Item
5 What is your current marital status? Are you:
text
C0024819 (UMLS CUI [1])
Code List
5 What is your current marital status? Are you:
CL Item
married (married)
CL Item
widowed (widowed)
CL Item
divorced (divorced)
CL Item
separated (separated)
CL Item
never marriedd (never marriedd)
CL Item
other (specify) (other (specify))
marital status other
Item
Other, specify:
text
C0024819 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Item
6 I would like to ask you some questions that we also asked you 6 months ago. The reason for asking them again is that we are interested in possible changes that might have occurred. Would you say, in general, your health is:
text
C0516984 (UMLS CUI [1])
Code List
6 I would like to ask you some questions that we also asked you 6 months ago. The reason for asking them again is that we are interested in possible changes that might have occurred. Would you say, in general, your health is:
CL Item
excellent? (excellent?)
CL Item
very good? (very good?)
CL Item
refused/don't know (refused/don't know)
Item
7 How would you say your health compares to other persons of your age? Would you say your health is:
integer
C0018759 (UMLS CUI [1,1])
C0027362 (UMLS CUI [1,2])
Code List
7 How would you say your health compares to other persons of your age? Would you say your health is:
CL Item
Better than others of your age? (1)
CL Item
About the same as others your age? (2)
CL Item
Worse than others your age? (3)
Item
8 How does your to when we saw you in [month]? Would you say your health is?
text
Code List
8 How does your to when we saw you in [month]? Would you say your health is?
CL Item
about the same (about the same)
CL Item
don't know (don't know)
days in bed because of injury
Item
9 During the past two weeks, how many days have you stayed in bed all or most of the day because of illness or injury? Do not include past days in a hospital or nursing home?
integer
C0221423 (UMLS CUI [1,1])
C0004910 (UMLS CUI [1,2])
C0439228 (UMLS CUI [1,3])
Item
10 What illness caused you to stay in bed?
text
C0221423 (UMLS CUI [1,1])
C0425251 (UMLS CUI [1,2])
Code List
10 What illness caused you to stay in bed?
CL Item
heart attack/heart failure (heart attack/heart failure)
CL Item
diabetes (diabetes)
CL Item
arthritis (arthritis)
CL Item
mental illness (mental illness)
CL Item
cold or flu (cold or flu)
CL Item
general fatique or weakness (incl. old age) (general fatique or weakness (incl. old age))
CL Item
lung disease or emphysema, bronchitis (lung disease or emphysema, bronchitis)
CL Item
don't know (don't know)
myocardial infarction
Item
11a. Has a doctor told you that you had a new myocardial infarction or heart attack since we saw you about six month ago?
boolean
C0027051 (UMLS CUI [1])
date myocardial infarction
Item
b. Date of event or diagnosis
date
C0027051 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
myocardial infarction seen doctor
Item
c. How many times altogether did you see a doctor for this condition over the last six months, that is, since [month]?
integer
C0027051 (UMLS CUI [1,1])
C0583527 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
myocardial infarction hospitalization
Item
d. Were you in the hospital at least one night for this condition over the last six months?
text
C0019993 (UMLS CUI [1,1])
C0027051 (UMLS CUI [1,2])
myocardial infarction times hospitalized
Item
e. How many different times were you in the hospital for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0027051 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
number of days hospitalized for MI
Item
g. How many days altogether were you hospitalized for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0027051 (UMLS CUI [1,2])
C0449238 (UMLS CUI [1,3])
angina pectoris
Item
12a. Has a doctor told you that you had a new episode of angina pectoris or chest pain due to heart disease since we saw you about six month ago?
boolean
C0002962 (UMLS CUI [1])
date angina pectoris
Item
b. Date of event or diagnosis
date
C0002962 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
angina pectoris seen doctor
Item
c. How many times altogether did you see a doctor for this condition over the last six months, that is, since [month]?
integer
C0002962 (UMLS CUI [1,1])
C0583527 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
angina pectoris hospitalization
Item
d. Were you in the hospital at least one night for this condition over the last six months?
