I. Physical Measures

Module I. Physical Measures of HRS 2018

item label type description
I600 Question Before we begin, I’d like to have you read and sign a form explaining your rights as a participant in this part of the study.
I802 Question Did R sign the physical measures consent form?
I954 Question Why didn't R sign the physical measures consent form? (Enter all that apply)
I955 Question What other reason?
I601 Question Equipment needed: Omron BP 760N Monitor, Batteries or AC Adapter, Health Assessment Pamphlet
I602 Question BLOOD PRESSURE MEASUREMENT Demonstration: Use your left arm to demonstrate First, I will place the cuff on your left arm approximately one half inch above the elbow.
I662 Question Do you have a rash, a cast, edema (swelling) in the arm, open sores or wounds, or a significant bruise where the blood pressure cuff will be in contact on your left arm?
I663 Question Do you have a rash, a cast, edema (swelling) in the arm, open sores or wounds, or a significant bruise where the blood pressure cuff will be in contact on your right arm?
I961 Question Do you understand these directions and feel it would be safe for you to do this measurement?
I603 Question BLOOD PRESSURE MEASUREMENT
I857 Question BLOOD PRESSURE MEASUREMENT
I859 Question BLOOD PRESSURE MEASUREMENT
I860 Question BLOOD PRESSURE MEASUREMENT
I861 Question BLOOD PRESSURE MEASUREMENT
I604 Question BLOOD PRESSURE MEASUREMENT Enter [1] to continue upon completion of countdown.
I862 Question BLOOD PRESSURE MEASUREMENT
I864 Question BLOOD PRESSURE MEASUREMENT
I865 Question BLOOD PRESSURE MEASUREMENT
I866 Question BLOOD PRESSURE MEASUREMENT
I605 Question BLOOD PRESSURE MEASUREMENT Enter [1] to continue upon completion of countdown.
I867 Question BLOOD PRESSURE MEASUREMENT Third Reading – TIME of reading
I869 Question BLOOD PRESSURE MEASUREMENT
I870 Question BLOOD PRESSURE MEASUREMENT
I871 Question BLOOD PRESSURE MEASUREMENT
I668 Question Do you feel well enough to continue the interview or would you like to stop and continue at a later date?
I963 Question Record the respondent’s measurements on the inside cover of the Health Assessment Pamphlet.
I854 Question BLOOD PRESSURE MEASUREMENT
I872 Question BLOOD PRESSURE MEASUREMENT
I874 Question BLOOD PRESSURE MEASUREMENT
I669 Question Please suspend the interview at this time.
I855 Question I855_BPWhyNotComplete BLOOD PRESSURE MEASUREMENT Why didn’t R complete the blood pressure measurement? (Enter all that apply)
I856 Question BLOOD PRESSURE MEASUREMENT What other reason?
I670 Question Equipment needed: HearCheck Device, Disposable Ear Cup We would like to conduct a brief hearing test.
I678 Question LEFT EAR – TEST 1, 1000 Hz
I672 Question Do you have a cochlear implant?
I673 Question Do you have an ear infection in either ear at the moment?
I946 Question [In Section C, the respondent reported that they may sometimes wear a hearing aid.] If necessary: Are you currently wearing a hearing aid in one or both ears?
I674 Question Would you be willing to remove your hearing aid(s) for the purposes of this test?
I675 Question Do you understand these directions and feel it would be safe for you to do this measurement?
I676 Question HrLInstruct1
I947 Question We will begin the test on your left ear. I will say “Ready, begin” and you will listen for the tones played by the device, raising your finger when you hear a sound. Please let me know at any point if you feel uncomfortable.
I677 Question LEFT EAR –TESTS 1 AND 2 [F1 – Help]
I679 Question LEFT EAR – TEST 2, 3000 Hz
I948 Question RIGHT EAR – TESTS 1 AND 2 [F1 – Help]
I680 Question RIGHT EAR – TEST 1, 1000 Hz
I681 Question RIGHT EAR – TEST 2, 3000 Hz
I682 Question Did R complete at least one of the four hearing tests?
I683 Question Which of the following occurred during the hearing test? Select all that apply
I684 Question Hearing Test
I685 Question Why didn’t R complete the hearing tests? (Enter all that apply)
I686 Question Hearing Test
I606 Question Equipment needed: Peak flow meter, Disposable mouthpiece packaged in plastic bag
I607 Question Demonstration
I964 Question Do you understand these directions and feel it would be safe for you to do this measurement?
I608 Question BREATHING TEST
I807 Question BREATHING TEST
I609 Question BREATHING TEST
I808 Question BREATHING TEST
I610 Question BREATHING TEST
I809 Question BREATHING TEST
I804 Question BREATHING TEST
I805 Question BREATHING TEST
I806 Question BREATHING TEST
I810 Question BREATHING TEST
I811 Question BREATHING TEST
I612 Question Now I would like to assess the strength of your hand in a gripping action.
I611 Question I will ask you to squeeze this handle as hard as you can, just for a couple of seconds and then let go. I will take alternately two measurements from your right and your left hands.
I966 Question Before we begin, I’d like to make sure it is safe for you to do this measurement. Have you experienced any severe swelling, inflammation, pain, or injury in one or both hands within the last month or had surgery on your hands or wrists in the last 6 month
I967 Question In which hand (have you experienced severe swelling, inflammation, pain or injury in the last month or had surgery in the last six months)?
I968 Question Do you understand these directions and feel it would be safe for you to do this measurement?
I815 Question Which is your dominant hand?
I613 Question We can practice with your [right/left] hand Squeeze the handle as hard as you can for a couple of seconds then let go.
I816 Question HAND STRENGTH TEST
I851 Question HAND STRENGTH TEST
I852 Question HAND STRENGTH TEST
I853 Question HAND STRENGTH TEST
I813 Question HAND STRENGTH TEST
I814 Question HAND STRENGTH TEST
I812 Question HAND STRENGTH TEST
I817 Question HAND STRENGTH TEST
I818 Question HAND STRENGTH TEST
I819 Question HAND STRENGTH TEST
I614 Question Equipment needed: Stopwatch, Show Card
I615 Question Demonstrate the semi-tandem balance test
I970 Question Before we begin, do you have any problems from recent surgery, injury or other health conditions that might prevent you from standing up from a chair and balancing?
I616 Question Would the respondent like to proceed with this balance measurement?
I971 Question Do you understand these directions and feel it would be safe for you to do this measurement?
I617 Question BALANCE TEST – SEMI-TANDEM STAND
I618 Question BALANCE TEST – SEMI-TANDEM STAND
I879 Question BALANCE TEST – SEMI-TANDEM STAND
I876 Question BALANCE TEST – SEMI-TANDEM STAND
I880 Question BALANCE TEST – SEMI-TANDEM STAND Record time in seconds to two decimal places
I881 Question BALANCE TEST – SEMI-TANDEM STAND
I877 Question BALANCE TEST – SEMI-TANDEM STAND
I878 Question BALANCE TEST – SEMI-TANDEM STAND
I620 Question Equipment needed: Stopwatch, Show Card
I973 Question Do you understand these directions and feel it would be safe for you to do this measurement?
I621 Question BALANCE TEST – SIDE-BY-SIDE STAND
I622 Question BALANCE TEST – SIDE-BY-SIDE STAND
I886 Question BALANCE TEST – SIDE-BY-SIDE STAND
I883 Question BALANCE TEST – SIDE-BY-SIDE STAND
I887 Question BALANCE TEST – SIDE-BY-SIDE STAND
I888 Question BALANCE TEST – SIDE-BY-SIDE STAND
I884 Question BALANCE TEST – SIDE-BY-SIDE STAND
I885 Question BALANCE TEST – SIDE-BY-SIDE STAND
I619 Question Equipment needed: Stopwatch, Show Card
I975 Question Do you understand these directions and feel it would be safe for you to do this measurement?
I623 Question BALANCE TEST – FULL TANDEM STAND
I624 Question BALANCE TEST – FULL TANDEM STAND
I896 Question BALANCE TEST – FULL TANDEM STAND
I893 Question BALANCE TEST – FULL TANDEM STAND
I897 Question BALANCE TEST – FULL TANDEM STAND
I898 Question BALANCE TEST – FULL TANDEM STAND
I894 Question BALANCE TEST – FULL TANDEM STAND
I895 Question BALANCE TEST – FULL TANDEM STAND
I977 Question Equipment Needed: Tape measure, Stopwatch, Masking Tape, Administration Booklet
I625 Question Press [1] to play demonstration video.
I626 Question I will set up a short course with masking tape. I will then ask you to walk the course at your normal pace. We will conduct this measurement once in each direction.
I978 Question Do you understand these directions and feel it would be safe for you to do this measurement?
I627 Question Now let’s find a place where we can conduct the measurement. We will need a clear space about 12 feet long in a non-carpeted area, if possible.
I628 Question Once the measurement has been completed, press [1] to continue.
I823 Question Time from first trial
I824 Question WALKING SPEED TEST
I820 Question WALKING SPEED TEST
I828 Question WALKING SPEED TEST
I829 Question WALKING SPEED TEST
I660 Question WALKING SPEED TEST
I661 Question WALKING SPEED TEST
I821 Question WALKING SPEED TEST
I822 Question WALKING SPEED TEST
I630 Question HWW_Preface
I631 Question On the next screen is an image demonstrating how this measurement will be conducted. Please turn your screen/laptop so the respondent is able to see this image.
I629 Question Height Measurement Demonstration
I632 Question Then I would like to measure your weight. To measure your weight, I will ask you to stand on a scale, with your shoes off, while I read the display.
I633 Question On the next screen is an image demonstrating how this measurement will be conducted. Please turn your screen/laptop so the respondent is able to see this image.
I635 Question Waist Measurement
I687 Question Do you understand these directions and feel it would be safe for you to do the height[, weight] and waist-circumference measurements?
I637 Question Once all data and observations have been recorded in the booklet, please set it aside. You will be prompted to enter the data at the end of the Physical Measures and Biomarkers section.
I638 Question The next measure involves collecting a saliva sample. This simply involves depositing a small amount of saliva into a collection container. Before we begin, I would like to have you read and sign this consent form.
I913 Question SALIVA SAMPLE
I941 Question SALIVA SAMPLE
I942 Question SALIVA SAMPLE
I667 Question SALIVA SAMPLE
I987 Question Do you understand these directions and feel it would be safe for you to do this measurement?
I914 Question SALIVA SAMPLE
I640 Question SALIVA SAMPLE
I644 Question SALIVA SAMPLE
I933 Question SALIVA BARCODE ID ENTRY
I641 Question SALIVA BARCODE ID MANUAL ENTRY
I642 Question SALIVA BARCODE ID MANUAL ENTRY
I643 Question SALIVA BARCODE ID MANUAL ENTRY
I645 Question SALIVA COLLECTION
I639 Question SALIVA COLLECTION
I646 Question SALIVA SAMPLE
I647 Question SALIVA SAMPLE
I918 Question SALIVA SAMPLE
I915 Question SALIVA SAMPLE
I919 Question SALIVA SAMPLE
I920 Question SALIVA SAMPLE
I916 Question SALIVA SAMPLE
I917 Question SALIVA SAMPLE
I658 Question Thank you for your cooperation. This concludes the physical measures and biomarkers portion.
I659 Question HEIGHT/WEIGHT/WAIST DATA ENTRY After recording Height, Weight (if eligible) and Waist measurements and observations in the administration booklet, you will now be prompted to enter these data.
I831 Question HEIGHT MEASUREMENT
I834 Question HEIGHT MEASUREMENT
I837 Question HEIGHT MEASUREMENT
I832 Question HEIGHT MEASUREMENT
I833 Question HEIGHT MEASUREMENT
I838 Question HEIGHT MEASUREMENT
I841 Question HEIGHT MEASUREMENT
I842 Question HEIGHT MEASUREMENT
I843 Question WEIGHT MEASUREMENT
I666 Question WEIGHT MEASUREMENT
I844 Question WEIGHT MEASUREMENT
I839 Question WEIGHT MEASUREMENT
I840 Question WEIGHT MEASUREMENT
I904 Question WAIST CIRCUMFERENCE
I907 Question WAIST CIRCUMFERENCE
I908 Question WAIST CIRCUMFERENCE
I909 Question WAIST CIRCUMFERENCE
I911 Question WAIST CIRCUMFERENCE
I912 Question WAIST CIRCUMFERENCE
I905 Question WAIST CIRCUMFERENCE
I906 Question WAIST CIRCUMFERENCE
I845 Question Enter [1] to continue with the interview.
I936 Question PhysMeasBio_CompletionFlag
I800 Question ENTER CURRENT MODE OF INTERVIEW
Start of I. Physical Measures
 
