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Start of E. Cognition
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E1A How would you evaluate your memory nowadays? Would you say it is...
HOW WOULD YOU EVALUATE YOUR MEMORY NOWADAYS? WOULD YOU SAY IT IS...
1 Excellent
2 Very good
3 Good
4 Fair
5 Poor
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E1B Compared to the last two years, would you say your memory is?
COMPARED TO THE LAST TWO YEARS, WOULD YOU SAY YOUR MEMORY IS?
1 Better
2 More less the same
3 Worse
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E2 Do you need glasses to read or see objects on a page?
DO YOU NEED GLASSES TO READ OR SEE OBJECTS ON A PAGE?
1 Yes
2 No
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If Do you need glasses to read or see objects on a page? = 1 Yes »
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E3A Interviewer: Find out if the respondent wear glasses to see close objects and ask that he/she wears them. If he/she doesn't have glasses or they aren't available, offer a pair of glasses. Indicate if the person can see close objects with the glasses.
INTERVIEWER: FIND OUT IF THE RESPONDENT WEAR GLASSES TO SEE CLOSE OBJECTS AND ASK THAT HE/SHE WEARS THEM. IF HE/SHE DOESN'T HAVE GLASSES OR THEY AREN'T AVAILABLE, OFFER A PAIR OF GLASSES. INDICATE IF THE PERSON CAN SEE CLOSE OBJECTS WITH THE GLASSES.
1 Yes
2 No
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E3B Next we will present words to exercise your reading. Please read the text out loud.
NEXT WE WILL PRESENT WORDS TO EXERCISE YOUR READING. PLEASE READ THE TEXT OUT LOUD.
1 Read it perfectly
2 Refused to read
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E4 Do you have problems using a pencil?
DO YOU HAVE PROBLEMS USING A PENCIL?
1 Yes
2 No
8 NR
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If Do you have problems using a pencil? = 1 Yes »
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E5 What kind of difficulties do you have?
WHAT KIND OF DIFFICULTIES DO YOU HAVE?
1 Paralysis, or no hands or fingers
2 Other difficulties - The respondent tried but could not hold the pencil
3 The respondent refused to hold the pencil
4 The respondent can hold the pencil
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E6 Spontaneous Memory
SPONTANEOUS MEMORY
1 List A
2 List B
3 List C
8 RF
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If Spontaneous Memory != 8 RF »
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E7A Clearly read the words, one every two seconds, do not repeat words after reading the list. Circle the mentioned words by the informant in test 1. I am going to read a list of words. Listen carefully. When I have finished, you must repeat all the words you can. The order does not matter.
CLEARLY READ THE WORDS, ONE EVERY TWO SECONDS, DO NOT REPEAT WORDS AFTER READING THE LIST. CIRCLE THE MENTIONED WORDS BY THE INFORMANT IN TEST 1. I AM GOING TO READ A LIST OF WORDS. LISTEN CAREFULLY. WHEN I HAVE FINISHED, YOU MUST REPEAT ALL THE WORDS YOU CAN. THE ORDER DOES NOT MATTER.
______ List A
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E7B After the informant has stopped responding, wait for 15 second and read the list of test 2. Follow the same procedure as test 1 I am going to read the same list again. Once more, when I have stopped, tell me all the words you can, including the ones you said before.
AFTER THE INFORMANT HAS STOPPED RESPONDING, WAIT FOR 15 SECOND AND READ THE LIST OF TEST 2. FOLLOW THE SAME PROCEDURE AS TEST 1 I AM GOING TO READ THE SAME LIST AGAIN. ONCE MORE, WHEN I HAVE STOPPED, TELL ME ALL THE WORDS YOU CAN, INCLUDING THE ONES YOU SAID BEFORE.
______ List B
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E7C After the informant has stopped responding, wait for 15 second and read the list of test 3. Follow the same procedure as test 1 I am going to read the same list again. Once more, when I have stopped, tell me all the words you can, including the ones you said before.