text
C0019993 (UMLS CUI [1,1])
C0002962 (UMLS CUI [1,2])
angina pectoris times hospitalized
Item
e. How many different times were you in the hospital for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0002962 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
number of days hospitalized for angina pectoris
Item
g. How many days altogether were you hospitalized for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0002962 (UMLS CUI [1,2])
C0449238 (UMLS CUI [1,3])
heart failure
Item
13a. Has a doctor told you that you had a new episode of heart failure or congestive heart failure since we saw you about six month ago?
boolean
C0018801 (UMLS CUI [1])
date heart failure
Item
b. Date of event or diagnosis
date
C0018801 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
heart failure seen doctor
Item
c. How many times altogether did you see a doctor for this condition over the last six months, that is, since [month]?
integer
C0018801 (UMLS CUI [1,1])
C0583527 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
heart failure hospitalization
Item
d. Were you in the hospital at least one night for this condition over the last six months?
text
C0019993 (UMLS CUI [1,1])
C0018801 (UMLS CUI [1,2])
heart failure times hospitalized
Item
e. How many different times were you in the hospital for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0018801 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
number of days hospitalized for heart failure
Item
g. How many days altogether were you hospitalized for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0018801 (UMLS CUI [1,2])
C0449238 (UMLS CUI [1,3])
intermittent claudication
Item
14a. Has a doctor told you that you had a new episode of intermittent claudication or leg pain from artery blockage since we saw you about six month ago?
boolean
C0021775 (UMLS CUI [1])
date intermittent claudication
Item
b. Date of event or diagnosis
date
C0021775 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
intermittent claudication seen doctor
Item
c. How many times altogether did you see a doctor for this condition over the last six months, that is, since [month]?
integer
C0021775 (UMLS CUI [1,1])
C0583527 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
intermittent claudication hospitalization
Item
d. Were you in the hospital at least one night for this condition over the last six months?
text
C0019993 (UMLS CUI [1,1])
C0021775 (UMLS CUI [1,2])
intermittent claudication times hospitalized
Item
e. How many different times were you in the hospital for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0021775 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
number of days hospitalized for intermittent claudication
Item
g. How many days altogether were you hospitalized for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0021775 (UMLS CUI [1,2])
C0449238 (UMLS CUI [1,3])
stroke
Item
15a. Has a doctor told you that you had a new stroke or cerebrovascular accident since we saw you about six month ago?
boolean
C0038454 (UMLS CUI [1])
date stroke
Item
b. Date of event or diagnosis
date
C0038454 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
stroke seen doctor
Item
c. How many times altogether did you see a doctor for this condition over the last six months, that is, since [month]?
integer
C0038454 (UMLS CUI [1,1])
C0583527 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
stroke hospitalization
Item
d. Were you in the hospital at least one night for this condition over the last six months?
text
C0019993 (UMLS CUI [1,1])
C0038454 (UMLS CUI [1,2])
stroke times hospitalized
Item
e. How many different times were you in the hospital for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0038454 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
number of days hospitalized for stroke
Item
f. How many days altogether were you hospitalized for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0038454 (UMLS CUI [1,2])
C0449238 (UMLS CUI [1,3])
TIA
Item
16a. Has a doctor told you that you had a new transient ischemic attack or TIA or silent stroke since we saw you about six month ago?
boolean
C0007787 (UMLS CUI [1])
date TIA
Item
b. Date of event or diagnosis
date
C0007787 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
TIA seen doctor
Item
c. How many times altogether did you see a doctor for this condition over the last six months, that is, since [month]?
integer
C0007787 (UMLS CUI [1,1])
C0583527 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
TIA hospitalization
Item
d. Were you in the hospital at least one night for this condition over the last six months?
text
C0019993 (UMLS CUI [1,1])
C0007787 (UMLS CUI [1,2])
TIA times hospitalized
Item
e. How many different times were you in the hospital for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0007787 (UMLS CUI [1,2])
C0439603 (UMLS CUI [1,3])
number of days hospitalized for TIA
Item
g. How many days altogether were you hospitalized for this condition?