I800

ENTER CURRENT MODE OF INTERVIEW

ENTER CURRENT MODE OF INTERVIEW
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If OX090_R = ENHANCEDFTF »
 
   
 
If ENTER CURRENT MODE OF INTERVIEW = 2. FACE-TO-FACE and OA028 = NO and LANGUAGE = SPANISH or ENGLISH »
 
     
   
I802

Did R sign the physical measures consent form?

DID R SIGN THE PHYSICAL MEASURES CONSENT FORM?
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If Did R sign the physical measures consent form? = 1. Yes……………Go to I601 »
 
       
     
I854

BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
DID R COMPLETE AT LEAST ONE BLOOD PRESSURE MEASUREMENT?
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If BLOOD PRESSURE MEASUREMENT = 5. NO »
 
         
       
I855

I855_BPWhyNotComplete BLOOD PRESSURE MEASUREMENT Why didn’t R complete the blood pressure measurement? (Enter all that apply)

I855_BPWHYNOTCOMPLETE
BLOOD PRESSURE MEASUREMENT
WHY DIDN’T R COMPLETE THE BLOOD PRESSURE MEASUREMENT? (ENTER ALL THAT APPLY)
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ElseIf BLOOD PRESSURE MEASUREMENT = 1. YES »
 
         
       
I857

BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
♦ INSTRUCT THE R TO REMAIN STILL.
♦ PRESS THE START/STOP BUTTON AND RECORD MEASUREMENTS
         
       
I859

BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
FIRST READING – SYSTOLIC
♦ ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT OR IF AN UNRESOLVABLE EQUIPMENT PROBLEM OCCURS.
♦ ENTER 999 IF R CHOSE NOT TO DO IT.
         
       
If BLOOD PRESSURE MEASUREMENT != 9993 and BLOOD PRESSURE MEASUREMENT != 999 »
 
           
         
I860

BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
FIRST READING – DIASTOLIC
           
         
I861

BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
FIRST READING – PULSE
           
         
I862

BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
ENSURE THAT YOU’VE ALLOWED 45 SECONDS TO ELAPSE SINCE FIRST MEASUREMENT.
SECOND READING – TIME OF READING
           
         
I864

BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
SECOND READING – SYSTOLIC
♦ ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT OR IF AN UNRESOLVABLE EQUIPMENT PROBLEM OCCURS.
♦ ENTER 999 IF R CHOSE NOT TO DO IT.
           
