Thank you for agreeing to be interviewed

PREVALENCE SCREEN

Thank you for agreeing to be interviewed. As we explained in our letter, we are collecting information on the changes that occur as people get older. Many of the questions I would like to ask concern your general health and your day-to day activities. Any information you provide will be treated in the strictest confidence.	Q1-Q10: ORIENTATION SECTION The aim of this section is to establish the presence of cognitive impairment which will lead to errors in the reply to factual questions. They concern simple facts about the subject and their orientation. There should be no difficulty in rating the questions in this section. Do not explore inconsistencies (except age and birth date) but simply rate from the subject's reply.
Q1 First I would like you to remember my name. My name is …………. Can you repeat that? 0. Unable to repeat 1. Correctly repeated 2.	Q1 Give only one name, either the first of the last, choosing the shortest and easiest to pronounce. Reiterate up to three times as necessary. Do not exceed three repetitions.
Now I'd like to check that my information about you is correct. PROMPT ONLY AS INSTRUCTED EXCESSIVE REPETITION IS NOT RECOMMENDED Q2 What is your full name? 0. Incorrect 1. Correct	.
IF THE SUBJECT IS LIVING IN AN INSTITUTION ASK Q3, IF NOT SKIP TO Q4. PROBE FOR FULL ADDRESS	Q2a A subsidiary question is entered here, on the machine only, to direct the skips. Answer whether or not the subject is living in an institution. Residential homes, nursing homes and long stay hospitals count as institutions; a day hospital does not.
Q3 What is the name of this place? Where is it located. 1. Correct 2. Error in name 3. Error in address 4. Error in name and address 7. Don't know 8. No answer 9. Not asked	Q3 Rate 1-Correct, if subject gives only a partial name. Rate 3-Error in address, if subject only gives locality.
Q4 What is the name of this city/town/village? 0. Incorrect 1. Correct 7. Don't know 8. No answer 9. Not asked	Q4 A localising answer is required here. If the subject lives in a remote area, the name of the nearest farm would be considered correct. The answer to this question will be scored either as part of Q3 or Q5
ONLY ASK THIS QUESTION IF THE SUBJECT IS LIVING IN THEIR OWN HOME. OTHERWISE SKIP TO Q6. PROBE FOR FULL ADDRESS
Q5 What is the full address of this place? 0. Incorrect or incomplete 1. Correct 7. Don't know 8. No answer 9. Not asked	Q5 The full address is required. Probe for full address including city, suburb or postal district but not post code. If in a day hospital ask "What is the postal address of your home?"
Q6 How old are you? 0. Not as listed 1. As listed 7. Don't know 8. No answer 9. Not asked IF RATING 0, RECORD AGE GIVEN BY SUBJECT.	Q6 The information provided by the FHSA may not be correct. If the answer provided by the subject is not consistent with your information, record the age given by the subject.
Q7 What is your date of birth? 1 As listed 2. Not as listed, probably correct 3. Not as listed, probably incorrect 7. Don't know 8. No Answer 9. Not asked. IF RATING 2 OR 3, RECORD DATE OF BIRTH GIVEN BY SUBJECT. IF DATE OF BIRTH AND AGE ARE INCONSISTENT BY MORE THAN ONE YEAR ASK Q8, IF NOT SKIP TO Q9.	Q7 Again the information provided by the FHSA may not be correct. If the answer provided by the subject is not consistent with your information, but consistent with the subject's previous answer, (and realistic) rate 2. If the subject's answers to Q6 and Q7 are inconsistent, rate 3. If you have rated either 2 or 3, record the date of birth given by the subject.
Q8 That doesn't seem to come out right when I add it up. Can you help me? 0. Discrepancy not corrected 1. Discrepancy corrected 2. Marked uncertainty about age 8. No answer 9. Not asked	Q8 Answers 0 and 2 need not be mutually exclusive. If both are appropriate select answer 2.
Q9 Have you ever seen me before? 1. Correct, No or Yes 2. Incorrect, No 3. Incorrect, Yes 8. No Answer 9. Not asked.	Q9 In this question you are looking for evidence of pathology. Rate 1- Correct, either if the subject has or has not seen you before, or if they claim they don not know. Ratings 2 and 3 are manifestations of pathology. If the subject claims they have not seen you before and you know they have, probe with "Could you try to remember?" If they incorrectly believe they have seen you before continue to Q10.
IF YES OR UNCERTAIN PROMPT FOR DETAILS
Q10 When? Where? What was I doing? What did we do? RATE PRESENCE OF CONFABULATION. 0. No confabulation 1. Confabulation	Q10 In this question you are looking for evidence of confabulation. This means the subject can be led to give an elaborate description of events which clearly could not have occured (not delusional i.e. a whole frame work or mind set, nor misidentification). If the subject has given incorrect answers for 3 or more of the previous questions (Q1-Q9) the machine will automatically skip to Q108-Q116, and thence to Q159. If using a paper schedule, make the calculation and then skip these sections if necessary.
Now I'd like to ask you some questions about your background. Q11 Are you married, single, widowed or divorced? (If NO are you separated or do you have a partner?) 1 Married 2. Cohabiting 3. Single 4. Widowed 5. Divorced/Separated	Q11 For multiple marriages code current status.
ITEM 12 Establish type of accommodation. 1. House/Flat/Granny flat 2. Warden Controlled flat 3. Council Residential home 4. Private Residential home 5. Private Nursing Home 6. Long stay hospital 7. Not established IF THE ANSWER TO Q12 IS 3,4,5 OR 6 SKIP TO Q15	ITEM 12 Bungalow - rate as house. Rate 3 for Part III Accommodation. If the respondent is in an Elderly Mentally Infirm Unit within an institution rate as for the institution.
Q13 Is this house/flat owned or rented? 1. Owned 2. Council rented 3. Private rented 8. No answer	Q13 In order to rate 1 it is necessary that no rent is paid on the property. It may be owned by the subject, a member of the household in which the subject lives or a member of the subject’s family who does not live in the property. Housing association property is classed as council rented.
Q14 Does anyone else live here? No Yes Spouse/Partner No/Yes Parents nn Siblings nn Children nn Grandchildren nn Other relatives nn Friends nn Others nn	Q14 If the subject does not live on their own record the relationship of anyone they live with (eg. Parents including in laws, children, including in laws, housekeeper, friend etc.). Only include individuals who are permanent members of the household. If the subject lives in a granny flat this counts as a complete household if it is self-contained. NB. Part-time members of the household are included if their membership is permanent (eg. The child who stays during the week but is away every weekend).
Q15 How long have you lived in (the area)? Answer in years nn 777 Don’t know	Q15 This questionis included to elicit information on migration. Rate the number of years the subject has lived within the locality. Rate for latest period only if the subject has returned to the area. Rate 1 year for 1 year or less.
Q15i What was your previous address? Textual Answer	Q15i Answer of the form Village, Town, County.
Q15ii How long did you live there? Nn years 777 Don’t know	Q15ii Answer to the nearest year
Q15a Where were you born Textual answer	Q15a Answer of the form – Town, Country, eg. Liverpool, England. If the answer has already been given in Q15 do not ask again.
