cognitive Examination (CAMCOG) and subscales (Roth, 1988)

CAMCOG and its subscales has been coded up at prevalence and incidence assessments (ccog_a0, ccog_a2), annual follow ups 1 and 2 (ccog_f1, ccog_f3), combined screen and assessments at years 2, 6, 8 and 10 (ccog_c2, ccog_c6 and ccog_s6, ccog_c8, ccog_cx). It has not been possible to do this at the prevalence and incidence screen interviews (s0, s2) because the questions were not asked then.

Key: * Items in MMSE also                .physical items

Three items were not asked from the standard CAMCOG interview (Roth, 1988). The omitted items were the tactile recognition of coins (which is omitted in the revised CAMCOG-R (Roth, 1998)) and calculating their sum (omitted because UK coins had just changed), and recognition of two people in the room. These items counted for 4 points and hence the maximum score that could be achieved was 103, rather than 107. The subscales are defined as in CAMCOG-R (Roth, 1998) except the attention/ calculation and the perception subscales which are worth one point less due to an item missing.

Questions that may have been missed due to sensory or motor impairment (the 'physical items' identified above by a dot before the description) were recoded to 0 (i.e. treated as not able to answer question).

Some questions (i.e. nod, hotel, hammer, chemist, teeth, wave) were skipped in the combined screen and assessments. These were recoded to correct if previous questions were answered correctly for all interviews.

When just one item was missing, 0 was imputed so that the whole scale would not be missing. The various subscales were calculated before this final stage.

Number of people with complete CAMCOG score by interview

See Williams et al. (2003) for psychometric properties and normative values based on a first attempt at coding ccog_a0 and its subscales.

References

Williams JG, Huppert FA, Matthews FE, Nickson J, MRC CFAS (2003) Psychometric properties and normative values on a concise neuropsychological test (CAMCOG) from an elderly population sample. Int J Ger Psychiatry,18(7):631-44

Roth M, Huppert FA, Tym E, Mountjoy CQ (1988) CAMDEX The Cambridge examination for mental disorders of the elderly. Cambridge University Press

Roth M, Huppert FA, Mountjoy CQ, Tym E  (1998) CAMDEX The Cambridge examination for mental disorders of the elderly - revised. Cambridge University Press

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ADL-IADL disability/ IADL disability/ No ADL or IADL disability

Our classification splits people into one of four groups. The first is those who have ADL-IADL disability and is based on activities of daily living(ADL) and instrumental activities of daily living (IADL). This group require help at least several times per week. The second is those who have IADL disability and are not in the first group, and this is based on two IADLs. This group require help regularly. The third group is those that have no ADL or IADL disability, and the fourth group is those who were unclassifiable due to their pattern of missing data.

ADL-IADL disability requiring help at least several times per week (disab = 2)

Questions which determine ADL-IADL disability in screen/combined screen and assessment interviews are:

Q122/Q299     Are you able to wash all over or bath?    

Q127/Q304     Are you able to prepare and cook a hot meal?     [This is an IADL]

Q130/Q307     Are you able to put on your shoes and socks or stockings?

   Answers:

0.    (No), needs help

1.    (Yes), some difficulty   *(Use of special aids: Code 1)*

2.    (Yes), no difficulty

Q149/Q313     Mobility of subject

1.    Usually ambulant nonhousebound

2.    Usually ambulant housebound

3.    Chairfast permanently

4.    Bedfast permanently

A person has ADL-IADL disability if they need help with washing or hot meals or shoes and socks (any of first three questions answered 0) or if they cannot get around outside (last question 2, 3 or 4).

It is inferred that if a person answered the first few questions showing they were unfocussed in time (at Q10/Q15c), they have ADL-IADL disability. These people were asked a select subset of questions (i.e. went into priority mode) which did not include the above questions. 10% of those at prevalence screen that had ADL-IADL disability were classified on this basis.

If a person did not need help with washing or hot meals or shoes and socks (i.e. all of first three questions answered 1 or 2) and they could get around outside (i.e. last question rated 1) then they were divided into IADL disability or no ADL or IADL disability.

IADL disability (disab = 1)

A person has IADL disability if they need help with heavy housework or shopping and carrying heavy bags.

Q125/Q302     Are you able to do the heavy housework?

Q126/Q303     Are you able to shop and carry heavy bags?