         
If BLOOD PRESSURE MEASUREMENT != 9993 and BLOOD PRESSURE MEASUREMENT != 999 »
 
             
           
I865

BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
SECOND READING – DIASTOLIC
             
           
I866

BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE
SECOND READING – PULSE
             
           
I867

BLOOD PRESSURE MEASUREMENT Third Reading – TIME of reading

BLOOD PRESSURE MEASUREMENT
THIRD READING – TIME OF READING
             
           
I869

BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
THIRD READING – SYSTOLIC
♦ ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT OR IF AN UNRESOLVABLE EQUIPMENT PROBLEM OCCURS.
♦ ENTER 999 IF R CHOSE NOT TO DO IT.
             
           
If BLOOD PRESSURE MEASUREMENT != 9993 and BLOOD PRESSURE MEASUREMENT != 999 »
 
               
             
I870

BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
THIRD READING – DIASTOLIC
               
             
I871

BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
THIRD READING –PULSE
               
         
I872

BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
WHICH ARM WAS USED TO CONDUCT THE MEASUREMENTS?
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I874

BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
WHAT WAS R’S POSITION FOR THIS TEST?
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I804

BREATHING TEST

BREATHING TEST
DID R COMPLETE AT LEAST ONE TRIAL OF THE BREATHING TEST?
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If BREATHING TEST != 1. YES »
 
         
       
I805

BREATHING TEST

BREATHING TEST
WHY DIDN’T R COMPLETE THE BREATHING TEST? (ENTER ALL THAT APPLY)
expand
         
     
If BREATHING TEST = 1. YES »
 
         
       
I807

BREATHING TEST

BREATHING TEST
MEASUREMENT
FIRST READING - RECORD TO THE NEAREST 10 L/MIN
ENTER 30 IF READING IS LESS THAN 60.
ENTER 890 IF READING IS PAST LAST TICK MARK.
ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT.
ENTER 999 IF R CHOSE NOT TO DO IT.
         
       
I808

BREATHING TEST

BREATHING TEST
MEASUREMENT
SECOND READING - RECORD TO THE NEAREST 10 L/MIN
ENTER 30 IF READING IS LESS THAN 60.
ENTER 890 IF READING IS PAST LAST TICK MARK.
ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT.
ENTER 999 IF R CHOSE NOT TO DO IT.
         
       
I809

BREATHING TEST

BREATHING TEST
MEASUREMENT
THIRD READING - RECORD TO THE NEAREST 10 L/MIN
ENTER 30 IF READING IS LESS THAN 60.
ENTER 890 IF READING IS PAST LAST TICK MARK.
ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT.
ENTER 999 IF R CHOSE NOT TO DO IT.
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I810

BREATHING TEST

BREATHING TEST
HOW MUCH EFFORT DID R GIVE TO THIS TEST?
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I811

BREATHING TEST

BREATHING TEST
WHAT WAS R’S POSITION FOR THIS TEST?
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I812

HAND STRENGTH TEST

[INTRODUCTION]---[DEMONSTRATION]---[SAFETY]---[SETUP]---[MEASURE]---[OBSERVATIONS (2 OF 5]
[INTRO]---[DEMO]---[SFTY]---[STP]---[MSR]---[OBSERVATIONS (2 OF 5)]
[I]---[D]---[E]---[S]---[MEASURE (4 OF 4)]---[OBSERVATIONS (2 OF 5)]
DID R COMPLETE AT LEAST ONE TRIAL OF THE HAND STRENGTH TEST?
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If HAND STRENGTH TEST != 1. YES »
 
         
       
I813

HAND STRENGTH TEST

[INTRODUCTION]---[DEMONSTRATION]---[SAFETY]---[SETUP]---[MEASURE]---[OBSERVATIONS (1 OF 5]
[INTRO]---[DEMO]---[SFTY]---[STP]---[MSR]---[OBSERVATIONS (1 OF 5)]
[I]---[D]---[E]---[S]---[MEASURE (4 OF 4)]---[OBSERVATIONS (1 OF 5)]
WHY DIDN’T R COMPLETE THE HAND STRENGTH TEST? (ENTER ALL THAT APPLY)
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Else If HAND STRENGTH TEST = 1. YES »
 
         
       
I815

Which is your dominant hand?

WHICH IS YOUR DOMINANT HAND?
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I816

HAND STRENGTH TEST

HAND STRENGTH TEST
[INTRODUCTION]---[DEMONSTRATION]---[SAFETY]---[SETUP]---[MEASURE (1 OF X)]---[OBSERVATIONS]
[INTRO]---[DEMO]---[SFTY]---[STP]---[MEASURE (1 OF X)]---[OBS]
[I]---[D]---[E]---[S]---[MEASURE (1 OF X)]---[O]
REMEMBER: RESET THE GAUGE BETWEEN MEASURES.
LEFT HAND, FIRST MEASURE:
ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.
ENTER 993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT
ENTER 999 IF R CHOSE NOT TO DO IT
         
       
I851

HAND STRENGTH TEST

[INTRODUCTION]---[DEMONSTRATION]---[SAFETY]---[SETUP]---[MEASURE (2 OF X)]---[OBSERVATIONS]
[INTRO]---[DEMO]---[SFTY]---[STP]---[MEASURE (2 OF X)]---[OBS]
[I]---[D]---[E]---[S]---[MEASURE (2 OF X)]---[O]
REMEMBER: RESET THE GAUGE BETWEEN MEASURES.
RIGHT HAND, FIRST MEASURE:
ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.
ENTER 993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT
ENTER 999 IF R CHOSE NOT TO DO IT
         
       
I852

HAND STRENGTH TEST

[INTRODUCTION]---[DEMONSTRATION]---[SAFETY]---[SETUP]---[MEASURE (3 OF 4)]---[OBSERVATIONS]
[INTRO]---[DEMO]---[SFTY]---[STP]---[MEASURE (3 OF 4)]---[OBS]
[I]---[D]---[E]---[S]---[MEASURE (3 OF 4)]---[O]
REMEMBER: RESET THE GAUGE BETWEEN MEASURES.
LEFT HAND, SECOND MEASURE:
ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.
ENTER 993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT
ENTER 999 IF R CHOSE NOT TO DO IT
         
       
I853

HAND STRENGTH TEST

[INTRODUCTION]---[DEMONSTRATION]---[SAFETY]---[SETUP]---[MEASURE (4 OF 4)]---[OBSERVATIONS]
[INTRO]---[DEMO]---[SFTY]---[STP]---[MEASURE (4 OF 4)]---[OBS]
[I]---[D]---[E]---[S]---[MEASURE (4 OF 4)]---[O]
REMEMBER: RESET THE GAUGE BETWEEN MEASURES.
RIGHT HAND, SECOND MEASURE:
ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.
ENTER 993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT
ENTER 999 IF R CHOSE NOT TO DO IT
         
       
I817

HAND STRENGTH TEST

[INTRODUCTION]---[DEMONSTRATION]---[SAFETY]---[SETUP]---[MEASURE]---[OBSERVATIONS (3 OF 5]
[INTRO]---[DEMO]---[SFTY]---[STP]---[MSR]---[OBSERVATIONS (3 OF 5)]
[I]---[D]---[E]---[S]---[MEASURE (4 OF 4)]---[OBSERVATIONS (3 OF 5)]
HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
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I818

