Item
1. I would like to ask you a few questions dealing with your concentration and memory. Some are a little bit more difficult than others. a. What is the year?
integer
C0439234 (UMLS CUI [1])
Code List
1. I would like to ask you a few questions dealing with your concentration and memory. Some are a little bit more difficult than others. a. What is the year?
CL Item
not attempted (2)
q1 answer in error
Item
Record answer in error:
text
Item
b. What season of the year is it?
integer
C0036497 (UMLS CUI [1])
Code List
b. What season of the year is it?
CL Item
not attempted (2)
q2 answer in error
Item
Season:
text
Item
c. What is the date?
integer
C0011008 (UMLS CUI [1])
Code List
c. What is the date?
CL Item
not attempted (2)
q3 answer in error
Item
Date:
text
Item
d. What is the day of the week?
integer
C0585023 (UMLS CUI [1])
Code List
d. What is the day of the week?
CL Item
not attempted (2)
q4 answer in error
Item
Day:
text
Item
e. What is the month?
integer
C0439231 (UMLS CUI [1])
Code List
e. What is the month?
CL Item
not attempted (2)
q5 answer in error
Item
Month:
text
Item
f. What state are we in?
integer
C1301808 (UMLS CUI [1])
Code List
f. What state are we in?
CL Item
not attempted (2)
q6 answer in error
Item
State:
text
Item
g. What country are you in?
integer
C0454664 (UMLS CUI [1])
Code List
g. What country are you in?
CL Item
not attempted (2)
q7 answer in error
Item
Country:
text
Item
h. What (city/town) are we in?
integer
C0008848 (UMLS CUI [1])
Code List
h. What (city/town) are we in?
CL Item
not attempted (2)
q8 answer in error
Item
City:
text
Item
i. What floor of the building are we on?
integer
Code List
i. What floor of the building are we on?
CL Item
not attempted (2)
q9 answer in error
Item
Floor:
text
Item
j. What is this address? (if intitutionalized: What is the name of this place?)
integer
C1442065 (UMLS CUI [1])
Code List
j. What is this address? (if intitutionalized: What is the name of this place?)
CL Item
not attempted (2)
q10 answer in error
Item
Address/home:
text
Item
2. I am going to name 3 objects. After I have said them. I want you to repeat them. Remember what they are because I am going to ask you to name them again in a few minutes: APPLE TABLE PENNY Could you repeat the 3 items for me? a. Apple
integer
C1705914 (UMLS CUI [1])
Code List
2. I am going to name 3 objects. After I have said them. I want you to repeat them. Remember what they are because I am going to ask you to name them again in a few minutes: APPLE TABLE PENNY Could you repeat the 3 items for me? a. Apple
CL Item
not attempted (2)
Item
b. Table
integer
C1705914 (UMLS CUI [1])
CL Item
not attempted (2)
Item
c. Penny
integer
C1705914 (UMLS CUI [1])
CL Item
not attempted (2)
Item
3. Can you subtract 7 from 100, and then subtract 7 from the answer you get and keep subtracting 7 until I tell you to stop? Please do the subtraction out loud. a. 93
integer
C2586243 (UMLS CUI [1])
Code List
3. Can you subtract 7 from 100, and then subtract 7 from the answer you get and keep subtracting 7 until I tell you to stop? Please do the subtraction out loud. a. 93
CL Item
not attempted/refused (9)
subtraction task answer in error
Item
a.
text
Item
b. 86
integer
C2586243 (UMLS CUI [1])
CL Item
not attempted/refused (9)
subtraction task 2 answer in error
Item
b.
text
Item
c. 79
integer
C2586243 (UMLS CUI [1])
CL Item
not attempted/refused (9)
subtraction task 3 answer in error
Item
c.
text
Item
d. 72
integer
C2586243 (UMLS CUI [1])
CL Item
not attempted/refused (9)
subtraction task 4 answer in error
Item
d.
text
Item
e. 65
integer
C2586243 (UMLS CUI [1])
CL Item
not attempted/refused (9)
subtraction task 5 answer in error
Item
e.