No ADL or IADL disability (disab = 0)

A person has no ADL or IADL disability if they do not need help with washing, hot meals, shoes and socks, heavy housework or shopping and carrying heavy bags, and they can get around outside. If a person did not need help with the two IADLs* and had some missing data on the ADLs then they were coded as having no ADL or IADL disability (by the hierarchical nature of ADL and IADL). Also a person could be recoded to no ADL or IADL disability if they had one IADL missing and ADL disability had been ruled out. These ways of dealing with missing data affected a very small number of people.

*For this paragraph preparing a hot meal is treated as an ADL

Unclassifiable (disab = -1)

This only affects people who did not answer all of the questions above. This includes a lot of cognitively frail people who went into priority mode but not immediately after the first few questions.

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Modified Townsend Disability Scale

It consists of 9 activities: cutting own toenails, washing all over or bath, getting on a bus (replacing running to catch a bus in Townsend (1979)), going up and down stairs, heavy housework, shopping and carrying heavy bags, preparing and cooking a hot meal, reaching an overhead shelf and tying a good knot in string (Bond, 1982).

For each activity a person was assigned a score of 2 if they needed help; 1 if they had some difficulty or used aids in order to do it; and 0 if they had no difficulty and without the use of aids.

The scores(town_?#) from these activities are added up to form a score from 0-18 where 0 is no functional incapacity and 18 is very severe functional incapacity.

The relevant questions are Q121-9 in screen and Q298-306 in the combined screen and assessment interviews. At assessment interviews, these questions were not all asked.

Getting on a bus, and to a lesser extent, going up and down stairs were quite often missing, and so a score of 2 was imputed if a person's mobility as assessed by the interviewer (Q149/Q313) was poor. If these activities were still missing then if not asked, a score of 2 was given, and if no answer or the interviewee didn't know, a score of 1 was given.

A person had an unclassifiable score(town_?# = -1) if they were missing an answer to any questions other than getting on a bus and going up and down stairs. This mostly happened to people who went into priority mode due to being disorientated in time and space.

This scale of functional incapacity has also been dichotomized (towng_?#) where a score of 1 is given if the scale was 11-18, and 0 if the scale was 0-10. If someone did not have a modified Townsend Disability score, but they were likely (or certainly) going to fall one side of 10/11, they were coded.

Percentage of people with town_?# and towng_?# scores at each interview.

References

Bond J, Carstairs V. (1982) Services for the Elderly. Scottish Health Service Studies No 42.

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Dementia Scale of Blessed (1968)

As has been done by other researchers(e.g. Roth, 1998), the section on personality, interests and drive has been discarded and a score from 0-17 has been produced. The score has been composed for individuals where an informant was interviewed i.e. at prevalence assessment (bless_h0), incidence assessment (bless_h2), and at combined screen and assessments at years 2 (bless_ch2), 6 (bless_h6), 8 (bless_h8) and 10 (bless_hx). The items of the scale, their corresponding questions, ways of dealing with missingness, and maximum points are given below.

The comment 'go to other interviews' means go to the same question(s) on earlier or later informant interviews. Earlier interviews are used if they were unable to perform the task. Later interviews are used if they were able to perform the task.

1. Inability to perform household tasks 1

Q41 Does s/he have difficulty performing common household tasks, for example, can s/he make a cup of tea? (Recode 9 ('due to disability') to 0 ('no difficulty'))

If missing:

Q16d (new after h0) Is s/he less able to take care of her/himself without help?

If still missing: go to other interviews.

2. Inability to cope with small sums of money 1

Q42 Does s/he have difficulty managing small amounts of money?

If missing:

Go to other interviews

If still missing: assume can't use money if Q42 not asked, and recode to 0

3. Inability to remember short list of items, e.g. in shopping 1

Q17 Can s/he remember short lists of items when shopping? (For example if s/he went to buy 3 things would s/he remember them or be able to tell someone else what s/he needs?)

If missing:

Go to other interviews.

If still missing: Q15 Has s/he had any difficulty with her/his memory? (If yes: Have you noticed any change over the last year or two?)

4. Inability to find way about indoors 1

Q27 Does s/he have difficulty finding the way around the home (or ward), or finding the toilet?

If missing:

Go to other interviews.

If still missing: and few or no problems with Q28(see below), assume fine on this question.

5. Inability to find way about familiar streets 1

Q28 Has s/he had difficulty finding the way around the neighbourhood, for example, to the shops or post office near home? (If yes: Has there been any change in the last year or two?)