Q15aa Were either of your parents born in Gwynedd? 0. No 1. Yes, one or both 2. Don’t know 3. No answer 4. Not asked	If any doubt about change of County boundaries, write on contact sheet for coding later.
Q15b What ethnic group do you consider you belong to? Are you…(supply likely options)	Q15b Rate this answer by observation if it is obvious. Otherwise ask the question.
Q15cc Do you speak Welsh? (If YES how fluent would you say you are?) 0. Not Welsh speaking 1. Speaks a little 2. Fairly fluent 3. Fully fluent 4. No answer 8. Not asked	Don’t ask if opted to do interview in Welsh and rate fully fluent.
Q16 How many years did you spend in full-time education? Answer in years nn 77 Don’t know	Q16 Most people will have had either 8 or 9 years at school, with a starting age of 5 or 6 and a leaving age of 13 or 14. Include years in full-time higher education.
Q17 Have you retired? 0. No 1. Yes 2. Never worked	Q17 The information required here is whether the subject has retired from their major paid employment. Count as retired someone who has retired from full-time but taken on part-time work.
IF NO SKIP TO Q19. IF NEVER WORKED SKIP TO Q24.
Q18 At what age did you retire? Answer in years nn 777 Don’t know
Q19 What has been your main occupation for most of your working life? Textual answer	Q19 Complete for the occupation that was held for the longest period, even if it is not the most recent. Give a detailed job title.
Q20 What type of work was/is this? Textual answer	Q20 Answer should include a description of the work and a description of the employer. This information is required to code both social class and socio-economic group and it is important that sufficient information is collected. For example: a carpenter in the building industry would be coded differently from a carpenter in a biscuit factory.
Q21 Were/are you self employed? 0. No 1. Yes
IF YES SKIP TO Q23
Q22 Were/are you a foreman, supervisor or manager? (If Yes, what did you do?) 0. No 1. Foreman/Supervisor 2. Manager
IF NO SKIP TO Q24
Q23 How many employees were/are you responsible for? 1. Less than 25 2. 25 or more
QUESTIONS 24-30 SHOULD ONLY BE ASKED OF MARRIED, DIVORCED, SEPARATED OR WIDOWED WOMEN
Q24 Is your husband retired? (Did your husband retire?) 0. No 1. Yes 2. Never worked 7. Don’t know	Q24 For multiple marriages code for current/last husband
Q25 At what age did your husband retire? Age in years nn 777 Don’t know 999 Not asked
Q26 What has been/was your husband’s main occupation for most of his working life? Textual answer	Q26 Complete for the occupation that was held for the longest period, even if it is not the most recent.
Q27 What type of work was/is this? Textual answer	Q27 Answer should include a description of the work plus a description of the employer.
Q28 Was/is he self employed? 0. No 1. Yes 7. Don’t know 9. Not asked
IF YES SKIP TO Q30
Q29 Was/is your husband a foreman, supervisor or manager? (If yes, what did he do?) 0. No 1. Foreman/Supervisor 2. Manager 7. Don’t know 9. Not asked
IF NO SKIP TO Q31
Q30 How many employees was/is he responsible for? 1. Less than 25 2. 25 or more 7. Don’t know 9. Not asked
This next set of question is about your social contacts and social activities	In this following section rate 1 – regularly for daily, weekly, monthly or predictably. Rate 2 – occasionally if unpredictable, or regularly less than monthly. For less than yearly, rate 0.
QN1 Do you attend religious meetings? 0. No 1. Yes, regularly 2. Yes, occasionally 8. No answer 9. Not asked
QN2 Do you attend meetings of any community or church or social groups, such as over 60’s clubs, evening classes or anything like that? 0. No 1. Yes, regularly 2. Yes, occasionally 8. No answer 9. Not asked
QN3 How far away does your nearest (in terms of distance) child or other relative live? 0. No relatives 1. Within 1 mile/same home 2. 1-5 miles 3. 6-15 miles 4. 16-50 miles 5. 60+ miles 8. No answer 9. Not asked
IF NO RELATIVES SKIP TO QN12
QN4 Do you have any children of your own? 0. No 1. Yes 7. Don’t know 8. No answer 9. Not asked	QN4 Rate as 1: Yes if stubject volunteers that they have ever had children. Include adopted children.
QN5 How many children? nn Number of living children 77 Don’t know 99 Not asked
QN6 Number of children not living (if volunteered) nn Number of dead children 77 Don’t know 99 Not asked
QN7 Where does your nearest (in terms of distance) child live? 1. Within 1 mile/same home 2. 1-5 miles 3. 6-15 miles 4. 16-50 miles 5. 60+ miles 8. No answer 9. Not asked
QN8 Do you have any living sisters or brothers? (If Yes, where does your nearest sister or brother live?) 0. No sisters or brothers 1. Within 1 mile/same home 2. 1-5 miles 3. 6-15 miles 4. 16-50 miles 5. 60+ miles 8. No answer 9. Not asked
QN9 How often do you see any of your (children or other) relatives to speak to? 0. Never 1. Daily 2. 2-3 times a week 3. At least weekly 4. At least monthly 5. Less often 8. No answer 9. Not asked	QN9 Here you must rate cumulative contact – if the subject sees a different relative every day rate as 1 – daily contact.
QN10 Of all your (children or other) relatives which one do you have the most contact with? A. Daughter B. Son C. Daughter-in-law D. Son-in-law E. Parent F. Sister/Brother G. Other female relative H. Other male relative X. Don’t know Z. Not asked	Qn10 If subject claims to see two people equally prompt to establish which one they have the most contact with. Step relative to be rates as ‘other male’ or ‘other famale relative’.
QN11 How often do you see her/him to talk to? 1. Daily 2. 2-3 times a week 3. At least weekly 4. At least monthly 5. Less often 8. No answer 9. Not asked	QN11 Rate face to face contact only not telephone calls.
QN12 Do you have friends in this community? (If Yes how often do you have a chat or do something with one of your friends?) 0. No friends/Never 1. Daily 2. 2-3 times a week 3. At least weekly 4. At least monthly 5. Less often 8. No answer 9. Not asked	Qn12 Rate ‘face to face’ rather than telephone calls.
IF SUBJECT IS IN A NURSING HOME OR LONG STAY HOSPITAL ETC SKIP TO Q39
QN13 How often do you see any of your neighbours to have a chat or do something with? 0. No neighbours/Never 1. Daily 2. 2-3 times a week 3. At least weekly 4. At least monthly 5. Less often 8. No answer 9. Not asked
Q39 In general, do you get out and about as much as you would like to? 0. No 1. Yes 8. Don’t know 9. Not asked
Now I’m going to ask you some questions about your general health
Q40 Would you say that for someone of your age, your own health in general is: 0. Excellent 1. Good 2. Fair 3. Poor 8. Don’t know 9. Not asked
Q41 Have you ever suffered with angina. 0. No 1. Yes 8. No answer 9. Not asked	Q41 Rate here if the subject has been diagnosed by a doctor as suffering with angina. If answer is No enter the skip section.
IF YES SKIP TO Q51
Q42 Have you ever had any pain or discomfort in the chest?	Q42-50 These 9 questions seek to elicit symptoms of angina from subjects who have not been diagnosed. Indications contrary to a diagnosis of angina cause a skip to the next section.