integer
C0019993 (UMLS CUI [1,1])
C0007787 (UMLS CUI [1,2])
C0449238 (UMLS CUI [1,3])
times seen a doctor
Item
17 In addition to the visits to the doctor you have already told me about, how many times altogether have you seen a doctor because of your health since we saw you six month ago?
integer
C0583527 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
times seen a doctor
Item
18 In addition to the visits to the hospital you have already told me about, how many times altogether have you stayed overnight in a hospital since we saw you six month ago?
integer
C0019993 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
stay in nursing home or rehab center
Item
20 Have you stayed overnight as a patient in a nursing home or rehabilitation center since [month]?
boolean
C0019860 (UMLS CUI [1])
C0034993 (UMLS CUI [2])
Item
22 I am now going to ask you about a number of events that commonly happen in peoples's lives and tha can affect your health. In some cases, I will ask whether the event has happened to you or a member of your familiy during the past 6 months. In other cases, I will ask only whether it happened to you. When I ask a question about your spouse, I am referring to both married spouses and unmarried partners who live together. Please respond YES if the event happened and NO if it didn't. Have you retired or changed or lost your job since we saw you in [month]?
integer
C0035345 (UMLS CUI [1])
C0425083 (UMLS CUI [2])
Code List
22 I am now going to ask you about a number of events that commonly happen in peoples's lives and tha can affect your health. In some cases, I will ask whether the event has happened to you or a member of your familiy during the past 6 months. In other cases, I will ask only whether it happened to you. When I ask a question about your spouse, I am referring to both married spouses and unmarried partners who live together. Please respond YES if the event happened and NO if it didn't. Have you retired or changed or lost your job since we saw you in [month]?
Item
When did this happen?
text
Code List
When did this happen?
CL Item
during last month (during last month)
CL Item
not during the last month (not during the last month)
CL Item
don't know (don't know)
Item
Was this job change, loss or retirement positive or negative?
text
C1280500 (UMLS CUI [1,1])
C0035345 (UMLS CUI [1,2])
C1280500 (UMLS CUI [2,1])
C0425083 (UMLS CUI [2,2])
Code List
Was this job change, loss or retirement positive or negative?
CL Item
don't know (don't know)
Item
23 Have you had a grandchild born since we saw you in [month]?
integer
C0005615 (UMLS CUI [1,1])
C0337548 (UMLS CUI [1,2])
Code List
23 Have you had a grandchild born since we saw you in [month]?
Item
24 Has caring for a sick or disabled relative become a significant problem for you since we saw you in [month]?
integer
C0850427 (UMLS CUI [1])
Code List
24 Has caring for a sick or disabled relative become a significant problem for you since we saw you in [month]?
Item
Has providing care become significantly harder than last month?
integer
C0848945 (UMLS CUI [1,1])
C1457868 (UMLS CUI [1,2])
Code List
Has providing care become significantly harder than last month?
Item
25 Has there been a significant change in your personal finances since we saw you in [month]?
integer
C0680123 (UMLS CUI [1])
Code List
25 Has there been a significant change in your personal finances since we saw you in [month]?
Item
When did this happen?
text
C0680123 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Code List
When did this happen?
CL Item
during last month (during last month)
CL Item
not during the last month (not during the last month)
CL Item
don't know (don't know)
Item
Was this change positive or negative?
integer
C1280500 (UMLS CUI [1,1])
C0680123 (UMLS CUI [1,2])
Code List
Was this change positive or negative?
CL Item
don't know (don't know)
Item
26 Did you or a very close friend or close family member have a serious accident or illness since we saw you in [month]?
integer
C2169536 (UMLS CUI [1])
Code List
26 Did you or a very close friend or close family member have a serious accident or illness since we saw you in [month]?
Item
When did this accident or illness occur?
text
C2169536 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Code List
When did this accident or illness occur?