If missing:

Q20 Has s/he had difficulty finding her/his direction or has lost the way when you have been out together or s/he has been out alone? Have you noticed any change over the last year or two?

If still missing, and few or many problems with Q27(see above), assume difficulty with this question. If still missing go to other interviews.

6. Inability to interpret surroundings 1

Q26 Does s/he have difficulty in telling the difference between people such as visitors, relatives and doctors?

If missing:

Q26a (new after h0) Does s/he ever mistake you (or (other) family members or friends) for someone else?

If still missing go to other interviews.

7. Inability to recall recent events 1

Q19 Is there difficulty remembering what happened yesterday?

If missing:

Go to other interviews.

If still missing Q25 Does s/he have difficulty remembering when s/he last saw you?

8. Tendency to dwell in the past 1

Q23 Does s/he tend to talk about what happened long ago rather than in the present?

If missing:

Go to other interviews.

9. Eating 3

Q44 Does s/he have difficulty feeding her/himself?

If missing:

Go to other interviews.

10. Dressing 3

Q43 Does s/he have difficulty dressing? In what way? (Is help needed?) (Recode 9 ('due to disability') to 0 ('no difficulty'))

If missing:

Go to other interviews.

11. Complete sphincter control 3

Q45 Does s/he ever wet or soil her/himself by mistake? (How often?)

If missing:

Go to other interviews.

Questions from items 4, 5, 9 and 11 featured in skip sections, and hence persons not entering the skip section have no difficulties.

Many people did not have an answer to Item 5 (Inability to find way about familiar streets). It was fairly common for people to have up to 2 answers missing for the first 8 items (often items 4 and 5). As none of these questions dominate the scale, 0 was imputed for up to 2 of these questions, and a score given.

There is a bias in that cognitively frail people were more likely to have HAS interviews than cognitively intact people.

References

Blessed G, Tomlinson B and Roth M. The association between quantitative measures of dementia and senile change in the cerebral grey matter of elderly subjects. Brit. J. Psychiat. (1968), 114, 797-811.

Roth M, Huppert FA, Mountjoy CQ, Tym E  (1998) CAMDEX The Cambridge examination for mental disorders of the elderly - revised. Cambridge University Press

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Hachinski Ischaemic Score (HIS)

The HIS (Hachinski et al. 1975) has been coded up on all those who we classified as demented and for whom we had informant interviews. The notes of Wade et al. 1987 were particularly helpful. The HIS is coded up at prevalence assessment (h0), incidence assessment (h2), combined screen and assessments [CSA] at years 2 (ch2), 6 (h6), 8 (h8),     and 10 (hx). The questions and points for each component are given below. All questions are from informant (HAS) interviews unless stated otherwise. Answers to questions are given in brackets like this (first answer that would score positively/second answer that would score positively..: first answer that would score negatively/second answer that would score negatively.). With the exception of components D (Nocturnal confusion) and E (Relative preservation of personality), just one piece of evidence was enough to get the whole component positively scored. For D both questions had to be answered Yes. For E, one piece of  evidence in favour of a change in personality was enough to score it negatively. Components were missing if there was no evidence in favour or against the component. When appropriate, answers from backup questions were used to reduce the number of missing components and missing HIS scores. With the exception of component A (abrupt onset), this affected very few individuals and so these questions are not mentioned.

A. Abrupt onset  2

Q79 Did (the problems/symptoms/illness) happen suddenly, in a matter of hours or over   days, or did it happen slowly over weeks or months?(>=0.5 mths: <0.5 mths)

Backup questions - any evidence from:

Q31 Did these problems with memory begin rapidly or gradually? (Rapid onset 1-3 days probable/certain /Rapid onset 4-21 days probable/certain: Gradual onset probable/certain)

Q36 Have these difficulties with thinking and making decisions developed in a gradual manner or have they come on suddenly? (Sudden:Gradual)

Q47 Have these (aphasia/apraxia) difficulties developed gradually or did they come on suddenly? (Sudden:Gradual)

B. Stepwise deterioration  1

Q37 Have these difficulties (with thinking and making decisions) developed in steps and stages? (Yes:No)

C. Fluctuating course  2

Q57 Are there periods lasting days or weeks when his/her thinking seems quite clear and then muddled? (Yes:No)

Q81 Has the (present illness) tended to vary a lot, day to day, week to week, becoming worse and then perhaps improving for a while - up and down? (If yes, how much did it vary? How long did these periods last?)