IF YES SKIP TO Q44
Q43 Have you ever had any pressure of heaviness in your chest? 0. No 1. Yes 8. No answer 9. Not asked
IF BOTH THIS AND THE PREVIOUS QUESTION WERE ANSWERED NO SKIP TO Q51
Q44 Do you get it when you walk uphill or hurry? 0. No 1. Yes 2. Never hurries or walks uphill 8. No answer 9. Not asked
IF NO SKIP TO Q51
Q45 Do you get it when you walk at an ordinary pace on the level? 0. No 1. Yes 2. Never walks 8. No answer 9. Not asked
IF 2 SKIP TO Q51
Q46 What do you do if you get it while you are walking? 1. Stop or slow down 2. Carry on 8. No answer 9. Not asked	Q46 Record stop or slow down if subject carries on after taking nitroglycerine.
Q47 If you stand still what happens to it? 0. Not relieved 1. Relieved 8. No answer 9. Not asked
Q48 How soon? 1. 10 minutes or less 2. More than 10 minutes 8. No answer 9. Not asked
IF MORE THAN 10 MINUTES SKIP TO Q51
Q49 Will you show me where it was? (PROMPT: Anywhere else?) a) Above/in the centre of the breast bone b) Under the breast bone c) Left front of the chest d) Left arm e) Other
Q50 Did you see a doctor because of this pain (discomfort?) 0. No 1. Yes 8. No answer 9. Not asked
Q51 Have you ever suffered from intermittent claudication? 0. No 1. Yes 8. No answer 9. Not asked	Q51 Rate here if a doctor has made a diagnosis for intermittent claudication. If subject’s answer is No, or they don’t know, go into the skip section
IF YES SKIP TO Q61
Q52 Do you get pain in either leg on walking? 0. No 1. Yes 2. Chair/Bedfast 8. No answer 9. Not asked	Q52-Q60 These 9 questions are designed to elicit information for a diagnosis of intermittent claudication in the absence of the subject’s knowledge. Contra indications to the diagnosis cause a skip to the next section.
IF NO OR CHAIR/BEDFAST SKIP TO Q61
Q53 Does this pain ever begin when you are standing still or sitting? 0. No 1. Yes 8. No answer 9. Not asked
IF YES SKIP TO Q61
Q54 In what part of your leg do you feel it? 0. Not in calf or calves 1. In calf or calves 8. No answer 9. Not asked
IF CALVES NOT MENTIONED, ASK: Anywhere else? IF NOT IN CALVES SKIP TO Q61
Q55 Do you get it if you walk uphill or hurry? 0. No 1. Yes 2. Never hurries or walks uphill 8. No answer 9. Not asked
IF NO SKIP TO Q61
Q56 Do you get it if you walk at an ordinary pace on the level? 0. No 1. Yes 2. Never walks 8. No answer 9. Not asked
IF YES SKIP TO Q61
Q58 What do you do if you get it when you are walking? 1. Stop or slow down 2. Carry on 8. No answer 9. Not asked
Q59 What happens to it if you stand still? 0. Not relieved 1. Relieved 8. No answer 9. Not asked
Q60 How soon? 1. 10 minutes or less 2. More than 10 minutes 8. No answer 9. Not asked
IF NOT RELIEVED SKIP TO Q61
Q61 Have you ever suffered from a heart attack? 0. No 1. Yes 8. No answer 9. Not asked
IF NO SKIP TO Q66
Q62 How many heart attacks have you had? Number of attacks nn 88 No answer 99 Not asked
Q63 Who diagnosed this/these heart attack(s)? 0. No doctor 1. GP 2. Specialist 8. No answer 9. Not asked	Q63 If diagnosed y more than one person rate for the most specialised, e.g. if diagnosed by both a GP and a Specialist, code as specialist. If seen at a hospital, rate as specialist.
Q64 How old were you when you had the (first) attack? Age in years nnn 777 Don’t know 888 No answer 999 Not asked
Q65 How old were you when you had the last attack? Age in years nnn 777 Don’t know 888 No answer 999 Not asked
Q66 Have you ever been told that you have high blood pressure? 0. No 1. Yes, by GP 2. Yes, by other 8. No answer 9. Not asked	Q66 Exclude high blood pressure in pregnancy.
IF NO SKIP TO Q69
Q67 Were you given medicine for high blood pressure? 0. No 1. Yes, by GP 2. Yes, by specialist 8. No answer 9. Not asked	Q67 Rate 2 if given medicine by anyone at the hospital.
IF NO SKIP TO Q69
Q68 How long did you take/have you been taking this medicine? Length of time yy.mm 77.77 Don’t know 88.88 No answer 99.99 Not asked	Q68 Note in years and months.
Q69 Have you ever had a stroke that required medical attention? 0. No 1. Yes 8. No answer 9. Not asked	Q69 Record only episodes that lasted for 48 hours or longer with partial paralysis in left or right arm and/or leg, blindness in eye/s, or speech disturbance. Ensure that respondent doesn’t mean a heart attack. Rate No if the respondent does not know or cannot remember. Paralysis on the right hand side of the face may be associated with speech difficulty.
IF NO SKIP TO Q74
Q70 How many have you had? Number of strokes nn 77 Don’t know 88 No answer 99 Not asked
Q71 How old were you when you had the (first) stroke? Age in years nnn 777 Don’t know 888 No answer 999 Not asked
Q72 How old were you when you had the last stroke? Age in years nnn 777 Don’t know 888 No answer 999 Not asked
Q73 Who diagnosed the stroke/these strokes? 0. No doctor 1. GP 2. Specialist 8. No answer 9. Not asked	Q73 If diagnosed by more than one person rate for the most specialised e.g. if diagnosed by both a GP and a specialist code for specialist. Rate specialist if ever attended hospital.
Q74 Have you ever experienced sudden problems with your speech WHICH GOT BETTER AFTER A DAY? 0. No 1. Yes 8. No answer 9. Not asked	Q74 Include unclear speech, not being able to pronounce words that are definitely known and not forming the correct sound. Episodes to last less than 24 hours.
Q75 Have you ever experienced problems with your sight WHICH GOT BETTER AFTER A DAY? 0. No 1. Yes 8. No answer 9. Not asked	Q75 Include double vision, no vision, black in front of one/both eyes or something in vision (such as a beam, line or spot). Episodes to last less than 24 hours.
Q76 Have you ever experienced a sudden weakness in an arm or leg WHICH GOT BETTER AFTER A DAY? 0. No 1. Yes 8. No answer 9. Not asked
IF NO SKIP TO Q80
Q77 Have you ever had sugar diabetes? 0. No 1. Yes 8. No answer 9. Not asked
IF NO SKIP TO Q80
Q78 How old were you when diabetes was first diagnosed? Age in years nnn 777 Don’t know 888 No answer 999 Not asked
Q79 Are you currently being treated for your diabetes? (If YES what sort of treatment?) 0. No 1. Yes, dietary control only 2. Yes, injections 3. Yes, tablets 4. Yes, both 8. No answer 9. Not asked
Q80 Have you ever had fits or epilepsy? 0. No 1. Only 1 known fit 2. More than 1 fit 8. No answer 9. Not asked
Q81 Have you ever had a serious head injury and been unconscious after it? (Have you ever been knocked out?) 0. No 1. Yes 8. No answer 9. Not asked
IF NO SKIP TO Q85
Q82 How many times? Number of times nn 77 Don’t know 88 No answer 99 Not asked	Q82 If number is greater than 3, answer Q83 and Q84 for the longest three incidents.