CL Item
during last month (during last month)
CL Item
not during the last month (not during the last month)
CL Item
don't know (don't know)
Item
27 Have you, your spouse or partner, or a member of your immediate family been assaulted or robbed since we saw you in [month]?
integer
C0004063 (UMLS CUI [1,1])
C0086282 (UMLS CUI [1,2])
C0680502 (UMLS CUI [2,1])
C0086282 (UMLS CUI [2,2])
Code List
27 Have you, your spouse or partner, or a member of your immediate family been assaulted or robbed since we saw you in [month]?
Item
When did this assault or robbery happen?
text
C0004063 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Code List
When did this assault or robbery happen?
CL Item
during last month (during last month)
CL Item
not during the last month (not during the last month)
CL Item
don't know (don't know)
Item
28 Have you had any important relationship, for example with your spouse or a good friend, become significantly worse since we saw you in [month]?
integer
C2045651 (UMLS CUI [1])
Code List
28 Have you had any important relationship, for example with your spouse or a good friend, become significantly worse since we saw you in [month]?
Item
When did this relationship worsen?
text
C2045651 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Code List
When did this relationship worsen?
CL Item
during last month (during last month)
CL Item
not during the last month (not during the last month)
CL Item
don't know (don't know)
Item
29 Did someone you were close to die since we saw you in [month]?
integer
C0814602 (UMLS CUI [1])
Code List
29 Did someone you were close to die since we saw you in [month]?
Item
When did this person die?
integer
C0814602 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Code List
When did this person die?
Item
30 Have any other important things happened to you or your spouse or partner since [month] that made this period significantly different from the previous six months?
integer
C0023670 (UMLS CUI [1])
Code List
30 Have any other important things happened to you or your spouse or partner since [month] that made this period significantly different from the previous six months?
significant event specify
Item
What happened?
text
C0023670 (UMLS CUI [1])
Item
Was it positive or negative?
text
C1280500 (UMLS CUI [1,1])
C0023670 (UMLS CUI [1,2])
Code List
Was it positive or negative?
CL Item
don't know (don't know)
Item
31 In the last six months, have you had any change in your ability to walk a half-mile (about 5-6 blocks)?
integer
C0559964 (UMLS CUI [1])
Code List
31 In the last six months, have you had any change in your ability to walk a half-mile (about 5-6 blocks)?
Item
In what way has your aility to walk changed?
text
C0559964 (UMLS CUI [1,1])
C0443172 (UMLS CUI [1,2])
Code List
In what way has your aility to walk changed?
CL Item
less difficulty walking (less difficulty walking)
CL Item
new onset of difficulty waking (new onset of difficulty waking )
CL Item
more difficulty walking (more difficulty walking)
CL Item
can no longer walk (can no longer walk)
Item
32 In the last six months, have you had any change in your ability to walk up 10 steps?
integer
C0560066 (UMLS CUI [1])
Code List
32 In the last six months, have you had any change in your ability to walk up 10 steps?
Item
In what way has your ability to walk up 10 steps changed?
text
C0560066 (UMLS CUI [1,1])
C0443172 (UMLS CUI [1,2])
Code List
In what way has your ability to walk up 10 steps changed?
CL Item
less difficulty (less difficulty)
CL Item
new onset of difficulty (new onset of difficulty)
CL Item
more difficulty (more difficulty)
Item
33 In the last six months, have you had any change in your ability to do heavy housework (like scrubbing floors or washing windows) or yard work (like raking leaves or mowing)?
integer
C0563673 (UMLS CUI [1])
Code List
33 In the last six months, have you had any change in your ability to do heavy housework (like scrubbing floors or washing windows) or yard work (like raking leaves or mowing)?
Item
In what way has your ability to do heavy housework or yard work changed?
text
C0563673 (UMLS CUI [1,1])
C0443172 (UMLS CUI [1,2])
Code List
In what way has your ability to do heavy housework or yard work changed?
