1
7 / 77 / 777 = Not asked
8 / 88 / 888 = Don’t know / Refusal / Won’t answer / No answer
9 / 99 / 999 = Not applicable
CambridgeCity over-75s Cohort (CC75C) StudyInstitute of Public Health
University Forvie Site
Robinson Way
Cambridge CB2 2SR /
Department of Public Health
and Primary Care
CAMBRIDGE PROJECT FOR LATER LIFE
STUDY PARTICIPANT INTERVIEW SCHEDULE
CONFIDENTIAL
Project number / { }
projno
Subject initials / { }
initials
GP Practice / { }
gpc
Interviewer Code Number / { }
intcodee
Number of approaches/visits made / Before interview
For interviews
In total / { }
approache
{ }
intervwse
{ }
totalappe
1st visit / 2nd visitif needed / 3rd visitif needed
Interview
date / { }
intvdate1e / { }
intvdate2e / { }
intvdate3e
Respondent / 1. Subject
2. Proxy informant
3. Joint / { }
resp1e / { }
resp2e / { }
resp2e
Proxy informant? / 1. Spouse
2. Child
3. Other relative
4. Friend
5. Care assistant/warden/matron
6. Other
9. N/A: no proxy / { }
proxinf1e / { }
proxinf2e / { }
proxinf2e
Interview type? / 1. Face-to-face
2. Telephone / { }
inttype1e / { }
inttype2e / { }
inttype2e
Interview complete? / 1. Complete
2. Incomplete / { }
complete1e / { }
complete2e / { }
complete2e
Reason interview
incomplete / 1. Family refusal
2. Refusal
3. Frailty
4. Abandoned
5. Ill
6. Disturbed
7. Other (specify)
9. N/A: complete / { }
reasoni1e / { }
reasoni2e / { }
reasoni2e
Details
First of all, I'd like to ask you to remind me of some personal details.
** / 1. / What is your full name?
(not proxy) / 0. Error
1. Right / { }
ev1
** / 2(a) / Age?
(not proxy) / Record age given / { }
ev2a
** / 2(b) / 0. Error
1. Right / { }
ev2b
** / 3(a) / Date of Birth?
(not proxy) / Record date of birth given / { / / }
ev3
** / 3(b) / 0. Error
1. Right / { }
ev3b
4. / Marital Status?
At last interview………………………………
Do not ask if already widowed at last interview / 1. Married
2. Widowed
3. Separated/Divorced
4. Single
5. Other / { }
ev4
5. / How long have you been widowed,
separated /divorced?
Do not ask if already widowed at last interview / In years / { }
ev5
6. / Could you tell me how things have been for you in the past year?
Note any important comments
______
______
______
______
RESIDENCY
7. / Have you moved house in the last ……years?
Since last interviewed ………………………… / 0. No
1. Yes / { }
ev7
8. / Why did you move to this address?
Code reason(s)
To be near relative(s) / 0. No
1. Yes / { }
ev8a
Bereavement / 0. No
1. Yes / { }
ev8b
Ill health/disability / 0. No
1. Yes / { }
ev8c
Smaller/more convenient house / 0. No
1. Yes / { }
ev8d
Other reason (specify) / 0. No
1. Yes / { }
ev8e
Specify ______
9. / Record what type of house. Only ask if uncertain.
1. House/flat/granny flat
2. Warden controlled
3. Council residential home
4. Private residential home
5. Long stay hospital
6. Other (specify) / { }
ev9
Specify ______
10. / Is this house/flat owned or rented?
Only ask if moved since last interview
and need to clarify / 1. Owned
2. Council rented
3. Private rented
4. Other (specify) / { } ev10
Specify ______
11. / Who is head of the household?
Only ask if moved since last interview
and need to clarify / 1. Respondent or spouse
2. Sibling
3. Child
4. Other (specify) / { }
ev11
Specify ______
12. / Does anyone else live here? / 0. No
1. Yes / { }
ev12
Ask and record numbers of people in each category. / Spouse / { }
ev12a
Siblings / { }
ev12b
Children / { }
ev12c
In laws / { }
ev12d
Grandchildren / { }
ev12e
Others (specify) / { }
ev12f
Specify ______
13. / Is there anyone who lives with you who is frail and unwell and needs your help with day-to-day tasks? / 0. No
1. Yes / { }
ev13
14. / Establish whether due to / 1. Physical frailty
2. Mental frailty
3. Both / { }
ev14
FAMILY CONTACT
{15.}
{16.} / Any children (Y/N) already known from past interviews
Number of children ……… / ev15
ev16
17. / Do any of your (children or other) relatives live in the area or within easy reach of the area?