Q83 How old were you? Age incident 1 Age incident 2 Age incident 3	Q83 Record age in years. Rate 777 Don’t know; 888 No answer; 999 Not asked.
Q84 How long were you unconscious? Incident 1 dd.hh.mm Incident 2 dd.hh.mm Incident 3 dd.hh.mm	Q84 Record days, hours and minutes. If longer than 100 days, record 66.66.66; 77.77.77 for Don’t know; 88.88.88 for No answer and 99.99.99 for Not asked.
ASK MEN ONLY
Q85 Did you ever box when you were younger? 0. No 1. Yes, up to age 18 2. Yes, over 18
Q86 Have you ever had a general anaesthetic? (If NO: have you ever had a major operation?) 0. No 1. Yes 8. No answer 9. Not asked
IF NO SKIP TO Q88
Q87 How many times? Number of times	Q87 Rate 77 for Don’t know; 88 for No answer; 99 for Not asked.
Q88 Have you ever consulted a doctor about emotional problems, or problems with your nerves? Perhaps if you were depressed or anxious, or found that you couldn’t enjoy yourself? 0. No 1. Yes, sounds like depression 2. Yes, sounds like anxiety 3. Yes, other 8. No answer 9. Not asked	Q88 Depression: Feeling low in mood, no sleep, loss of weight, not able to get things done. Anxiety: Feelings of impending panic.
IF NO SKIP TO Q94
Q89 How old were you when you first saw a doctor about that? Age in years	Q89 Rate 777 for Don’t know; 888 for No answer; 999 for Not asked.
Q90 What did the doctor say you had? 1. Depression 2. Manic depression 3. Other/non-specific 8. No answer 9. Not asked
Q91 Did your GP arrange for you to see a specialist? 0. No 1. Yes 8. No answer 9. Not asked
Q92 Did you go into hospital? 0. No 1. Yes 8. No answer 9. Not asked
Q93 How was the problem treated? 1. Drugs 2. ECT 3. Both 4. Other 8. No answer 9. Not asked
Q94 Do you suffer from regular headaches? 0. No 1. Yes, non specific 2. Yes, migraine 8. No answer 9. Not asked
Q95 Do you suffer from hearing problems which interfere with day-to-day living? 0. No 1. Yes 8. No answer 9. Not asked	Q95 If hearing is not problematic because the subject uses an aid then rate 0.
Q96 Do you suffer from poor eyesight which interferes with day-to-day living? 0. No 1. Yes 8. No answer 9. Not asked	Q96 To count as poor eyesight must interfere even when wearing glasses. If subject wears glasses all the time or in certain conditions but otherwise reports no problems, rate 0.
Q97 Have you ever suffered from asthma? 0. No 1. Yes, childhood only 2. Yes 8. No answer 9. Not asked
Q98 Have you ever suffered from arthritis? 0. No 1. Yes 8. No answer 9. Not asked	Q98 Rate for arthritis in any part of the body. Include persistent joint pain.
Q99 Have you ever suffered with chronic bronchitis? 0. No 1. Yes 8. No answer 9. Not asked
Q100 Have you ever suffered from thyroid problems? 0. No 1. Underactive current 2. Overactive current 3. Other/non-specific current 4. Underactive past 5. Overactive past 6. Other/non specific past 8. No answer 9. Not asked
Q101 Have you ever suffered from peptic ulcers? 0. No 1. Yes 8. No answer 9. Not asked	Q101 Rate for both gastric and duodenal ulcers.
Q102 Have you ever suffered with pernicious anaemia? 0. No 1. Yes 8. No answer 9. Not asked
Q103 Have you ever suffered from meningitis or encephalitis (brain fever)? 0. No 1. Yes, meningitis 2. Yes, encephalitis 3. Yes, non specific 8. No answer 9. Not asked
Q104 Have you ever suffered from shingles? (If YES, Where?) (If HEAD NOT MENTIONED: Anywhere else?) 0. No 1. Yes, in the body 2. Yes, in the head 8. No answer 9. Not asked	Q104 The location of shingles is important here. Shingles in the trunk is less significant than shingles in the head. Rate in the head for shingles on the face, in the eyes, in the ears or on the scalp.
A105 Have you ever been diagnosed as having Parkinson’s disease? 0. No 1. Yes 8. No answer 9. Not asked
ASK WOMEN ONLY
Q105a How old were you when you had your last menstrual period? Answer in years nn 77 Not known 88 No answer 99 Not asked 00 Still menstruating	Q105 Age of menopause is thought to be a risk factor for vascular dementia. Age of last menstrual period is asked because it is more specific and therefore easier to pinpoint. Try to complete even if only an approximation. Answer with age of last period even if it was brought forward by hysterectomy or extended by HRT.
This next set of questions is about your first degree blood relatives, that is, your parents, brothers and sisters, or children.
Q106 How many of them have ever suffered from the following disorders: Down’s syndrome (What used to be known as a Mongol child) nn Senility/dementia/serious memory problems nn Alzheimer’s disease nn Parkinson’s disease nn Stroke nn Heart attack nn Sugar diabetes nn Leukemia/lymphoma nn Psychiatric disorder nn	Q106 Enter the number of first degree relatives that have ever suffered. First degree relatives: parents, brothers, sisters, children, half-brothers and sisters. Note: not second degree relatives: aunts, uncles, cousins. Rate 77 for Don’t know, 88 for No answer, 99 for Not asked. If the subject has been adopted and has no information about their blood relatives rate 77. In each case, if only one relative has been named, ask ‘Anyone else?’
Q107 How old was your mother when you were born? Age in years nn 88 No answer/not known 99 Not asked	Q107 Maternal age at birth is thought to be a risk factor for dementia. It is important that we collect this information as accurately as possible. If the subject cannot remember try to help them calculate this by asking their mother’s year of birth, or even year of death and age at death. If this still doesn’t help suggest a range and ask S to be more specific. A relatively inaccurate age is better than no age at all. Critical ages are with the change in risk: higher risk age 17-18, lower at 20, lowest at 21-22 rising to age 35. The greatest risk is at 35 and over. Rate 88 for No answer or Not known and 99 for Not asked.
RATE: WHO ANSWERED THIS ‘RISK FACTORS’ SECTION? 0. Subject 1. Proxy
This next section of questions is about your memory and how well you sleep.
Q108 Have you ever had any difficulty with your memory? 0. No 1. Yes 8. No answer 9. Not asked
IF NO SKIP TO Q110
Q109 Was?Is that a problem for you? 0. No 1. Yes, moderate 2. Yes, severe 8. No answer 9. Not asked	Q109 Rate as a problem if the subject says that it is a problem.
Q110 Have you tended to forget things recently? 0. No 1. Yes, several times a week 2. Yes, at least daily 8. No answer 9. Not asked	Q110 For this and the next two questions, rate only problems. DO NOT rate transient mistakes. A rating of 1 implies it causes difficulty several times a week. Likewise a rating of 2 relates to the frequency of the difficulty.