HAND STRENGTH TEST

WHAT WAS THE R’S POSITION FOR THIS TEST?
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I819

HAND STRENGTH TEST

DID THE R REST THEIR ARM ON A SUPPORT WHILE PERFORMING THIS TEST?
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I876

BALANCE TEST – SEMI-TANDEM STAND

DID R ATTEMPT TO COMPLETE THE SEMI-TANDEM STAND?
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If BALANCE TEST – SEMI-TANDEM STAND != 1. Yes »
 
         
       
I877

BALANCE TEST – SEMI-TANDEM STAND

WHY DIDN’T R ATTEMPT TO COMPLETE THE SEMI-TANDEM STAND? (ENTER ALL THAT APPLY)
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ElseIf BALANCE TEST – SEMI-TANDEM STAND = 1. Yes »
 
         
       
I879

BALANCE TEST – SEMI-TANDEM STAND

DID R HOLD SEMI-TANDEM STAND FOR FULL 10 SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?
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If BALANCE TEST – SEMI-TANDEM STAND = 1. Yes »
 
           
         
I880

BALANCE TEST – SEMI-TANDEM STAND Record time in seconds to two decimal places

BALANCE TEST – SEMI-TANDEM STAND
RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
           
       
If BALANCE TEST – SEMI-TANDEM STAND != 999 and BALANCE TEST – SEMI-TANDEM STAND != 993 »
 
           
         
I881

BALANCE TEST – SEMI-TANDEM STAND

DID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING SEMI-TANDEM STAND?
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If BALANCE TEST – SEMI-TANDEM STAND = 5. No or BALANCE TEST – SEMI-TANDEM STAND != 1. Yes »
 
         
       
I883

BALANCE TEST – SIDE-BY-SIDE STAND

DID R ATTEMPT TO COMPLETE THE SIDE-BY-SIDE STAND?
expand
         
       
If BALANCE TEST – SIDE-BY-SIDE STAND != 1. Yes  »
 
           
         
I884

BALANCE TEST – SIDE-BY-SIDE STAND

WHY DIDN’T R ATTEMPT TO COMPLETE THE SIDE-BY-SIDE STAND? (ENTER ALL THAT APPLY)
expand
           
       
ElseIf BALANCE TEST – SIDE-BY-SIDE STAND = 1. Yes  »
 
           
         
I886

BALANCE TEST – SIDE-BY-SIDE STAND

DID R HOLD SIDE-BY-SIDE STAND FOR FULL 10 SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?
expand
           
         
If BALANCE TEST – SIDE-BY-SIDE STAND = 1. Yes  »
 
             
           
I887

BALANCE TEST – SIDE-BY-SIDE STAND

RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
             
         
If BALANCE TEST – SIDE-BY-SIDE STAND != 993 and BALANCE TEST – SIDE-BY-SIDE STAND != 999 »
 
             
           
I888

BALANCE TEST – SIDE-BY-SIDE STAND

DID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING SIDE-BY-SIDE STAND?
expand
             
     
Else
 
         
       
I893

BALANCE TEST – FULL TANDEM STAND

DID R ATTEMPT TO COMPLETE THE FULL TANDEM STAND?
expand
         
       
If BALANCE TEST – FULL TANDEM STAND != 1. Yes »
 
           
         
I894

BALANCE TEST – FULL TANDEM STAND

WHY DIDN’T R ATTEMPT TO COMPLETE THE FULL -TANDEM STAND? (ENTER ALL THAT APPLY)
expand
           
       
Else
 
           
         
I896

BALANCE TEST – FULL TANDEM STAND

DID R HOLD FULL TANDEM STAND FOR FULL [30/60] SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?
expand
           
         
If BALANCE TEST – FULL TANDEM STAND = 1. Yes and OA019 > 70 »
 
             
           
I897

BALANCE TEST – FULL TANDEM STAND

RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
             
         
If BALANCE TEST – FULL TANDEM STAND != 993 and BALANCE TEST – FULL TANDEM STAND != 999 »
 
             
           
I898

BALANCE TEST – FULL TANDEM STAND

DID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING FULL TANDEM STAND?
expand
             
     
If OA019 > 64 »
 
         
       
I820

WALKING SPEED TEST

DID R COMPLETE AT LEAST ONE TRIAL OF THE WALKING TEST?
expand
         
       
If WALKING SPEED TEST != 1. YES »
 
           
         
I821

WALKING SPEED TEST

WHY DIDN’T R COMPLETE THE WALKING TEST
expand
           
       
Else
 
           
         
I823

Time from first trial

WALKING SPEED TEST
TIME FROM FIRST TRIAL
RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT.
ENTER 999 IF R CHOSE NOT TO DO IT.
           
         
If Time from first trial != 993 and Time from first trial != 999 »
 
             
           
I824

WALKING SPEED TEST

TIME FROM SECOND TRIAL
RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT.
ENTER 999 IF R CHOSE NOT TO DO IT.
             
           
I828

WALKING SPEED TEST

WHAT TYPE OF AID WAS USED?
expand
             
     
I831

HEIGHT MEASUREMENT

WERE YOU ABLE TO MEASURE R’S HEIGHT?
expand
       
     
If HEIGHT MEASUREMENT != 1. Yes »
 
         
       
I832

HEIGHT MEASUREMENT

WHY WEREN’T YOU ABLE TO MEASURE R’S HEIGHT? (ENTER ALL THAT APPLY)
expand
         
     
Else
 
         
       
I834

HEIGHT MEASUREMENT

ENTER RESPONDENT'S HEIGHT IN INCHES. ROUND TO THE NEAREST QUARTER INCH.
         
       
I837

HEIGHT MEASUREMENT

WAS R WEARING SHOES DURING MEASUREMENT?
expand
         
     
If OC139 < 300 »
 
         
       
I838

HEIGHT MEASUREMENT

WERE YOU ABLE TO MEASURE R’S WEIGHT?
expand
         
       
If HEIGHT MEASUREMENT != 1. Yes »
 
           
         
I839

WEIGHT MEASUREMENT

WHY WEREN’T YOU ABLE TO MEASURE R’S WEIGHT? (ENTER ALL THAT APPLY)
expand
           
       
Else
 
           
         
I841

HEIGHT MEASUREMENT

ENTER RESPONDENT'S WEIGHT IN POUNDS AS RECORDED ON SCALE (TO THE NEAREST 0.5 POUND).
♦ ENTER [993] IF R TRIED BUT RECEIVED AN ERROR MESSAGE
♦ ENTER [999] IF R CHOSE NOT TO DO IT
           
         
I842

HEIGHT MEASUREMENT

RECORD TYPE OF FLOOR SURFACE
IF YOU USED THE SUPPORT TILE, PLEASE RECORD THE SURFACE ON WHICH THE TILE WAS PLACED.
expand
           
         
I844

WEIGHT MEASUREMENT

WAS R WEARING SHOES DURING MEASUREMENT?
expand
           
     
I904

WAIST CIRCUMFERENCE

WERE YOU ABLE TO MEASURE R’S WAIST CIRCUMFERENCE?
expand
       
     
If WAIST CIRCUMFERENCE != 1. Yes »
 
         
       
I905

WAIST CIRCUMFERENCE

WHY WEREN’T YOU ABLE TO MEASURE R’S WAIST? (ENTER ALL THAT APPLY)
expand
         
     
Else
 
         
       
I907

WAIST CIRCUMFERENCE

ENTER RESPONDENT'S WAIST MEASUREMENT TO THE NEAREST QUARTER INCH.
♦ ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT
♦ ENTER [999] IF R CHOSE NOT TO DO IT
         