AFTER THE INFORMANT HAS STOPPED RESPONDING, WAIT FOR 15 SECOND AND READ THE LIST OF TEST 3. FOLLOW THE SAME PROCEDURE AS TEST 1 I AM GOING TO READ THE SAME LIST AGAIN. ONCE MORE, WHEN I HAVE STOPPED, TELL ME ALL THE WORDS YOU CAN, INCLUDING THE ONES YOU SAID BEFORE.
______ List C
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If Interviewer: Find out if the respondent wear glasses to see close objects and ask that he/she wears them. If he/she doesn't have glasses or they aren't available, offer a pair of glasses. Indicate if the person can see close objects with the glasses. != 2 No and Do you have problems using a pencil? != 8 NR and What kind of difficulties do you have? = 4 The respondent can hold the pencil »
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E8 Replication of drawing-1
REPLICATION OF DRAWING-1
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E9 I am going to ask you to name all the animals you can, you have one minute to complete the task. INTERVIEWER, WHEN THE INFORMANT SAYS THE FIRST WORD, START THE TIMER AND WRITE DOWN ALL THE NAMES OF ANIMALS EVEN IF THE INFORMANT REPEATS THEM. TWO SCORES ARE VALID: A) THE NUMBER OF DIFFERENT ANIMALS WITHOUT REPEATING THEM AND B) NUMBER OF REPEATED ANIMALS
I AM GOING TO ASK YOU TO NAME ALL THE ANIMALS YOU CAN, YOU HAVE ONE MINUTE TO COMPLETE THE TASK. INTERVIEWER, WHEN THE INFORMANT SAYS THE FIRST WORD, START THE TIMER AND WRITE DOWN ALL THE NAMES OF ANIMALS EVEN IF THE INFORMANT REPEATS THEM. TWO SCORES ARE VALID: A) THE NUMBER OF DIFFERENT ANIMALS WITHOUT REPEATING THEM AND B) NUMBER OF REPEATED ANIMALS
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If Interviewer: Find out if the respondent wear glasses to see close objects and ask that he/she wears them. If he/she doesn't have glasses or they aren't available, offer a pair of glasses. Indicate if the person can see close objects with the glasses. != 2 No and Do you have problems using a pencil? != 8 NR and What kind of difficulties do you have? = 4 The respondent can hold the pencil »
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E10 Show the test page horizontally oriented to the informant, in order to have the little point on top of the page, show this page with the designed object E, and instruct to the informant: Please find out the figures that look like this one, in the following page. Find as many figures as you can, and circle around the figure as I am doing it (with a pencil circle an example in the middle of the page). Just circle the figures that are the same as this one. Work as fast as you can, until I say to stop. Start to count the time when the informant circles the first figure, and stop in 60 seconds.
SHOW THE TEST PAGE HORIZONTALLY ORIENTED TO THE INFORMANT, IN ORDER TO HAVE THE LITTLE POINT ON TOP OF THE PAGE, SHOW THIS PAGE WITH THE DESIGNED OBJECT E, AND INSTRUCT TO THE INFORMANT: PLEASE FIND OUT THE FIGURES THAT LOOK LIKE THIS ONE, IN THE FOLLOWING PAGE. FIND AS MANY FIGURES AS YOU CAN, AND CIRCLE AROUND THE FIGURE AS I AM DOING IT (WITH A PENCIL CIRCLE AN EXAMPLE IN THE MIDDLE OF THE PAGE). JUST CIRCLE THE FIGURES THAT ARE THE SAME AS THIS ONE. WORK AS FAST AS YOU CAN, UNTIL I SAY TO STOP. START TO COUNT THE TIME WHEN THE INFORMANT CIRCLES THE FIRST FIGURE, AND STOP IN 60 SECONDS.
______ Seconds

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E11 Orientation: Can you please tell me what is today's date?
ORIENTATION: CAN YOU PLEASE TELL ME WHAT IS TODAY'S DATE?
______ Day
______ Month
______ Year
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E12 In the following exercise, please count from 20 to 0. Do it as fast as possible. I am going to count the time and I will tell you when you can stop.
IN THE FOLLOWING EXERCISE, PLEASE COUNT FROM 20 TO 0. DO IT AS FAST AS POSSIBLE. I AM GOING TO COUNT THE TIME AND I WILL TELL YOU WHEN YOU CAN STOP.