IF NO SKIP TO O113
Q111 What kinds of things? Names of family and close friends? 0. No 1. Yes, several times a week 2. Yes, at least daily 8. No answer 9. Not asked	Q111 This concerns family and close friends, not persons only met occasionally.
Q112 What about where you have put things? 0. No 1. Yes, several times a week 2. Yes, at least daily 8. No answer 9. Not asked	Q112 To rate here means that the subject suffers some degree of inconvenience.
Q113 Do you have to make more effort to remember things than you used to? 0. No 1. Yes 8. No answer 9. Not asked	Q113 Rate as present only if this is a constant problem which the subject has to overcome by some strategy.
IF NO SKIP TO Q115
Q114 When did you first notice this beginning? 1. Less than 1 year 2. In the last 1-2 years 3. In the last 3-4 years 4. In the last 5-10 years 5. Over 10 years ago 8. No answer 9. Not asked
Q115 Do you remember my name? What is it? 0. Incorrect 1. Correct 8. No answer 9. Not asked	Q115 Allow minor mispronunciations. If the subject indicates s/he does not know, ask once, ‘Could you try to remember?’ If not known, rate as incorrect.
ITEM 116 – INTERVIEWER RATING IN INTERVIEWER’S OPINION SUBJECT HAS DIFFICULTY WITH THEIR MEMORY. 0. No 1. Yes, mild to moderate 2. Yes, severe 9. Inapplicable	I116 Here you must judge whether there is a genuine difficulty experienced. Many subjects with depression complain about their memory but in practice it does not really present difficulties in daily living. Do not rate minor problems with remembering the names of acquaintances.
RATE: WHO ANSWERED THIS ‘MEMORY’ SECTION 0. Subject 1. Proxy
Q117 Do you ever have any problems sleeping? (PROMPT: How often?) 0. Never 1. Seldom 2. Sometimes 3. Often 4. All the time 8. No answer 9. Not asked	Q117 If the subject uses one of the terms on the checklist code as such. Otherwise, using prompts, code appropriately. For example: every night, always (All the time); most nights, at least two or three times a week, usually (Often); a recognisable problem at least once a month (Sometimes); hardly ever, very rarely, not more than once a month (Seldom). If subject takes sleeping pills rate according to their answer e.g. No, because I take tablets, rate 0. Sleeping problems caused by snoring spouses traffic noise etc. are sleeping problems.
IF NEVER OR SELDOM SKIP TO Q120
Q118 Do you have problems staying asleep or falling asleep? 1. Staying asleep 2. Falling asleep 3. Both 8. No answer 9. Not asked	Q118 Rate 1 if the subject has repeated awakenings during the nights and has trouble getting back to sleep. Rate 2 if the subject spends a long time trying to get to sleep.
Q119 At what age did your sleep become a problem? Age in years nnn 777 Don’t know 888 No answer 999 Not asked
Q120 Do you snore? (PROMPT: How often?) 0. No 1. Sometimes 2. All the time 7. GENUINELY doesn’t know 8. No answer 9. Not asked	Q120 Code as for Q117. Code regularly as all the time.
I would now like to ask you questions about day to day activities which some people find difficult. Some of these questions are relevant to your GP. Do you have any objections if I pass on the answers?	The following 9 questions (Q121-Q129) take the same form and these notes should be applied consistently throughout. It will be necessary to probe in order to confirm the use of aids in carrying out activities of daily living. Using scissors as an aid to cut toe nails does not count as we would all normally use these. However, specially adapted furniture or the use of adapted cooking utensils would count as special aids.
Q121 I would like to know if you are able, or if you have any difficulty with, the following activities. Are you able to cut your own toe nails? (If YES: Do you have difficulty?) 0. (No), needs help 1. (Yes), some difficulty 2. (Yes), no difficulty 7. Don’t know 8. No answer 9. Not asked	Probing will also be necessary to establish whether the subject would be able to undertake the activity in the absence of another person. This particularly applies to men when asking about household activities but it could equally apply to women where someone else is available.
Q122 Are you able to wash all over or bath? (If YES: Do you have difficulty?) 0. No, needs help 1. Yes, some difficulty 2. Yes, no difficulty 7. Don’t know 8. No answer 9. Not asked	People with mental frailties who cannot undertake activities because of their mental frailty should be coded as needing help.
Q123 Are you able to get on a bus? (If YES: Do you have difficulty?) 0. No, needs help 1. Yes, some difficulty 2. Yes, no difficulty 7. Don’t know 8. No answer 9. Not asked	Rate 0 - Needs help if the subject requires assistance from another person to undertake the activity. Do not use this code if they could undertake the activity for themselves but someone usually does it for them. Rate 1 - Some difficulty if the subject reports difficulty undertaking activity or if they report no difficulty but use an aid. Rate 2 – No difficulty if the subject is able to undertake this activity by themselves without difficulty and without the use of aids or help from others.
Q124 Are you able to go up and down stairs? (If YES: Do you have difficulty?) 0. No, needs help 1. Yes, some difficulty 2. Yes, no difficulty 7. Don’t know 8. No answer 9. Not asked
Q125 Are you able to do heavy housework? (If YES: Do you have difficulty?) 0. No, needs help 1. Yes, some difficulty 2. Yes, no difficulty 7. Don’t know 8. No answer 9. Not asked	Q125 Heavy Housework – for example, washing floors.
Q126 Are you able to shop and carry heavy bags? (If YES: Do you have difficulty? 0. No, needs help 1. Yes, some difficulty 2. Yes, no difficulty 7. Don’t know 8. No answer 9. Not asked
Q127 Are you able to prepare and cook a hot meal? (If YES: Do you have difficulty?) 0. No, needs help 1. Yes, some difficulty 2. Yes, no difficulty 7. Don’t know 8. No answer 9. Not asked	Q127 If the subject claims they never have to cook a hot meal because this is always done for them, ask them to make a judgment as to whether they could if they had to.
Q128 Are you able to reach an overhead shelf? (If YES: Do you have difficulty?) 0. No, needs help 1. Yes, some difficulty 2. Yes, no difficulty 7. Don’t know 8. No answer 9. Not asked
Q129 Are you able to tie a good knot in a piece of string? (If YES: Do you have difficulty?) 0. No, needs help 1. Yes, some difficulty 2. Yes, no difficulty 7. Don’t know 8. No answer 9. Not asked
Q130 Are you able to put on your shoes and socks or stockings? (If YES: do you have difficulty?) 0. (No), needs help 1. (Yes), some difficulty 2. (Yes), no difficulty 7. Don’t know 8. No answer 9. Not asked
Q135 Are you able to get to or use the toilet? (If YES: do you have difficulty?) 0. No, needs help 1. Yes, some difficulty 2. Yes, no difficulty 7. Don’t know 8. No answer 9. Not asked
Q144 Are you able to do the light housework? (If YES: do you have difficulty?) 0. No, needs help 1. Yes, some difficulty 2. Yes, no difficulty 7. Don’t know 8. No answer 9. Not asked
Q145 Does anyone help you with any of the day-to-day tasks I’ve just asked about? 0. No 1. Yes 8. No answer 9. Not asked
IF NO SKIP TO Q149
Q146 Who usually helps? A No-one B Spouse C Daughter D Daughter-in-law E Son F Son-in-Law G Brother H Sister I Other relative J Friend or neighbour K Home help L Care worker M Meals on wheels N Community worker O Community nurse P Warden Q Paid help R Other (specify) S Not applicable	Q146 Code main helper.
