This next set of questions asks you to rate any change in your abilities, daily functioning and activities. Fill in the circle for each question that best fits your current ability level compared to 5 years ago.

Do you feel like your memory is becoming worse?

This next set of questions asks you to rate any change in your abilities, daily functioning and activities.  Fill in the circle for each question that best fits your current ability level compared to 5 years ago. Recalling information when I really try.

This next set of questions asks you to rate any change in your abilities, daily functioning and activities.  Fill in the circle for each question that best fits your current ability level compared to 5 years ago. Remembering names and faces of new people I meet.

This next set of questions asks you to rate any change in your abilities, daily functioning and activities.  Fill in the circle for each question that best fits your current ability level compared to 5 years ago. Remembering things that have happened recently.

This next set of questions asks you to rate any change in your abilities, daily functioning and activities.  Fill in the circle for each question that best fits your current ability level compared to 5 years ago. Recalling conversations a few days later.

This next set of questions asks you to rate any change in your abilities, daily functioning and activities.  Fill in the circle for each question that best fits your current ability level compared to 5 years ago. Remembering where things are usually kept.

This next set of questions asks you to rate any change in your abilities, daily functioning and activities.  Fill in the circle for each question that best fits your current ability level compared to 5 years ago. Remembering new information told to me.

This next set of questions asks you to rate any change in your abilities, daily functioning and activities.  Fill in the circle for each question that best fits your current ability level compared to 5 years ago. Remembering where I placed familiar objects.

This next set of questions asks you to rate any change in your abilities, daily functioning and activities.  Fill in the circle for each question that best fits your current ability level compared to 5 years ago. Remembering what I intended to do.

This next set of questions asks you to rate any change in your abilities, daily functioning and activities.  Fill in the circle for each question that best fits your current ability level compared to 5 years ago. Remembering names of family members and friends.

This next set of questions asks you to rate any change in your abilities, daily functioning and activities.  Fill in the circle for each question that best fits your current ability level compared to 5 years ago. Remembering without notes and reminders.

This next set of questions asks you to rate any change in your abilities, daily functioning and activities.  Fill in the circle for each question that best fits your current ability level compared to 5 years ago. People who know me would find that my memory is.

This next set of questions asks you to rate any change in your abilities, daily functioning and activities.  Fill in the circle for each question that best fits your current ability level compared to 5 years ago. Remembering things compared to my age group.

Computed from Form 158 questions 7.1-7.12.  Source: Adapted from Saykin et al, Neurology 2006;67:834-842.  The index assesses the perception of cognitive decline.  The index sums the 12 questions, and ranges from 12 to 60, where a higher score indicates more memory concerns.  A score ≥ 16 indicates significant memory concern.

Number of presentations (up to 7)  necessary for the participant to repeat the sequence of words "socks, blue, charity" or "shirt, brown, honesty"

What animals have four legs? Tell me as many as you can (in 30 seconds).

id	Variable	Description	Collected	File
idRECINFO	VariableRecalling information past 5 years	DescriptionThis next set of questions asks you to rate any change in your abilities, daily functioning and activities. Fill in the circle for each question that best fits your current ability level compared to 5 years ago.	CollectedExt2	FileForm 151A - Activities of Daily Life
idREMNAMES	VariableRemembering names past 5 years	DescriptionThis next set of questions asks you to rate any change in your abilities, daily functioning and activities. Fill in the circle for each question that best fits your current ability level compared to 5 years ago.	CollectedExt2	FileForm 151A - Activities of Daily Life
idREMEVENTS	VariableRecent events past 5 years	DescriptionThis next set of questions asks you to rate any change in your abilities, daily functioning and activities. Fill in the circle for each question that best fits your current ability level compared to 5 years ago.	CollectedExt2	FileForm 151A - Activities of Daily Life
idRECCONVRSTN	VariableRecalling conversations past 5 years	DescriptionThis next set of questions asks you to rate any change in your abilities, daily functioning and activities. Fill in the circle for each question that best fits your current ability level compared to 5 years ago.	CollectedExt2	FileForm 151A - Activities of Daily Life
idREMTHINGS	VariableRemembering where things kept past 5 years	DescriptionThis next set of questions asks you to rate any change in your abilities, daily functioning and activities. Fill in the circle for each question that best fits your current ability level compared to 5 years ago.	CollectedExt2	FileForm 151A - Activities of Daily Life
idREMNEWINFO	VariableRemembering new info past 5 years	DescriptionThis next set of questions asks you to rate any change in your abilities, daily functioning and activities. Fill in the circle for each question that best fits your current ability level compared to 5 years ago.	CollectedExt2	FileForm 151A - Activities of Daily Life
idREMOBJECTS	VariableRemembering where placed objects past 5 years	DescriptionThis next set of questions asks you to rate any change in your abilities, daily functioning and activities. Fill in the circle for each question that best fits your current ability level compared to 5 years ago.	CollectedExt2	FileForm 151A - Activities of Daily Life
idREMTODO	VariableRemembering what intended to do past 5 years	DescriptionThis next set of questions asks you to rate any change in your abilities, daily functioning and activities. Fill in the circle for each question that best fits your current ability level compared to 5 years ago.	CollectedExt2	FileForm 151A - Activities of Daily Life
idREMFAMFRNDS	VariableRemembering family friends names past 5 years	DescriptionThis next set of questions asks you to rate any change in your abilities, daily functioning and activities. Fill in the circle for each question that best fits your current ability level compared to 5 years ago.	CollectedExt2	FileForm 151A - Activities of Daily Life
idREMNONOTES	VariableRemembering without notes past 5 years	DescriptionThis next set of questions asks you to rate any change in your abilities, daily functioning and activities. Fill in the circle for each question that best fits your current ability level compared to 5 years ago.	CollectedExt2	FileForm 151A - Activities of Daily Life

Variables related to Cognition