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E12A Start the stopwatch when the informant says the first number and stop it when gets to 11, if the first spoken number was 20; or when it gets to 10, if the first spoken number was 19. Mark "correct" if the informant does not have any mistake when counting from 20 to 11 or from 19 to 10. Allow the informant starts again one more time if stops or makes a mistake and wants to start again. Tell him/her that can try again. Mark "wants to start again" if the informant wants to start again.
START THE STOPWATCH WHEN THE INFORMANT SAYS THE FIRST NUMBER AND STOP IT WHEN GETS TO 11, IF THE FIRST SPOKEN NUMBER WAS 20; OR WHEN IT GETS TO 10, IF THE FIRST SPOKEN NUMBER WAS 19. MARK "CORRECT" IF THE INFORMANT DOES NOT HAVE ANY MISTAKE WHEN COUNTING FROM 20 TO 11 OR FROM 19 TO 10. ALLOW THE INFORMANT STARTS AGAIN ONE MORE TIME IF STOPS OR MAKES A MISTAKE AND WANTS TO START AGAIN. TELL HIM/HER THAT CAN TRY AGAIN. MARK "WANTS TO START AGAIN" IF THE INFORMANT WANTS TO START AGAIN.
1 Correct
2 Incorrect
3 Wants to start again
8 RF

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If Start the stopwatch when the informant says the first number and stop it when gets to 11, if the first spoken number was 20; or when it gets to 10, if the first spoken number was 19. Mark "correct" if the informant does not have any mistake when counting from 20 to 11 or from 19 to 10. Allow the informant starts again one more time if stops or makes a mistake and wants to start again. Tell him/her that can try again. Mark "wants to start again" if the informant wants to start again. = 3 Wants to start again or Start the stopwatch when the informant says the first number and stop it when gets to 11, if the first spoken number was 20; or when it gets to 10, if the first spoken number was 19. Mark "correct" if the informant does not have any mistake when counting from 20 to 11 or from 19 to 10. Allow the informant starts again one more time if stops or makes a mistake and wants to start again. Tell him/her that can try again. Mark "wants to start again" if the informant wants to start again. = 8 RF »
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E12B Lets try again. Follow the same instructions as the first attempt
LETS TRY AGAIN. FOLLOW THE SAME INSTRUCTIONS AS THE FIRST ATTEMPT
1 Correct
2 Incorrect
8 RF
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If Lets try again. Follow the same instructions as the first attempt != 8 »
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E12C Note the number of seconds to get to 10 if subject counts from 19 to 10, or to 11 if subject counts from 20 to 11. Note 60 if took the full minute without getting to 10 (if counts from 19 to 10) or to 11 (if counts from 20 to 11) or if the result of both attempts are incorrect.
NOTE THE NUMBER OF SECONDS TO GET TO 10 IF SUBJECT COUNTS FROM 19 TO 10, OR TO 11 IF SUBJECT COUNTS FROM 20 TO 11. NOTE 60 IF TOOK THE FULL MINUTE WITHOUT GETTING TO 10 (IF COUNTS FROM 19 TO 10) OR TO 11 (IF COUNTS FROM 20 TO 11) OR IF THE RESULT OF BOTH ATTEMPTS ARE INCORRECT.
______ Seconds
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ElseIf Start the stopwatch when the informant says the first number and stop it when gets to 11, if the first spoken number was 20; or when it gets to 10, if the first spoken number was 19. Mark "correct" if the informant does not have any mistake when counting from 20 to 11 or from 19 to 10. Allow the informant starts again one more time if stops or makes a mistake and wants to start again. Tell him/her that can try again. Mark "wants to start again" if the informant wants to start again. = 1 Correct or Start the stopwatch when the informant says the first number and stop it when gets to 11, if the first spoken number was 20; or when it gets to 10, if the first spoken number was 19. Mark "correct" if the informant does not have any mistake when counting from 20 to 11 or from 19 to 10. Allow the informant starts again one more time if stops or makes a mistake and wants to start again. Tell him/her that can try again. Mark "wants to start again" if the informant wants to start again. = 2 Incorrect »
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E12C Note the number of seconds to get to 10 if subject counts from 19 to 10, or to 11 if subject counts from 20 to 11. Note 60 if took the full minute without getting to 10 (if counts from 19 to 10) or to 11 (if counts from 20 to 11) or if the result of both attempts are incorrect.