IF 00 SKIP TO Q149
Q147 Do they help every day, most days or less often? 0. Every day 1. Most days 2. Less often 8. No answer 9. Not asked
Q148 Does anyone else help? A No-one else B Spouse C Daughter D Daughter-in-law E Son F Son-in-Law G Brother H Sister I Other relative J Friend or neighbour K Home help L Care worker M Meals on wheels N Community worker O Community nurse P Warden Q Paid help R Other (specify) S Not applicable	Q148 Code up to three other helpers.
ITEM 149 Establish degree of mobility of subject. 1. Usually ambulant non-housebound 2. Usually ambulant housebound 3. Chairfast permanently 4. Bedfast permanently 7. Unable to establish mobility	I149 Where subject’s degree of mobility is obvious you may code from observation or from information already obtained. However check that the observed state is permanent and not temporary i.e. the subject is not expected to improve markedly in the short term. If in doubt over-estimate degree of disability and notify. Rate 1 - For people who are usually able to get out without assistance. Rate 2 - For people who can get about on the level inside but who never go out of the house or garden without assistance. Rate 3 - For people who spend all their time confined to a chair or who need help to transfer from the chair to the toilet or bed. Use this rating for a wheelchair user even if they can get out of the house. Rate 4 - For people who spend all their time confined to bed.
Now I am going to ask you about smoking and drinking.
Q150 Do you smoke? 0. No 1. Yes 8. No answer 9. Not asked
IF NO SKIP Q152
Q151 How many cigarettes to you smoke in a day? 0. Cigars/pipe only 1. Only smoke occasionally 2. 1 – 3 3. 4 – 9 4. 10 – 19 5. 20 – 29 6. 30+ 8. No answer 9. Not asked	Q151 Record amount currently smoked.
SKIP TO Q155
Q152 Have you ever smoked? 0. No 1. Yes 8. No answer 9. Not asked
IF NO SKIP TO Q156
Q153 How old were you when you stopped? Age in years nn	Q153 Record subject’s age when they last stopped smoking. Enter 888 if no answer and 999 if not asked.
Q154 How many cigarettes did you smoke in a day? 0. Cigars/pipe only 1. Only smoke occasionally 2. 1 – 3 3. 4 – 9 4. 10 – 19 5. 20 – 29 6. 30+ 8. No answer 9. Not asked	Q154 Record consumption prior to giving up.
Q155 How old were you when you first started smoking? Age in years nn	Q144 Record subject’s age when they first started smoking on a regular basis.
Q156 Have you every taken an alcoholic drink of any kind? 0. No 1. Yes 8. No answer 9. Not asked
IF NO SKIP TO Q159
Q158AA What is the most you now drink per week on a regular basis? nn Units beer, lager, shandy nn Units wines, sherry, port, vermouth, etc. nn Units spirits, liqueurs	AAA (1 pint beer/lager=2 units; 1 pint shandy=1 unit) BBB (1 glass=1 unit) CCC (1 pub measure=1 unit)
Q158BB Has there been any significant change (in your pattern of drinking)? 0. No 1. Yes 8. No answer 9. Not asked
IF NO SKIP TO Q157BB
Q157AA What is the most you would drink per week on a regular basis before you reached the age of 65? nn Units beer, lager, shandy nn Units wines, sherry, port, vermouth, etc. nn Units spirits, liqueurs	(1 pint beer/lager=2 units; 1 pint shandy=1 unit) (1 glass=1 unit) (1 pub measure=1 unit)
Q157BB Has a doctor ever advised you to stop or reduce your drinking for your health’s sake? 0. No 1. Yes 8. No answer 9. Not asked	Q157BB Don’t ask and code 9 for non-drinkers.
Q157CC Did anyone – relations, friends, workmates, employer – ever suggest that you should reduce your drinking? 0. No 1. Yes 8. No answer 9. Not asked	Q157CC Don’t ask and code 9 for non-drinkers.
RATE: WHO ANSWERED THIS ‘SMOKING & DRINKING SECTION’ 0. Subject 1. Proxy
The next part of the interview is concerned with memory and concentration. Some of the questions may seen rather easy, but others are more difficulty so please listen carefully. No-one is expected to manage them all so please don’t worry. If you wear reading glasses you will need them for some of the things I’m going to ask you to do. First:	This last section forms part of the cognitive examination. Some of the items (those marked with a star) are part of the Mini Mental State Examination. If you seem to be losing the subject’s co-operation ask these items as a priority. It is important that you speak slowly and clearly. If the subject appears not to have heard or understood, repeat the question (unless the item specifically prohibits repetition). DO NOT CORRECT IF A WRONG ANSWER IS GIVEN.
*Q159 What day of the week is it today? 0. Incorrect 1. Correct 9. Inapplicable
*Q160 What is the date today? Day 1. Correct 2. Incorrect by 1 day 3. Incorrect by >1 day 7. Don’t know 8. No answer 9. Not asked Month 1. Correct 2. Incorrect by 1 month 3. Incorrect by >1 month 7. Don’t know 8. No answer 9. Not asked Year 1. Correct 2. Incorrect by 1 year 3. Incorrect by >1 year 7. Don’t know 8. No answer 9. Not asked	Rate as correct if the subject claims it is the previous month in the first week of the month (e.g. March in the first week of April).
*Q161 What is the season? 0. Incorrect 1. Correct 9. Inapplicable	Q161 Allow flexibility when season changes, e.g.: March = winter/spring June = spring/summer September = summer/autumn Late Nov/Dec = autumn/winter
Can you tell me where we are now? For instance:
*Q162 What county are we in? 0. Incorrect 1. Correct 9. Inapplicable
*Q163 Name two main streets nearby (or near to your home)? 0. Incorrect 1. Correct 9. Inapplicable	Q163 Not including their own street.
*Q164 What floor of this building are we on? 0. Incorrect 1. Correct 9. Inapplicable
ITEM 195 Rate if there are any errors in the orientation (Q1-10) or memory (Q108-155, 160) sections, or if responses to many of the other items were inaudible, inappropriate or incoherent.
Errors made in clear consciousness due to agitation, depression or elation. 0. Absent 1. Agitation 2. Depression 3. Elation 9. Inapplicable	Clear consciousness – i.e. not falling asleep, or under the influence of alcohol or drugs or delirium due to acute physical illness. The individual will be alert, responsive and focused. Agitation: will appear anxious. Depression: typified by slow and low mood. Most people with dementia will make an effort, whilst those who are depressed will emanate negative feelings and not try. Elation typified by fast speech and high mood with an inability to concentrate and easily distracted.
Errors made in clear consciousness due to memory defect. 0. Absent 1. Present 9. Inapplicable
Errors made in clouded consciousness. 0. Absent 1. Present 9. Inapplicable	Clouded consciousness – i.e. subject was falling asleep, under the influence of alcohol, drugs or delirium due to acute physical illness. The individual will be very distractible, unfocused and my drift in and out of consciousness. Often worse in the evening and afternoon.