(Same town/village or nearby villages up to 7 miles) / 0. No relatives
1. None in area
2. Yes / { }
ev17
Number of children / { }
ev17a
Number of grandchildren / { }
ev17b
Number of brothers/ sisters / { }
ev17c
Number of parents / { }
ev17d
Number of other relatives. / { }
ev17e
18. / How often do you see any of your relatives to speak to? / 0. Never
1. Daily
2. 2-3 times a week
3. At least weekly
4. At least monthly
5. Less often / { }
ev18
19. / Of all your relatives with which one do you have the most contact? / 1. Daughter
2. Son
3. Daughter-in-law
4. Son-in-law
5. Parent
6. Sister/Brother
7. Other female relative
8. Other male relative / { }
ev19
20. / In the last year, have you been in contact with your relatives as much as usual? / 1. More
2. Same
3. Less / { }
ev20
21. / Establish the main reason for change.
1. Physical illness (subject)
2. Mood change (subject eg. says depressed)
3. Interpersonal problems
4. Moving
5. Other / { }
ev21
Specify______
FRIENDS AND NEIGHBOURS
22. / Do you have any friends locally? / 0. No
1. Yes / { }
ev22
23. / In the last year, have you been in contact with your friends as much as usual? / 1. More
2. Same
3. Less / { }
ev23
24. / Establish the main reason for change. / { }
ev24
1. Physical illness (subject)
2. Mood change (subject e.g. says depressed)
3. Interpersonal problems
4. Moving
5. Other (Specify)
Specify ______
25. / In general, do you have as much contact with family and friends as you would like to? / 1. Yes, satisfied
2. No, would like more contact
3. No, would like less contact / { }
ev25
26. / How often do you see any of your neighbours? / 1. Daily
2. 2-3 times a week
3. At least weekly
4. At least monthly
5. Less often
6. Never/no neighbours / { }
ev26
I will read some comments people have made about their family and friends and
I would like you to say how much each statement is true for you.
27. / There are members of my family (friends)
who can be relied on no matter what happens. / 0. No
1. Yes to an extent
2. Yes, definitely / { }
ev27
28. / There are members of my family (friends)
who would see that I am taken care of if I needed to be. / 0. No
1. Yes to an extent
2. Yes, definitely / { }
ev28
29. / Is there someone in whom you can confide about anything that might be worrying you? / 0. No
1. Yes to an extent
2. Yes, definitely / { }
ev29
SOCIAL CONTACTS AND ACTIVITIES
30. / Have you had any contact with any clubs or organisations in the past week?
Ask each item
Over 60's Club / 0. No
1. Yes / { }
ev30a
Other social club / 0. No
1. Yes / { }
ev30b
Church / 0. No
1. Yes / { }
ev30c
Church group / 0. No
1. Yes / { }
ev30d
Voluntary work / 0. No
1. Yes / { }
ev30e
Other
Specify ______/ 0. No
1. Yes / { }
ev30f
Record any regular events less than weekly eg. monthly W.I.
Specify ______/ 0. No
1. Yes / { }
ev30g
31. / In general, do you get out and about as much as you would like to? / 0. No
1. Yes / { }
ev31
How many times a week do you go out?
Record number of times (excl. just out in garden, incl. being taken out) / { }
ev31e
32. / Do you manage to do any physical activity or exercise?
If yes then ask each item (do not ask if inappropriate)
Keep fit / 0. No
1. Yes / { }
ev32a
Walking / 0. No
1. Yes / { }
ev32b
Gardening / 0. No
1. Yes / { }
ev32c
DIY / 0. No
1. Yes / { }
ev32d
Cycling / 0. No
1. Yes / { }
ev32e
Other
Specify ______/ 0. No
1. Yes / { }
ev32f
How many times do you climb up a flight of stairs (approx 10 steps) each day?
Code average over the past year / None ……………………………0
1 to 5 times a day ………………1
6 to 10 times a day………………2
More than 10 times a day ...…….3 / { }
ev32g
SOCIAL CONTACTS AND ACTIVITIES (continued)
33. / Have you been involved in any other activities in the last fortnight?