NOTE THE NUMBER OF SECONDS TO GET TO 10 IF SUBJECT COUNTS FROM 19 TO 10, OR TO 11 IF SUBJECT COUNTS FROM 20 TO 11. NOTE 60 IF TOOK THE FULL MINUTE WITHOUT GETTING TO 10 (IF COUNTS FROM 19 TO 10) OR TO 11 (IF COUNTS FROM 20 TO 11) OR IF THE RESULT OF BOTH ATTEMPTS ARE INCORRECT.
______ Seconds
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If Interviewer: Find out if the respondent wear glasses to see close objects and ask that he/she wears them. If he/she doesn't have glasses or they aren't available, offer a pair of glasses. Indicate if the person can see close objects with the glasses. != 2 No and Do you have problems using a pencil? != 8 NR and What kind of difficulties do you have? = 4 The respondent can hold the pencil »
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E13 Show the next blank page to the informant, vertically oriented and instruct: Please remember the figure that you drew before. Draw it again in this paper. Suggest to the informant that he/she can guess or give a partial answer if he/she seems to be unsure. If the informant draws the design from the visual route, tell the informant: Please draw the other figure that you drew before. Allow just one and a half minute (90 seconds) to draw the figure.
SHOW THE NEXT BLANK PAGE TO THE INFORMANT, VERTICALLY ORIENTED AND INSTRUCT: PLEASE REMEMBER THE FIGURE THAT YOU DREW BEFORE. DRAW IT AGAIN IN THIS PAPER. SUGGEST TO THE INFORMANT THAT HE/SHE CAN GUESS OR GIVE A PARTIAL ANSWER IF HE/SHE SEEMS TO BE UNSURE. IF THE INFORMANT DRAWS THE DESIGN FROM THE VISUAL ROUTE, TELL THE INFORMANT: PLEASE DRAW THE OTHER FIGURE THAT YOU DREW BEFORE. ALLOW JUST ONE AND A HALF MINUTE (90 SECONDS) TO DRAW THE FIGURE.
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E14 Do you remember the long list of words that I read before? Please tell me all the words of the list that you can remember, in whatever order. Mark the ones that the informant says.
DO YOU REMEMBER THE LONG LIST OF WORDS THAT I READ BEFORE? PLEASE TELL ME ALL THE WORDS OF THE LIST THAT YOU CAN REMEMBER, IN WHATEVER ORDER. MARK THE ONES THAT THE INFORMANT SAYS.
______ List B Total
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E15 Successive Subtraction
SUCCESSIVE SUBTRACTION
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E15A What is 100-7?
WHAT IS 100-7?
______ Answer
88 RF
99 DK
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If What is 100-7? != 88 and What is 100-7? != 99 »
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E15B With anwer from previous question, continue to have respondent subtract by 7 and speak the number.
WITH ANWER FROM PREVIOUS QUESTION, CONTINUE TO HAVE RESPONDENT SUBTRACT BY 7 AND SPEAK THE NUMBER.
______ Answer
88 RF
99 DK
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If With anwer from previous question, continue to have respondent subtract by 7 and speak the number. != 88 and With anwer from previous question, continue to have respondent subtract by 7 and speak the number. != 99 »
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E15C Third Subtraction
THIRD SUBTRACTION
______ Answer
88 RF
99 DK
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If Third Subtraction != 88 and Third Subtraction != 99 »
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E15D Fourth Subtraction
FOURTH SUBTRACTION
______ Answer
88 RF
99 DK
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If Fourth Subtraction != 88 RF and Fourth Subtraction != 99 DK »
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E15E Fifth Subtraction
FIFTH SUBTRACTION
______Answer
88 RF
99 DK
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End of E. Cognition
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