       
If WAIST CIRCUMFERENCE != 993 and WAIST CIRCUMFERENCE != 999 »
 
           
         
I908

WAIST CIRCUMFERENCE

WHAT DIFFICULTIES OCCURRED DURING THIS MEASUREMENT?
expand
           
         
I911

WAIST CIRCUMFERENCE

WHO COMPLETED THE MEASUREMENT?
expand
           
         
I912

WAIST CIRCUMFERENCE

WAS R WEARING BULKY CLOTHING DURING THIS MEASUREMENT?
expand
           
   
I913

SALIVA SAMPLE

SALIVA SAMPLE
DID R SIGN THE SALIVA CONSENT FORM?
IF NO, PLEASE RETURN TO THE PREVIOUS QUESTION BY SELECTING [CTRL] + [UP] AND RE-LAUNCH THE CONSENT FORM.
expand
     
   
If SALIVA SAMPLE = 5. No »
 
       
     
I941

SALIVA SAMPLE

WHY DIDN'T R SIGN THE SALIVA CONSENT FORM? (ENTER ALL THAT APPLY)
expand
       
   
Else
 
       
     
I915

SALIVA SAMPLE

DID R ATTEMPT TO COMPLETE THE SALIVA SAMPLE?
expand
       
     
If SALIVA SAMPLE != 1. Yes »
 
         
       
I916

SALIVA SAMPLE

WHY DIDN’T R COMPLETE THE SALIVA SAMPLE? (ENTER ALL THAT APPLY)
expand
         
     
Else
 
         
       
I918

SALIVA SAMPLE

DID R FILL THE VIAL TO THE DESIRED LEVEL?
expand
         
       
I919

SALIVA SAMPLE

WHAT, IF ANY, PROBLEMS OCCURRED? (ENTER ALL THAT APPLY)
expand
         
End of I. Physical Measures
Start of I. Physical Measures

========================================================================
I800
ENTER CURRENT MODE OF INTERVIEW

ENTER CURRENT MODE OF INTERVIEW
- - - - - - - - - - - - - - - - - - - - - - - - -
1. TELEPHONE
2. FACE-TO-FACE

If OX090_R = ENHANCEDFTF »

If ENTER CURRENT MODE OF INTERVIEW (I800) = 2. FACE-TO-FACE and OA028 = NO and LANGUAGE = SPANISH or ENGLISH »

| |  ========================================================================
| | 
I802
Did R sign the physical measures consent form?

DID R SIGN THE PHYSICAL MEASURES CONSENT FORM?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes……………Go to I601
5. No

| |  If Did R sign the physical measures consent form? (I802) = 1. Yes……………Go to I601 »

| | |  ========================================================================
| | | 
I854
BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
DID R COMPLETE AT LEAST ONE BLOOD PRESSURE MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. YES
5. NO

| | |  If BLOOD PRESSURE MEASUREMENT (I854) = 5. NO »

| | | |  ========================================================================
| | | | 
I855
I855_BPWhyNotComplete BLOOD PRESSURE MEASUREMENT Why didn’t R complete the blood pressure measurement? (Enter all that apply)

I855_BPWHYNOTCOMPLETE
BLOOD PRESSURE MEASUREMENT
WHY DIDN’T R COMPLETE THE BLOOD PRESSURE MEASUREMENT? (ENTER ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe…………-> Go to I606
2. IWER felt it would not be safe…………-> Go to I606
3. R refused or was not willing to complete the test…………-> Go to I606
4. R tried but was unable to complete test…………-> Go to I606
5. R did not understand the instructions…………-> Go to I606
6. R had a rash, a cast, edema, open sores or wounds, or significant bruise where the blood cuff would contact R’s arm…………-> Go to I606
7. No suitable space…………-> Go to I606
8. Problem with equipment or supplies…………-> Go to I606
97. Other (specify)

| | |  ElseIf BLOOD PRESSURE MEASUREMENT (I854) = 1. YES »

| | | |  ========================================================================
| | | | 
I857
BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
♦ INSTRUCT THE R TO REMAIN STILL.
♦ PRESS THE START/STOP BUTTON AND RECORD MEASUREMENTS

| | | |  ========================================================================
| | | | 
I859
BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
FIRST READING – SYSTOLIC
♦ ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT OR IF AN UNRESOLVABLE EQUIPMENT PROBLEM OCCURS.
♦ ENTER 999 IF R CHOSE NOT TO DO IT.

| | | |  If BLOOD PRESSURE MEASUREMENT (I859) != 9993 and BLOOD PRESSURE MEASUREMENT (I859) != 999 »

| | | | |  ========================================================================
| | | | | 
I860
BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
FIRST READING – DIASTOLIC

| | | | |  ========================================================================
| | | | | 
I861
BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
FIRST READING – PULSE

| | | | |  ========================================================================
| | | | | 
I862
BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
ENSURE THAT YOU’VE ALLOWED 45 SECONDS TO ELAPSE SINCE FIRST MEASUREMENT.
SECOND READING – TIME OF READING

| | | | |  ========================================================================
| | | | | 
I864
BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
SECOND READING – SYSTOLIC
♦ ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT OR IF AN UNRESOLVABLE EQUIPMENT PROBLEM OCCURS.
♦ ENTER 999 IF R CHOSE NOT TO DO IT.

| | | | |  If BLOOD PRESSURE MEASUREMENT (I864) != 9993 and BLOOD PRESSURE MEASUREMENT (I864) != 999 »

| | | | | |  ========================================================================
| | | | | | 
I865
BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
SECOND READING – DIASTOLIC

| | | | | |  ========================================================================
| | | | | | 
I866
BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE
SECOND READING – PULSE

| | | | | |  ========================================================================
| | | | | | 
I867
BLOOD PRESSURE MEASUREMENT Third Reading – TIME of reading

BLOOD PRESSURE MEASUREMENT
THIRD READING – TIME OF READING

| | | | | |  ========================================================================
| | | | | | 
I869
BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
THIRD READING – SYSTOLIC
♦ ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT OR IF AN UNRESOLVABLE EQUIPMENT PROBLEM OCCURS.
♦ ENTER 999 IF R CHOSE NOT TO DO IT.

| | | | | |  If BLOOD PRESSURE MEASUREMENT (I869) != 9993 and BLOOD PRESSURE MEASUREMENT (I869) != 999 »

| | | | | | |  ========================================================================
| | | | | | | 
I870
BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
THIRD READING – DIASTOLIC

| | | | | | |  ========================================================================
| | | | | | | 
I871
BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
THIRD READING –PULSE

| | | | |  ========================================================================
| | | | | 
I872
BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
WHICH ARM WAS USED TO CONDUCT THE MEASUREMENTS?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Left arm
2. Right arm

| | | | |  ========================================================================
| | | | | 
I874
BLOOD PRESSURE MEASUREMENT