(a) / Visited places of interest / 0. No
1. Yes / { }
ev33a
(b) / Amateur Music, Acting, Singing / 0. No
1. Yes / { }
ev33b
(c) / Been to a pub/restaurant / 0. No
1. Yes / { }
ev33c
(d) / Class or lecture / 0. No
1. Yes / { }
ev33d
(e) / Knitting or sewing / 0. No
1. Yes / { }
ev33e
(f) / Hobbies such as painting, crafts or collecting things / 0. No
1. Yes / { }
ev33f
(g) / Games such as cards, board games or bingo / 0. No
1. Yes / { }
ev33g
(h) / Reading
Code 1 if reads magazines thoroughly and include talking books / 0. No
1. Yes / { }
ev33h
(i) / Other
Specify ______/ 0. No
1. Yes / { }
ev33i
35. / Would you say that you enjoy your life? / 0. No
1. Some of the time
2. Most of the time / { }
ev35
36. / Do you feel lonely? / 1. Very lonely
2. Lonely
3. Slightly lonely
4. Not at all lonely / { }
ev36
I am going to read some statements about the way some people feel as they get older. Please tell me if they apply to you.
37. / As I grow older, things seem better than I thought they would be. / 0. No
1. Yes / { }
ev37
38. / I am just as happy as when I was younger. / 0. No
1. Yes / { }
ev38
39. / The things I do are as interesting to me as they ever were. / 0. No
1. Yes / { }
ev39
SERVICE CONTACT
I'd like to ask you whether you have received various Health or Local Authority Services or any private help recently.
40. / Did you have any contact with any of these services in the past week?
(a) / Care assistants / No. of contacts / { }
ev40a
(b) / Home help / No. of contacts / { }
ev40b
(c) / Community nurse / No. of contacts / { }
ev40c
(d) / Private domestic help / No. of contacts / { }
ev40d
(e) / Warden / No. of contacts / { }
ev40e
(f) / Meals on wheels / No. of contacts / { }
ev40g
(g) / Cook chill delivery / No. of contacts / { }
ev40h
(h) / Day centre / No. of contacts / { }
ev40j
(i) / Day hospital / No. of contacts / { }
ev40k
(j) / Voluntary agencies
Specify ______/ No. of contacts / { }
ev40f
(k) / Other
Specify ______/ No. of contacts / { }
ev40l
And thinking back over the past year…
(l) / Have you seen a chiropodist
in the last year? / No. of contacts / { }
ev40i
(n) / Have you had a hearing test
in the last year? / No. of contacts / { }
ev40n
(o) / Have you had your sight tested by an optician
in the last year? / No. of contacts / { }
ev40o
(p) / Have you seen a physiotherapist
in the last year? / No. of contacts / { }
ev40p
(q) / Have you seen a occupational therapist
in the last year? / No. of contacts / { }
ev40q
(r) / Have you seen a dentist
in the last year? / No. of contacts / { }
ev40r
(s) / Have you seen a social worker
in the last year? / No. of contacts / { }
ev40s
(t) / Have you seen any nursing services
in the last year? / No. of contacts / { }
ev40s
SERVICE CONTACT (continued)
40… / (u) / Do you have any call alarm system?
None………………………………………
Personal call alarm …………………….…
Room alarm/call bell ..……………………
Personal and room alarm………………… / 0
1
2
3 / { }
carecallc
(v) / Reason for not having a personal call alarm
Considering ………………………………
Room alarm to warden……………………
Family usually around ……………………
In care ……………………….……………
Don’t think need one..……… ……………
Too expensive ……………………………
N/A: has a call alarm..……… …………… / 1
2
3
4
5
6
9 / { }
noalarmc
41. / Do you think you are receiving enough of these services? / 0. No
1. Yes / { }
ev41
Specify______
42. / Are there any services which you are not receiving which would be valuable to you? / 0. No
1. Yes / { }
ev42
Specify______
43. / Have you ever received respite care /
gone into a home or hospital to have a short break away from the family? / 0. No
1. Yes / { }
ev43
If ``YES'' then ask where?______
MOOD AND RECENT EVENTS
The next questions are about recent events that may have happened to you and about how you feel.