CL Item
less difficulty (less difficulty)
CL Item
new onset of difficulty (new onset of difficulty)
CL Item
more difficulty (more difficulty)
Item
34 In the last six month, have you had any change in your ability to take care of your personal care needs, such as eating, bathing, dressing or getting around the home?
integer
C0846604 (UMLS CUI [1])
Code List
34 In the last six month, have you had any change in your ability to take care of your personal care needs, such as eating, bathing, dressing or getting around the home?
Item
In what way has your ability to handle your personal needs changed?
text
C0846604 (UMLS CUI [1,1])
C0443172 (UMLS CUI [1,2])
Code List
In what way has your ability to handle your personal needs changed?
CL Item
less difficulty (less difficulty)
CL Item
new onset of difficulty (new onset of difficulty)
CL Item
more difficulty (more difficulty)
Item
35 In the last six months, have you had any change in your ability to do tasks with your arms and hands, such as reaching out, gripping, lifting or carrying something as heavy as ten pounds (a bag of groceries)?
integer
C0565699 (UMLS CUI [1])
Code List
35 In the last six months, have you had any change in your ability to do tasks with your arms and hands, such as reaching out, gripping, lifting or carrying something as heavy as ten pounds (a bag of groceries)?
Item
In what way has your ability to do tasks with your arms and hands changed?
text
C0565699 (UMLS CUI [1,1])
C0443172 (UMLS CUI [1,2])
Code List
In what way has your ability to do tasks with your arms and hands changed?
CL Item
less difficulty (less difficulty)
CL Item
new onset of difficulty (new onset of difficulty)
CL Item
more difficulty (more difficulty)
Item
36 In the last six months, have you had a fall?
integer
C0085639 (UMLS CUI [1])
Code List
36 In the last six months, have you had a fall?
times fallen
Item
How many times have you fallen in the last six month?
integer
C0085639 (UMLS CUI [1,1])
C0439603 (UMLS CUI [1,2])
information still correct
Item
37 You previously provided us with information about someone who could provide information and answer questions for you in the event that you were unable to answer yourself. Please tell me if the information I have is still correct.
boolean
information still correct
Item
38 You previously provided us with information about friends or relatives who you are likely to keep in touch with, but who do not live with you, and who are not planning to move anytime soon. Please tell me if the information I have is still correct.
boolean
plan to go out of the area
Item
39 Do you plan to be out of the area 6 months from now?
boolean
Item
Are you moving out of the area permanently or will you only be gone temporarily?
text
Code List
Are you moving out of the area permanently or will you only be gone temporarily?
CL Item
permanently (permanently)
CL Item
temporarily out of the area (vacation, business, etc.) (temporarily out of the area (vacation, business, etc.))
new address known
Item
Do you know what your new address and telephone number will be?
boolean
new address street
Item
Street:
text
C1301826 (UMLS CUI [1])
new address city
Item
City
text
C0008848 (UMLS CUI [1])
new address state
Item
State
text
C1442792 (UMLS CUI [1])
new telephone number
Item
Telephone number
text
C1515258 (UMLS CUI [1])
general area
Item
Do you know which general area you will be moving to?
text
time of return
Item
When will you return?
text
C0579192 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
time end of interview
Item
40 Time interview ended:
time
C0021822 (UMLS CUI [1])
Item
41 May I please speak with [name]?
text
Code List
41 May I please speak with [name]?
date time interview another participant
Item
Can you tell me when I should call [participant] to make the interview?
datetime
Item
If by proxy, reason:
text
C0021823 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
C0600420 (UMLS CUI [1,3])
Code List
If by proxy, reason:
CL Item
hearing (hearing)
CL Item
cognitive (cognitive)
CL Item
hospitalized (hospitalized)
CL Item
other illness (other illness)
interview completed by proxy reason other
Item
Other, specify:
text
C0021823 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
C0600420 (UMLS CUI [1,3])
Item
Interview completed by:
text
C0021822 (UMLS CUI [1,1])
C0805732 (UMLS CUI [1,2])
Code List
Interview completed by:
CL Item
participant (participant)