(Mild/Moderate or marked fluctuation:No fluctuations)

D. Nocturnal confusion  1

Q59 Are there long periods during the day when s/he is lucid and not confused (that is, knows where s/he is and knows what s/he is doing and saying)? (Yes:No)  AND

Q60 Does s/he get confused at night, wander about or talk nonsense? (Yes:No)

E. Relative preservation of personality  1 (includes preservation of insight)

Q48 Have you noticed any changes in his/her personality such as the way s/he behaves socially (with other people)? (No:Yes)

Q52 How does s/he treat you (his/her relatives, friends) now. Is there a tendency to show a lack of interest, concern or affection? (No:Mild/Severe)

Q302(Assessment)[Q364 CSA] Observer:  Lack of insight into present disability (No:Yes)

F. Depression  1

dep_??[Assessment/CSA] from the AGECAT algorithm (dp3/dp4/dp5/dn3/dn4/dn5:d0/d1/d2)

Q63 Has there been any indication that s/he may be depressed, for example, is there a loss of interest or enjoyment in things in general? (Yes:No)

Q68 Do you think s/he is depressed? (Yes:No)

G. Somatic complaints  1 

Q276(Assessment)[Q334 CSA] Observer: Gait normal, just unsteady (Mild/Severe:Absent)

Q94(Screen) [Q290 CSA] Do you suffer from regular headaches? (Yes, non-specific:No/Yes, migraine)

Q74(Assessment)[Q104 CSA] Do you often feel dizzy? (More than once per week:No or rarely)

Q203 Does s/he have a tendency to fall? (Yes:No)

H. Emotional incontinence  1

Q202 If something happens to make subject laugh or feel sad or cry, is it sometimes difficult to control? (Fairly certain/Unsure but probably:No)

I. History of hypertension 1

Q194 & Q195 Has s/he ever had high blood pressure? How was it treated? (Hypertension probable/Certain and Medication Probable/Certain: No/ Yes but not treated)

J. History of strokes  2

Q201 Has there ever been a stroke or a time when part of the body became paralysed? (If YES when was that? Did it happen suddenly? (Probably/Certainly after age 40:No history of stroke or sudden paralysis)

K. Evidence of associated atherosclerosis  1

Q192 Has a heart attack ever been diagnosed by a doctor when several weeks rest was advised? (Probable/Certain:No)

Q187 Has there ever been pain or discomfort in the legs on walking that goes away with rest? (Intermittent Claudication Probable/Certain:No)

Q193 Has there ever been pain or discomfort in the chest that goes away with rest? (Angina pectoris Probable/Certain:No)

angin_?? / intcl_?? at all interviews up to and including current interview. First reported having angina/intermittent claudication respectively according to Rose(1962) or diagnosed by doctor? (Yes:No)

L. Focal neurological symptoms  2

Q197 Has s/he ever had sudden blindness in one eye? (Probable/Certain:No)

Q198 Has s/he ever had weakness or difficulty with speech, memory or vision which got better after a day? (Yes:No)

Q199 Has there been a weakness in one arm or one leg, or an arm and a leg on the same side of the body? (Probably lasted <24hrs/Certainly lasted <24 hrs/ Probably lasted 24+hrs/Certainly lasted 24+hrs:No)

Q288(Assessment)[Q348 CSA] Observer: Dysarthria due to brain damage (Yes:No)

M. Focal neurological signs  2

Q274(Assessment)[Q332 CSA] Observer: Obvious evidence of paralysis or stroke (mild/severe:no)

Q78(Assessment)[Q107 CSA] Observer: One or more limbs appear to be wholly or partially paralysed, or one side of the face (yes left sided/yes right sided/other:no)

The score has also been grouped (hisg_??) such that

1= score 0-4

2= score 5-6

3= score 7-18

There are fewer missing here because often the scores of people, who had just a few missing components, would fall into one group irrespective of the missing values had they been observed.

Table of HIS scores

References

Hachinski VC, Ibiff LD, Zilhka E, et al. 1975 Cerebral blood flow in dementia. Arch Neurol 32:632-7

Wade JPH, Hachinski VC. 1987 Multi-infarct dementia. In: Pitt B, ed. Dementia (Medicine in Old Age). London: Churchill Livingstone, 209-228

Rose GA 1962 The Diagnosis of Ischaemic Heart Pain and Intermittent Claudication in Field Surveys. Bulletin of the World Health Organisation. 27 645-658.