Respondent rambles: talks in an aimless fashion. Object in view at the beginning is not reached. 0. No 1. Yes, to some extent 2. Yes, to a marked extent 9. Not applicable
Reaction to errors was characteristically bland, indifferent or euphoric. 0. Absent 1. Present 9. Inapplicable	Euphoria: overall sense of well being.
SHOW PENCIL
*Q166 What is this called? 0. Incorrect 1. Correct 9. Inapplicable	Q166 – 169 For these questions accurate naming is required. Descriptions of function or approximate answers are not acceptable. For example: used for telling the time, for wristwatch, would be incorrect. Present the objects to the subject and allow them to be held. Put the objects out of sight before proceeding.
SHOW WRISTWATCH
*Q167 What is this called? 0. Incorrect 1. Correct 9. Inapplicable
SHOW KEYS
Q168 What are these called? 0. Incorrect 1. Correct 9. Inapplicable
SHOW ENVELOPE
Q169 What is this called? 0. Incorrect 1. Correct 9. Inapplicable
Later on I’m going to give you a name and address to write on this envelope. When you have finished doing that I’d like you to do the following: turn it over, seal it, and write your initials on the back. Could you remember to do that then, without me reminding you?	Illustrate the actions whilst giving the instructions.
Q170 Now I’d like you to tell me as many different animals as you can think of in one minute. Enter number nn 88 No answer 99 Not asked	Q170 If subject asks for clarification, explain that animals include birds, insects, humans etc. if subject gets stuck, encourage with ‘Can you think of any more?’ Record number correct in one minute (repetitions not to be counted). Enter 88 for No answer and 99 for Not asked. Pressing any key on the laptop will activate the timer. Write the list of animals on the paper contact sheet.
I am now going to say something and I would like you to repeat it after me.
*ITEM 171 No ifs, and or buts. 0. Incorrect 1. Correct 9. Inapplicable	I170 Only one presentation is allowed so it is essential that you read the phrase clearly and slowly, enunciating all the S’s.
Q172 What are the four things I asked you to name a few minutes ago? Pencil 0. Not recalled 1. Recalled 9. Not asked	Q172 Rate as correct if the subject remembers what they said previously, even if it was originally misidentified. When asking this question gesticulate as though presenting the respondent with the object.
Wristwatch 0. Not recalled 1. Recalled 9. Not asked
Keys 0. Not recalled 1. Recalled 9. Not asked
Envelope 0. Not recalled 1. Recalled 9. Not asked
Q173 Who is the Prime Minister? 0. Incorrect 1. Correct 9. Inapplicable
Q174 Who is the president of the United States of America? 0. Incorrect 1. Correct 9. Inapplicable
Q175 What are the colours of the Union Jack? (Our the national flag) 0. Incorrect 1. Correct, red, white & blue 9. Inapplicable
Q176 Who was Neville Chamberlain? 0. Incorrect 1. Correct, A Prime Minister. 9. Inapplicable
Q177 Who was Guy Burgess? 0. Incorrect 1. Correct, A spy. 9. Inapplicable
*ITEM 178 I am now going to say three words. After I have finished saying all three, I want you to repeat them. Remember what they are because I am going to ask you to name them in a few minutes. NAME THESE 3 OBJECTS TAKING 1 SECOND TO SAY EACH: Apple, Table, Penny Apple 0. Not named on first try 1. Named on first try 9. Not asked Table 0. Not named on first try 1. Named on first try 9. Not asked Penny 0. Not named on first try 1. Named on first try 9. Not asked	If any errors or omissions are made on the first attempt, repeat all the names until subject learns all three up to a maximum of five repeats.
*ITEM 179 Now I would like you to take 7 away from 100. Now take 7 away from the number you get. Now keep taking 7 away until I tell you to stop. Record the answers: nn, nn, nn, nn, nn. 888 No answer 999 Not asked	ITEM 179 Score 1 point for each time the difference is 7, even if a previous answer was incorrect. Maximum score 5 points. DO NOT repeat the number you were given. Enter 888 if No answer given and 999 for Not asked. An entry of 999 will cause a skip to the next question.
*Q180 What were the three words I asked you to repeat a little while ago? Apple 0. Not recalled 1. Recalled 9. Not asked Table 0. Not recalled 1. Recalled 9. Not asked Penny 0. Not recalled 1. Recalled 9. Not asked
OFFER SUBJECT THE SENTENCE AT THE END OF THE HANDBOOK (Close your eyes)
ITEM 181 Please read what is here and do what it says. 0. Incorrect 1. Correct 9. Inapplicable	ITEM 181 It is not necessary for the subject to read aloud. Score as correct only if the action is correctly carried out. If the subject reads the instruction but fails to carry out the action, say ‘Now do what it says’.
OFFER SUBJECT THE DRAWING PAGE
*ITEM 182 Here is a drawing. Please copy the drawing on the same paper. 0. Incorrect 1. Correct 9. Inapplicable	ITEM 182 Correct if the two five-sided figures intersect to form a four-sided figure and if all the angles in the five-sided figures are preserved. NB Copy to be below the original and drawing to be done freehand. If will not attempt it mark as incorrect.
*ITEM 183 Write a complete sentence on this sheet of paper. 0. Incorrect 1. Correct 9. Inapplicable	ITEM 183 Sentence to be written in the box on the same piece of paper as the previous item. Spelling and grammar are not important. The sentence must have a subject (real or implied) and a verb. ‘Help’ or ‘Go away’ are acceptable. If sentence is illegible ask subject what they have written and write it underneath. Under no circumstances should you write it for them from dictation.
RATE: *IS THE SUBJECT LEFT- OR RIGHT-HANDED? 1. Right-handed 2. Left-handed 3. Ambidextrous 7. Unable to judge
READ FULL STATEMENT STRESSING THE WORDS IN CAPITALS AND THEN HAND OVER PAPER
*ITEM 184 I am now going to give you a piece of paper. When I do, take the paper in your RIGHT hand. Fold the paper in HALF with BOTH hands and put the paper down on your LAP. Takes in right hand 0. Incorrect 1. Correct 9. Inapplicable Folds in half 0. Incorrect 1. Correct 9. Inapplicable Places on lap 0. Incorrect 1. Correct 9. Inapplicable	ITEM 184 If the full sequence is not completed repeat the whole instruction to ensure that it has been heard and understood. Do not prompt. Score a move as correct only if it takes place in the correct sequence. Modify instruction for one-handed subjects. If one-handed score “Takes in right hand” as 9.
GIVE THE ENVELOPE TO THE SUBJECT
ITEM 185 Please write the following name and address on this envelope: John Brown 42 West Street Bedford. 0. Incorrect 1. Poor but acceptable 2. Correct 9. Not asked	ITEM 185 Dictate the name and address slowly enough for the subject to be able to write from your dictation. Spelling and neatness are not important. The criterion by which you should judge the subject’s response is whether the letter is likely to reach the exact destination. So, Jon Brwn is acceptable, 24 and ‘Burford’ are not. If the subject is unable to write, say the address slowly twice and ask them to remember it.
Please go on remembering this name and address and I will ask you about it later.