BLOOD PRESSURE MEASUREMENT
WHAT WAS R’S POSITION FOR THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Standing
2. Sitting
3. Lying down

| | |  ========================================================================
| | | 
I804
BREATHING TEST

BREATHING TEST
DID R COMPLETE AT LEAST ONE TRIAL OF THE BREATHING TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. YES
5. NO

| | |  If BREATHING TEST (I804) != 1. YES »

| | | |  ========================================================================
| | | | 
I805
BREATHING TEST

BREATHING TEST
WHY DIDN’T R COMPLETE THE BREATHING TEST? (ENTER ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe…………→ Go to I612
2. IWER felt it would not be safe…………→ Go to I612
3. R refused or was not willing to complete the test…………→ Go to I612
4. R tried but was unable to complete test…………→ Go to I612
5. R did not understand the instructions………→ Go to I612
97. Other (specify)

| | |  If BREATHING TEST (I804) = 1. YES »

| | | |  ========================================================================
| | | | 
I807
BREATHING TEST

BREATHING TEST
MEASUREMENT
FIRST READING - RECORD TO THE NEAREST 10 L/MIN
ENTER 30 IF READING IS LESS THAN 60.
ENTER 890 IF READING IS PAST LAST TICK MARK.
ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT.
ENTER 999 IF R CHOSE NOT TO DO IT.

| | | |  ========================================================================
| | | | 
I808
BREATHING TEST

BREATHING TEST
MEASUREMENT
SECOND READING - RECORD TO THE NEAREST 10 L/MIN
ENTER 30 IF READING IS LESS THAN 60.
ENTER 890 IF READING IS PAST LAST TICK MARK.
ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT.
ENTER 999 IF R CHOSE NOT TO DO IT.

| | | |  ========================================================================
| | | | 
I809
BREATHING TEST

BREATHING TEST
MEASUREMENT
THIRD READING - RECORD TO THE NEAREST 10 L/MIN
ENTER 30 IF READING IS LESS THAN 60.
ENTER 890 IF READING IS PAST LAST TICK MARK.
ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT.
ENTER 999 IF R CHOSE NOT TO DO IT.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Continue

| | | |  ========================================================================
| | | | 
I810
BREATHING TEST

BREATHING TEST
HOW MUCH EFFORT DID R GIVE TO THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R gave full effort
2. R was prevented from giving full effort by illness, pain, or other symptoms or discomforts
3. R did not appear to give full effort, but no obvious reason for this

| | | |  ========================================================================
| | | | 
I811
BREATHING TEST

BREATHING TEST
WHAT WAS R’S POSITION FOR THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Standing
2. Sitting
3. Lying down

| | |  ========================================================================
| | | 
I812
HAND STRENGTH TEST

[INTRODUCTION]---[DEMONSTRATION]---[SAFETY]---[SETUP]---[MEASURE]---[OBSERVATIONS (2 OF 5]
[INTRO]---[DEMO]---[SFTY]---[STP]---[MSR]---[OBSERVATIONS (2 OF 5)]
[I]---[D]---[E]---[S]---[MEASURE (4 OF 4)]---[OBSERVATIONS (2 OF 5)]
DID R COMPLETE AT LEAST ONE TRIAL OF THE HAND STRENGTH TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. YES
5. NO

| | |  If HAND STRENGTH TEST (I812) != 1. YES »

| | | |  ========================================================================
| | | | 
I813
HAND STRENGTH TEST

[INTRODUCTION]---[DEMONSTRATION]---[SAFETY]---[SETUP]---[MEASURE]---[OBSERVATIONS (1 OF 5]
[INTRO]---[DEMO]---[SFTY]---[STP]---[MSR]---[OBSERVATIONS (1 OF 5)]
[I]---[D]---[E]---[S]---[MEASURE (4 OF 4)]---[OBSERVATIONS (1 OF 5)]
WHY DIDN’T R COMPLETE THE HAND STRENGTH TEST? (ENTER ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe………Go to I614
2. IWER felt it would not be safe………Go to I614
3. R refused or was not willing to complete the test………Go to I614
4. R tried but was unable to complete test………Go to I614
5. R did not understand the instructions………Go to I614
6. R had surgery, injury, swelling, etc. on both hands………Go to I614
97. Other (specify)

| | |  Else If HAND STRENGTH TEST (I812) = 1. YES »

| | | |  ========================================================================
| | | | 
I815
Which is your dominant hand?

WHICH IS YOUR DOMINANT HAND?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Right hand
2. Left hand
3. Both hands equally dominant

| | | |  ========================================================================
| | | | 
I816
HAND STRENGTH TEST

HAND STRENGTH TEST
[INTRODUCTION]---[DEMONSTRATION]---[SAFETY]---[SETUP]---[MEASURE (1 OF X)]---[OBSERVATIONS]
[INTRO]---[DEMO]---[SFTY]---[STP]---[MEASURE (1 OF X)]---[OBS]
[I]---[D]---[E]---[S]---[MEASURE (1 OF X)]---[O]
REMEMBER: RESET THE GAUGE BETWEEN MEASURES.
LEFT HAND, FIRST MEASURE:
ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.
ENTER 993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT
ENTER 999 IF R CHOSE NOT TO DO IT

| | | |  ========================================================================
| | | | 
I851
HAND STRENGTH TEST

[INTRODUCTION]---[DEMONSTRATION]---[SAFETY]---[SETUP]---[MEASURE (2 OF X)]---[OBSERVATIONS]
[INTRO]---[DEMO]---[SFTY]---[STP]---[MEASURE (2 OF X)]---[OBS]
[I]---[D]---[E]---[S]---[MEASURE (2 OF X)]---[O]
REMEMBER: RESET THE GAUGE BETWEEN MEASURES.
RIGHT HAND, FIRST MEASURE:
ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.
ENTER 993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT
ENTER 999 IF R CHOSE NOT TO DO IT

| | | |  ========================================================================
| | | | 
I852
HAND STRENGTH TEST

[INTRODUCTION]---[DEMONSTRATION]---[SAFETY]---[SETUP]---[MEASURE (3 OF 4)]---[OBSERVATIONS]
[INTRO]---[DEMO]---[SFTY]---[STP]---[MEASURE (3 OF 4)]---[OBS]
[I]---[D]---[E]---[S]---[MEASURE (3 OF 4)]---[O]
REMEMBER: RESET THE GAUGE BETWEEN MEASURES.
LEFT HAND, SECOND MEASURE:
ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.
ENTER 993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT
ENTER 999 IF R CHOSE NOT TO DO IT

| | | |  ========================================================================
| | | | 
I853
HAND STRENGTH TEST

[INTRODUCTION]---[DEMONSTRATION]---[SAFETY]---[SETUP]---[MEASURE (4 OF 4)]---[OBSERVATIONS]
[INTRO]---[DEMO]---[SFTY]---[STP]---[MEASURE (4 OF 4)]---[OBS]
[I]---[D]---[E]---[S]---[MEASURE (4 OF 4)]---[O]
REMEMBER: RESET THE GAUGE BETWEEN MEASURES.
RIGHT HAND, SECOND MEASURE:
ENTER THE RESULT TO THE NEAREST 0.5 KILOGRAM.
ENTER 993 IF R WAS UNABLE TO PERFORM THIS MEASUREMENT
ENTER 999 IF R CHOSE NOT TO DO IT

| | | |  ========================================================================
| | | | 
I817
HAND STRENGTH TEST

[INTRODUCTION]---[DEMONSTRATION]---[SAFETY]---[SETUP]---[MEASURE]---[OBSERVATIONS (3 OF 5]
[INTRO]---[DEMO]---[SFTY]---[STP]---[MSR]---[OBSERVATIONS (3 OF 5)]
[I]---[D]---[E]---[S]---[MEASURE (4 OF 4)]---[OBSERVATIONS (3 OF 5)]
HOW MUCH EFFORT DID THE R GIVE TO THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R gave full effort
2. R was prevented from giving full effort by illness, pain, or other symptoms or discomforts
3. R did not appear to give full effort, but no obvious reason for this

| | | |  ========================================================================
| | | | 
I818
HAND STRENGTH TEST

WHAT WAS THE R’S POSITION FOR THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Standing
2. Sitting
3. Lying down

| | | |  ========================================================================
| | | | 
I819
HAND STRENGTH TEST

DID THE R REST THEIR ARM ON A SUPPORT WHILE PERFORMING THIS TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Both hands
2. Left hand only
3. Right hand only
5. No

| | |  ========================================================================
| | | 
I876
BALANCE TEST – SEMI-TANDEM STAND