text
Item
4. I am going to spell a word forwards and I want you to spell it backwards. The word is world. W-O-R-L-D. Spell world backwards. a. D
integer
C0869025 (UMLS CUI [1])
Code List
4. I am going to spell a word forwards and I want you to spell it backwards. The word is world. W-O-R-L-D. Spell world backwards. a. D
CL Item
not attempted/refused (9)
Item
b. L
integer
C0869025 (UMLS CUI [1])
CL Item
not attempted/refused (9)
Item
c. R
integer
C0869025 (UMLS CUI [1])
CL Item
not attempted/refused (9)
Item
d. O
integer
C0869025 (UMLS CUI [1])
CL Item
not attempted/refused (9)
Item
e. W
integer
C0869025 (UMLS CUI [1])
CL Item
not attempted/refused (9)
Item
5. Now what were the 3 objects I asked you to remember? a. apple
integer
C0034770 (UMLS CUI [1])
Code List
5. Now what were the 3 objects I asked you to remember? a. apple
CL Item
not attempted (2)
Item
b. table
integer
C0034770 (UMLS CUI [1])
CL Item
not attempted (2)
Item
c. penny
integer
C0034770 (UMLS CUI [1])
CL Item
not attempted (2)
Item
6. What is this called?
integer
C0451342 (UMLS CUI [1])
Code List
6. What is this called?
CL Item
not attempted (2)
Item
7. What is this called?
integer
C0451342 (UMLS CUI [1])
Code List
7. What is this called?
CL Item
not attempted (2)
Item
8. I'd like you to repeat a phrase after me: No it's, and's, or but's.
integer
C3828340 (UMLS CUI [1])
Code List
8. I'd like you to repeat a phrase after me: No it's, and's, or but's.
Item
9. Read the words on this card then do what it says.
integer
Code List
9. Read the words on this card then do what it says.
Item
10. I am 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. a. Takes paper in right
integer
Code List
10. I am 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. a. Takes paper in right
Item
b. Folds paper in half
integer
Code List
b. Folds paper in half
Item
c. Puts paper down on lap
integer
Code List
c. Puts paper down on lap
Item
11. Write any complete sentence on that piece of paper for me.
integer
Code List
11. Write any complete sentence on that piece of paper for me.
Item
12. Here's a drawing. Please copy the drawing on the same paper.
integer
C0204463 (UMLS CUI [1])
Code List
12. Here's a drawing. Please copy the drawing on the same paper.
problems
Item
13. Special problems?
boolean
problems description
Item
Decribe problem and questions affected below.
text
sum of scores
Item
14. Sum of scores in items 1 through 12:
float
C1515051 (UMLS CUI [1,1])
C0449820 (UMLS CUI [1,2])
sum of maximum scores
Item
15. Sum of maximum scores for scored tasks:
float
C1515051 (UMLS CUI [1,1])
C0449820 (UMLS CUI [1,2])
corrected score
Item
16. Correted score (#14/#15 x 30= corrected score)
float
C0449820 (UMLS CUI [1])
Item
17. Look at these boxes across the top of the page. On the top of each box are numbers from one through nine. On the bottom part of each box there is a symbol. Each symbol is paired with a number. -- Down here are boxes with numbers on the top, but the bottom part is blank. I want you to put the correct symbol in each box like this: -- Now I want you to fill in all boxes up to this line. -- When I tell you to begin, start here and fill in the boxes in these four rows. Do them in any order and don't skip any. Please try to work as quickly as possible. Let's begin. -- That's good. That completes this set of tasks. a. Test items:
integer
C0814254 (UMLS CUI [1])
Code List
17. Look at these boxes across the top of the page. On the top of each box are numbers from one through nine. On the bottom part of each box there is a symbol. Each symbol is paired with a number. -- Down here are boxes with numbers on the top, but the bottom part is blank. I want you to put the correct symbol in each box like this: -- Now I want you to fill in all boxes up to this line. -- When I tell you to begin, start here and fill in the boxes in these four rows. Do them in any order and don't skip any. Please try to work as quickly as possible. Let's begin. -- That's good. That completes this set of tasks. a. Test items:
digit-symbol substitution task 2
Item
b. Number of symbols correctly coded:
integer
C0814254 (UMLS CUI [1])
digit-symbol substitution task 3
Item
c. Number of symbols incorrectly coded:
integer
C0814254 (UMLS CUI [1])