ITEM 186 HERE THE SUBJECT SHOULD REMEMBER YOUR EARLIER REQUEST TO SEAL THE ENVELOPE AND WRITE THEIR INITIALS ON THE BACK. WAIT A FEW SECONDS TO ALLOW THEM TO REMEMBER. 0. No correct action 1. One action with prompt 2. Both actions with prompt 3. One action without prompt, one with 4. Seals and writes own name without prompt 5. One action without prompt only	ITEM 186 If sealing envelope and writing initials on back is not spontaneously done, say ‘Were you going to do something else with the envelope?’ If only one action is carried out, say ‘Was there something else you were going to do?’ If initials still not written, say ‘You may remember I asked you to write something special on the back of the envelope’. If incorrect response made, e.g. folding, say ‘Was there anything else?’ Any combination of name and/or initials is acceptable.
TAKE THE ENVELOPE BACK
I am going to name two things and I’d like you to tell me in what way they are alike. For example, a dog and a monkey are alike because they are both animals. I wonder if you can tell me:
Q189 In what way are an apple and a banana alike? 0. Incorrect 1. Food, grow, have peel 2. Fruit 9. Not asked	Q189-190 These questions assess the ability to think abstractly. Abstract answers score 2, concrete answers score 1. Examples are given beside each score.
Q190 In what way are a boat and a car alike? 0. Incorrect 1. Have seats 2. Means of transport 9. Not asked
Q191 What was the name and address I asked you to remember a short while ago? John 0. Not recalled 1. Recalled 9. Not asked Brown 0. Not recalled 1. Recalled 9. Not asked 42 0. Not recalled 1. Recalled 9. Not asked West Street 0. Not recalled 1. Recalled 9. Not asked Bedford 0. Not recalled 1. Recalled 9. Not asked	Q191 Score each component as either correct or incorrect.
SHOW SUBJECT THE PICTURES IN THE HANDBOOK
Q192 These are pictures of ordinary things taken from unusual angles. Can you tell me what they are? Shoe 0. Incorrect 1. Correct 9. Inapplicable Spectacles 0. Incorrect 1. Correct 9. Inapplicable Pipe 0. Incorrect 1. Correct 9. Inapplicable	Q192 Score as correct if object is recognised. It does not have to be named correctly.
RATE: REASONS FOR MISSING (8s AND 9s) IN COGNITIVE SECTION
Q193 Lastly, (subject’s name) do you take any medicine, tablets or injections of any kind, either that you buy yourself or that are prescribed by your doctor? 0. No 1. Yes 8. No answer 9. Not asked	Q193 Enter drug, dose, and frequency of up to 8 medications. Ask to see the medication so that you can accurately record the information. Check that each is taken as prescribed before entering dose and frequency. For nursing homes, information will be available from matron.
Q194 Thank you very much for answering all these questions. It is really helpful for us to know what things people find difficult. Would you tell me how you feel about the interview and the questions I’ve asked you? 1. Strong negative reaction 2. Lesser negative reaction 3. Neutral 4. Positive reaction	Q194 Rate 1 – If very anxious, annoyed, worried, angry or bored. Rate 2 – If somewhat concerned, anxious, annoyed or bored. Rate 3 – Unconcerned. Rate 4 – Enjoyed it.
ENTER ANY (BRIEF) COMMENTS MADE BY THE RESPONDENT. IF COMMENTS MADE:
Thank you for your comments. We like to hear how people feel, and we do take notice of what they say.
RATE: WHO ANSWERED THIS LAST SECTION: 0. Subject 1. Proxy
(Before I can switch off the machine) I have to tidy up a few details. It should only take a few minutes so I hope you won’t mind.
ITEM 196 Did the subject sound muddled? 0. No 1. Yes, infrequently 2. Yes, persistently 9. Inapplicable
ITEM 197 Did the subject appear indecisive? 0. No 1. Yes, infrequently 2. Yes, persistently 9. Inapplicable
ITEM 198 Perseveration? 0. No 1. Yes, infrequently 2. Yes, persistently 9. Inapplicable	ITEM 198 Perseveration is the inappropriate repetition of answers e.g. Q Weekday? A Tuesday Q Month? A Tuesday
ITEM 199 Did the subject have a poor grasp of English that interfered with the questioning? 0. No 1. Yes, English not mother tongue 2. Yes, unable to read 3. Yes, unable to write 4. Neither read nor write 9. Inapplicable
ITEM 200 Did the subject have poor/no eyesight that interfered with reading, writing or drawing? 0. No 1. To some extent 2. To a marked extent 3. Blind 9. Inapplicable
ITEM 201 Did the subject have unclear/no speech that interfered with questioning? 0. No 1. To some extent 2. To a marked extent 3. Dumb 9. Inapplicable
ITEM 202 Did the subject have hearing problems that interfered with the questioning? 0. No 1. To some extent 2. To a marked extent 3. Deaf 9. Inapplicable
ITEM 203 Did the subject have a weakness, tremor, etc. of hand that interfered with writing, drawing or folding paper? 0. No 1. To some extent 2. To a marked extent 3. Use of one hand/arm only 9. Inapplicable	ITEM 203 Do not rate benign tremor of old age such as slight shaking of the hand if it does not interfere with questioning. Rate for Parkinsonism (described as pin rolling and may be accompanied by slow response). Also rate here for difficulty caused by arthritis.
ITEM 20A Do you think that the subject may have dementia? IF YES: Is it severe? 0. No 1. Yes, not severe 2. Yes, severe 8. Cannot judge
ITEM 204 Which respondent answered the following sections: Orientation S/P Demographic S/P Risk Factors S/P Memory S/P Sleep S/P Daily Living S/P Smoking S/P Drinking S/P Cognition S/P Medication S/P	ITEM 204 This item takes this form in the paper schedule only. In the machine form this question is asked at the end of each section.
ITEM 205 Rater’s confidence in data. 0. Reasonable 1. A few doubts 2. Moderate doubts 3. Grave doubts 4. Worthless	ITEM 205 Rate 0 - if respondent gave properly considered answers to more or less all the questions. Rate 3 - if respondent was unable or unwilling to give properly considered answers to most questions. Rate 4 - if the answers were more or less random.
ITEM 206 Doubtful reliability because of 1. Exaggeration 2. Minimization 3. Another person present 9. Other (specify)	ITEM 206 Rate 1 - if respondent had a tendency to say yes indiscriminately. Rate 2 - if respondent had a tendency to say no indiscriminately.
ITEM 207 Date recorded: 1. During interview 2. After interview	ITEM 207 Rate 2 - if information keyed into the machine from a paper schedule
OUTCOME. Thank you very much for helping us. As I mentioned at the beginning, we are hoping to get a better understanding of how ageing affects us all. We are asking who takes part whether they would be willing to be seen again in the future. May we contact you again? 1. Interview complete, willing to be seen again 2. Interview incomplete, not willing to be seen again 3. Interview complete, refused to be seen again 4. Interview incomplete, refused to be seen again	OUTCOME After this item has been completed, the following information will be displayed on the screen. AGECAT SCORE: On (n=0-5) MMSE SCORE: nn (nn=0-30)
This is a longitudinal study which we hope will continue in the future. We hope it will be possible to see you again.
The study is described in more detail on this sheet I am giving you now.
HAND OVER THE INFORMATION SHEET
Thank you very much.