DID R ATTEMPT TO COMPLETE THE SEMI-TANDEM STAND?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| | |  If BALANCE TEST – SEMI-TANDEM STAND (I876) != 1. Yes »

| | | |  ========================================================================
| | | | 
I877
BALANCE TEST – SEMI-TANDEM STAND

WHY DIDN’T R ATTEMPT TO COMPLETE THE SEMI-TANDEM STAND? (ENTER ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe……… Go to I620
2. IWER felt it would not be safe……… Go to I620
3. R refused or was not willing to complete the test……… Go to I620
5. R did not understand the instructions……… Go to I620
6. R had surgery, injury, or other health condition that prevented R from standing……… Go to I620
97. Other (specify

| | |  ElseIf BALANCE TEST – SEMI-TANDEM STAND (I876) = 1. Yes »

| | | |  ========================================================================
| | | | 
I879
BALANCE TEST – SEMI-TANDEM STAND

DID R HOLD SEMI-TANDEM STAND FOR FULL 10 SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| | | |  If BALANCE TEST – SEMI-TANDEM STAND (I879) = 1. Yes »

| | | | |  ========================================================================
| | | | | 
I880
BALANCE TEST – SEMI-TANDEM STAND Record time in seconds to two decimal places

BALANCE TEST – SEMI-TANDEM STAND
RECORD TIME IN SECONDS TO TWO DECIMAL PLACES

| | | |  If BALANCE TEST – SEMI-TANDEM STAND (I879) != 999 and BALANCE TEST – SEMI-TANDEM STAND (I879) != 993 »

| | | | |  ========================================================================
| | | | | 
I881
BALANCE TEST – SEMI-TANDEM STAND

DID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING SEMI-TANDEM STAND?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
8. DK

| | |  If BALANCE TEST – SEMI-TANDEM STAND (I876) = 5. No or BALANCE TEST – SEMI-TANDEM STAND (I879) != 1. Yes »

| | | |  ========================================================================
| | | | 
I883
BALANCE TEST – SIDE-BY-SIDE STAND

DID R ATTEMPT TO COMPLETE THE SIDE-BY-SIDE STAND?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| | | |  If BALANCE TEST – SIDE-BY-SIDE STAND (I883) != 1. Yes  »

| | | | |  ========================================================================
| | | | | 
I884
BALANCE TEST – SIDE-BY-SIDE STAND

WHY DIDN’T R ATTEMPT TO COMPLETE THE SIDE-BY-SIDE STAND? (ENTER ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe
2. IWER felt it would not be safe
3. R refused or was not willing to complete the test
5. R did not understand the instructions
6. R had surgery, injury, or other health condition that prevented R from standing
97. Other (specify)

| | | |  ElseIf BALANCE TEST – SIDE-BY-SIDE STAND (I883) = 1. Yes  »

| | | | |  ========================================================================
| | | | | 
I886
BALANCE TEST – SIDE-BY-SIDE STAND

DID R HOLD SIDE-BY-SIDE STAND FOR FULL 10 SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| | | | |  If BALANCE TEST – SIDE-BY-SIDE STAND (I886) = 1. Yes  »

| | | | | |  ========================================================================
| | | | | | 
I887
BALANCE TEST – SIDE-BY-SIDE STAND

RECORD TIME IN SECONDS TO TWO DECIMAL PLACES

| | | | |  If BALANCE TEST – SIDE-BY-SIDE STAND (I886) != 993 and BALANCE TEST – SIDE-BY-SIDE STAND (I886) != 999 »

| | | | | |  ========================================================================
| | | | | | 
I888
BALANCE TEST – SIDE-BY-SIDE STAND

DID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING SIDE-BY-SIDE STAND?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
8. DK

| | |  Else

| | | |  ========================================================================
| | | | 
I893
BALANCE TEST – FULL TANDEM STAND

DID R ATTEMPT TO COMPLETE THE FULL TANDEM STAND?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| | | |  If BALANCE TEST – FULL TANDEM STAND (I893) != 1. Yes »

| | | | |  ========================================================================
| | | | | 
I894
BALANCE TEST – FULL TANDEM STAND

WHY DIDN’T R ATTEMPT TO COMPLETE THE FULL -TANDEM STAND? (ENTER ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe
2. IWER felt it would not be safe
3. R refused or was not willing to complete the test
5. R did not understand the instructions
6. R had surgery, injury, or other health condition that prevented R from standing
97. Other (specify)

| | | |  Else

| | | | |  ========================================================================
| | | | | 
I896
BALANCE TEST – FULL TANDEM STAND

DID R HOLD FULL TANDEM STAND FOR FULL [30/60] SECONDS WITHOUT STEPPING OUT OF PLACE OR GRABBING HOLD OF ANYTHING?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| | | | |  If BALANCE TEST – FULL TANDEM STAND (I896) = 1. Yes and OA019 > 70 »

| | | | | |  ========================================================================
| | | | | | 
I897
BALANCE TEST – FULL TANDEM STAND

RECORD TIME IN SECONDS TO TWO DECIMAL PLACES

| | | | |  If BALANCE TEST – FULL TANDEM STAND (I896) != 993 and BALANCE TEST – FULL TANDEM STAND (I896) != 999 »

| | | | | |  ========================================================================
| | | | | | 
I898
BALANCE TEST – FULL TANDEM STAND

DID R USE ANY COMPENSATORY MOVEMENTS OF HIS/HER TRUNK, ARMS OR LEGS TO STEADY HIM/HERSELF DURING FULL TANDEM STAND?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No
8. DK

| | |  If OA019 > 64 »

| | | |  ========================================================================
| | | | 
I820
WALKING SPEED TEST

DID R COMPLETE AT LEAST ONE TRIAL OF THE WALKING TEST?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. YES
5. NO

| | | |  If WALKING SPEED TEST (I820) != 1. YES »

| | | | |  ========================================================================
| | | | | 
I821
WALKING SPEED TEST

WHY DIDN’T R COMPLETE THE WALKING TEST
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe……… Go to I630
2. IWER felt it would not be safe……… Go to I630
3. R refused or was not willing to complete the test……… Go to I630
4. R tried but was unable to complete test……… Go to I630
5. R did not understand the instructions……… Go to I630
6. R had surgery, injury, or other health condition that prevented R from walking……… Go to I630
7. No suitable space available……… Go to I630
97. Other (specify)

| | | |  Else

| | | | |  ========================================================================
| | | | | 
I823
Time from first trial

WALKING SPEED TEST
TIME FROM FIRST TRIAL
RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT.
ENTER 999 IF R CHOSE NOT TO DO IT.

| | | | |  If Time from first trial (I823) != 993 and Time from first trial (I823) != 999 »

| | | | | |  ========================================================================
| | | | | | 
I824
WALKING SPEED TEST

TIME FROM SECOND TRIAL
RECORD TIME IN SECONDS TO TWO DECIMAL PLACES
ENTER 993 IF R TRIED BUT WAS UNABLE TO DO IT.
ENTER 999 IF R CHOSE NOT TO DO IT.

| | | | | |  ========================================================================
| | | | | | 
I828
WALKING SPEED TEST