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Social Class/Employment

Occupations were coded according to the Registrar General's occupation-based social class divisions using Computer Assisted Standard Occupational Classification software ( HMSO Publications Centre, London) . For social class based on occupation (class90) women were categorized based on their partner's occupation unless they were divorced or single, in which case they were assigned a social class based on their own occupation. Social class I denotes professionals, II managerial and technical workers, III Non-Manual (IIINM) non-manual skilled workers, III Manual (IIIM) manual skilled workers, IV partly skilled workers, and V unskilled manual workers. These are coded 00, 10, 20, 31, 32, 40, 50 respectively with 60 for armed forces and 00 for missing.

We also have socio-economic group (seg90), standard occupational classification (soc) and employment status (estatus) which ranges from 1-7 with 0 meaning missing.

All were calculated using baseline data.

References

Office of Population Censuses and Surveys (1990) Standard Occupational Classification Volumes 1 and 2. London: HMSO.

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Townsend Deprivation Index

The Townsend deprivation score is a measure of area-based socio-economic status. It does not include a component that overlaps with the individual indicators of socio-economic status. It is a composite measure that takes into account the proportion of unemployed, yet economically active, individuals aged 16-59/64, the proportion of households who do not possess a car, the proportion of households with more than one person per room, and the proportion of households that are not owner-occupied. The higher the score, the more deprived the area. Complete postcodes from 1991 for most participants were determined from either the initial interview or by entering the address into the Royal Mail Postcode Finder website (www.royalmail.co.uk).

Postcodes were mapped to the appropriate enumeration district, which is the smallest geographic division in the UK, containing about 200 households and 400 individuals, using the Manchester Information & Associated Services (MIMAS) website (http://convert.mimas.ac.uk/matchgoes.cfm) conversion feature. There were 1,746 enumeration districts represented in this data set with, at most, 60 individuals from the same enumeration district. Based on the 1991 census data, a Townsend deprivation score has been calculated for each enumeration district. Once the enumeration district for each individual was identified, the corresponding score was then identified using the MIMAS conversion feature.

Source of postcode (postcdfr) is coded: S0_0 Prevalence screen (if we still had their postcode); S0_1 Admin database of 1996 - for those not moved after 2 years; S0_2 Admin database of 1996 - for those who refused or died by wave 2; SC_0 Admin database of 1996 - for those that moved after 2 years - so this won't be their original postcodes; SC_1 Admin database of 1996 - for those where we don't have enough information on if they moved after 2 years.

References

Townsend, P., Phillimore, P.,  Beattie, A. ( 1988) . Health and deprivation: inequality and the North. London, Croom Helm 

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Education, Accommodation and Marital status at baseline with edits incorporated

educ_s0 is v16_s0 unless ed16_s0 had a value

accom_s0 is v12_s0 unless ed12_s0 had a value

marst_s0 is v11_s0 unless ed11_s0 had a value

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Other datasets managed by CFAS

RIS 1992/4 

- follow this link

ESRC Healthy Aging Project 1992/3

This study aimed to examine the relationship between sociological, psychological and biological variables in a representative sample of the normal elderly population. This was a collaborative project between Cambridge and Nottingham. It was funded by ESRC for a period of three years. Those interviewed at baseline, but not invited for assessment or the RIS, whose AGECAT score was less than 03, MMSE 18-30, and had no evidence of problems with communication, either from a physical cause or from a poor grasp of English, were approached and 2041 were interviewed a short time after baseline. Bloods were taken on half.

Young cohort 1996

A new cohort aged 65-69 in 1996 in the Cambridgeshire centre were given a screen interview (n=...).

Twice screened group combined screen and assessment interview at year 6 (s6) 1997

At wave 3, all those in the Cambridgeshire centre that had not previously refused or died were approached for interview. 719 of those that had taken part in two previous screen interviews but never any assessment interviews were interviewed. This interview is labelled s6, but it was not another screen interview as the label might suggest but a combined screen and assessment interview.

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Weights

Design sampling fractions (and modifications) - what fraction of people from the prevalence and incidence screen interviews were to be selected for assessment at that wave

* All individuals in this group who were not selected for assessment at wave 1 were selected for assessment at wave 2.

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