WHAT TYPE OF AID WAS USED?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. None
2. Walking stick or cane
3. Elbow crutches
4. Walking frame
7. Other (specify

| | |  ========================================================================
| | | 
I831
HEIGHT MEASUREMENT

WERE YOU ABLE TO MEASURE R’S HEIGHT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| | |  If HEIGHT MEASUREMENT (I831) != 1. Yes »

| | | |  ========================================================================
| | | | 
I832
HEIGHT MEASUREMENT

WHY WEREN’T YOU ABLE TO MEASURE R’S HEIGHT? (ENTER ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe
2. IWER felt it would not be safe
3. R refused or was not willing to complete the measurement
4. R tried but was unable to complete the measurement
5. R did not understand the instructions
6. Respondent too tall, interviewer could not reach
7. No suitable space available
97. Other (specify)

| | |  Else

| | | |  ========================================================================
| | | | 
I834
HEIGHT MEASUREMENT

ENTER RESPONDENT'S HEIGHT IN INCHES. ROUND TO THE NEAREST QUARTER INCH.

| | | |  ========================================================================
| | | | 
I837
HEIGHT MEASUREMENT

WAS R WEARING SHOES DURING MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| | |  If OC139 < 300 »

| | | |  ========================================================================
| | | | 
I838
HEIGHT MEASUREMENT

WERE YOU ABLE TO MEASURE R’S WEIGHT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| | | |  If HEIGHT MEASUREMENT (I838) != 1. Yes »

| | | | |  ========================================================================
| | | | | 
I839
WEIGHT MEASUREMENT

WHY WEREN’T YOU ABLE TO MEASURE R’S WEIGHT? (ENTER ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe
2. IWER felt it would not be safe
3. R refused or was not willing to complete the measurement
4. R tried but was unable to complete the measurement
5. R did not understand the instructions
6. Respondent was too heavy; did not attempt
7. No suitable space available
8. Scale did not work
97. Other (specify)

| | | |  Else

| | | | |  ========================================================================
| | | | | 
I841
HEIGHT MEASUREMENT

ENTER RESPONDENT'S WEIGHT IN POUNDS AS RECORDED ON SCALE (TO THE NEAREST 0.5 POUND).
♦ ENTER [993] IF R TRIED BUT RECEIVED AN ERROR MESSAGE
♦ ENTER [999] IF R CHOSE NOT TO DO IT

| | | | |  ========================================================================
| | | | | 
I842
HEIGHT MEASUREMENT

RECORD TYPE OF FLOOR SURFACE
IF YOU USED THE SUPPORT TILE, PLEASE RECORD THE SURFACE ON WHICH THE TILE WAS PLACED.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Linoleum/tile/wood ………Go to I844
2. Low-pile carpet ………Go to I666
3. High-pile carpet………Go to I666
4. Concrete………Go to I844
5. Not sure………Go to I666
7. Other (specify)

| | | | |  ========================================================================
| | | | | 
I844
WEIGHT MEASUREMENT

WAS R WEARING SHOES DURING MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| | |  ========================================================================
| | | 
I904
WAIST CIRCUMFERENCE

WERE YOU ABLE TO MEASURE R’S WAIST CIRCUMFERENCE?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| | |  If WAIST CIRCUMFERENCE (I904) != 1. Yes »

| | | |  ========================================================================
| | | | 
I905
WAIST CIRCUMFERENCE

WHY WEREN’T YOU ABLE TO MEASURE R’S WAIST? (ENTER ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe
2. IWER felt it would not be safe
3. R refused or was not willing to complete the measurement
4. R tried but was unable to complete the measurement
5. R did not understand the instructions
6. R is not able to stand
97. Other (specify

| | |  Else

| | | |  ========================================================================
| | | | 
I907
WAIST CIRCUMFERENCE

ENTER RESPONDENT'S WAIST MEASUREMENT TO THE NEAREST QUARTER INCH.
♦ ENTER [993] IF R TRIED BUT WAS UNABLE TO DO IT
♦ ENTER [999] IF R CHOSE NOT TO DO IT

| | | |  If WAIST CIRCUMFERENCE (I907) != 993 and WAIST CIRCUMFERENCE (I907) != 999 »

| | | | |  ========================================================================
| | | | | 
I908
WAIST CIRCUMFERENCE

WHAT DIFFICULTIES OCCURRED DURING THIS MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. None
2. R had breathing difficulties
3. R was unable to hold breath at end of exhale
4. R was prevented from giving full effort by illness, pain, or other symptoms or discomforts
5. R did not appear to give full effort, but no obvious reason for this
97. Other (specify)

| | | | |  ========================================================================
| | | | | 
I911
WAIST CIRCUMFERENCE

WHO COMPLETED THE MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R completed the measurement
2. IWER completed the measurement

| | | | |  ========================================================================
| | | | | 
I912
WAIST CIRCUMFERENCE

WAS R WEARING BULKY CLOTHING DURING THIS MEASUREMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| |  ========================================================================
| | 
I913
SALIVA SAMPLE

SALIVA SAMPLE
DID R SIGN THE SALIVA CONSENT FORM?
IF NO, PLEASE RETURN TO THE PREVIOUS QUESTION BY SELECTING [CTRL] + [UP] AND RE-LAUNCH THE CONSENT FORM.
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| |  If SALIVA SAMPLE (I913) = 5. No »

| | |  ========================================================================
| | | 
I941
SALIVA SAMPLE

WHY DIDN'T R SIGN THE SALIVA CONSENT FORM? (ENTER ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe………… Go to I658_PMThank
2. Iwer felt it would not be safe………… Go to I658_PMThank
3. R refused or was not willing to complete the measurement………… Go to I658_PMThank
5. R did not understand the instructions…………… Go to I658_PMThank
6. R could not complete the measurement due to health reasons………… Go to I658_PMThank
7. No suitable space………… Go to I658_PMThank
8. R ate, drank, smoked, or brushed teeth in last 30 minutes………… Go to I658_PMThank
9. Problem with equipment or supplies………… Go to I658_PMThank
97. Other (Specify)

| |  Else

| | |  ========================================================================
| | | 
I915
SALIVA SAMPLE

DID R ATTEMPT TO COMPLETE THE SALIVA SAMPLE?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| | |  If SALIVA SAMPLE (I915) != 1. Yes »

| | | |  ========================================================================
| | | | 
I916
SALIVA SAMPLE

WHY DIDN’T R COMPLETE THE SALIVA SAMPLE? (ENTER ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. R felt it would not be safe……… Go to I658_PMThank
2. IWER felt it would not be safe ……… Go to I658_PMThank
3. R refused or was not willing to complete the measurement ……… Go to I658_PMThank
5. R did not understand the instructions ……… Go to I658_PMThank
8. Problem with equipment or supplies………… Go to I658_PMThank
97. Other (specify)

| | |  Else

| | | |  ========================================================================
| | | | 
I918
SALIVA SAMPLE

DID R FILL THE VIAL TO THE DESIRED LEVEL?
- - - - - - - - - - - - - - - - - - - - - - - - -
1. Yes
5. No

| | | |  ========================================================================
| | | | 
I919
SALIVA SAMPLE

WHAT, IF ANY, PROBLEMS OCCURRED? (ENTER ALL THAT APPLY)
- - - - - - - - - - - - - - - - - - - - - - - - -
1. None
2. Solution in cover leaked before vial was sealed
3. Saliva spilled
4. R was unable to produce enough saliva
97. Other (specify

End of I. Physical Measures