46. / Have you lost anyone close to you in the last year - such as someone close to you dying or moving away, or losing a cherished pet?
Bereavement / 0. No
1. Yes / { }
ev46a
Close friend or relative moving away or becoming ill / 0. No
1. Yes / { }
ev46b
Loss of pet / 0. No
1. Yes / { }
ev46c
47. / Have you been very worried about anything in the last year, for example, money worries? / 0. No
1. Worried
2. Very worried / { }
ev47
Specify______
______
______
48. / Do you feel more tense and worry more than usual about little things? / 0. No
1. Yes / { }
ev48
49. / Have you felt more irritable lately (eg. intolerant of noise)? / 0. No
1. Yes / { }
ev49
50. / Do you consider yourself a nervous person? / 0. No
1. Yes / { }
ev50
51. / Do you often feel like crying? / 0. No
1. Sometimes
2. Often / { }
ev51
52. / Have you lost or gained a lot of weight in the last six months? / 0. No
1. Some loss
2. Considerable loss
3. Some gain
4. Considerable gain / { }
ev52
53. / Do you find it more difficult to make decisions than you used to? / 0. No
1. Yes / { }
ev53
54. / Have you lost pleasure or interest in doing things you usually cared about or enjoyed? / 0. No
1. Sometimes
2. Most of the time / { }
ev54
55. / Have you preferred to be more on your own recently? / 0. No
1. Yes / { }
ev55
56. / Do you find it more difficult to concentrate than is normal for you? / 0. No
1. Yes / { }
ev56
57. / Are there times when your thoughts come much more slowly than usual? / 0. No
1. Yes / { }
ev57
58. / Do you feel sad or depressed or miserable? / 0. No
1. Occasionally
2.Most of the time / { }
ev58
59. / How do you feel about the future?
How do you think things will work out for you?
0. Neutral/Positive/Optimistic
1. Pessimistic/Negative / { }
ev59
60. / Do you sometimes feel that life isn't worth living? / 0. No
1. Yes / { }
ev60
61(a) / Have you ever had an emotional or nervous illness requiring treatment? / 0. No
1. Yes / { }
ev61a
61(b) / Establish how many episodes requiring treatment by psychiatrist.
Record number of episodes. IF MORE THAN 5 CODE 6 / { }
ev61b
61(c) / Establish how many episodes requiring treatment by general practitioner.
Record number of episodes. IF MORE THAN 5 CODE 6 / { }
ev61c
PHYSICAL HEALTH
I would like to move on to some questions about your health now.
62. / Would you say you have more or less energy
than most people your age? / 1. More
2. Same
3. Less / { }
ev62
63. / Would you say you have more or less energy
at the moment than you did a year ago? / 1. More
2. Same
3. Less / { }
ev63
64. / Have you had more trouble sleeping recently
than is normal for you? / 0. No
1. Yes / { }
ev64
65. / How would you rate your physical health
at present compared to others of the same age? / 1. Very good
2. Good
3. Fair
4. Poor
5. Very poor / { }
ev65
66. / How would you rate your physical health
at present compared to a year ago? / 1. Better
2. Same
3. Worse / { }
ev66
PHYSICAL HEALTH (continued)
I would like to ask you about some special conditions you may have had.
67. / Have you ever had or has a doctor ever told you that you have had:
(a) / Angina? / 0. No
1. Yes / { }
ev67a
(b) / Heart attack? / 0. No
1. Yes / { }
ev67b
(c) / Problems with circulation in your legs? / 0. No
1. Yes / { }
ev67c
(d) / High blood pressure? / 0. No
1. Yes / { }
ev67d
(e) / Chronic bronchitis? / 0. No
1. Yes / { }
ev67e
(f) / Sugar diabetes? / 0. No
1. Yes / { }
ev67f
(g) / Thyroid problems? / 0. No
1. Yes / { }
ev67g
(h) / Severe headaches or migraine? / 0. No
1. Yes / { }
ev67h
(i) / A stroke? / 0. No
1. Yes / { }
ev67i
(j) / A mini-stroke? / 0. No
1. Yes / { }
ev67j
(k) / A Transient Ischaemic Attack (TIA)? / 0. No
1. Yes / { }
ev67k
(l) / Have you ever had sudden weakness, or difficulty with speech, memory or vision which got better after a short time? / 0. No
1. Yes / { }
ev67l
(m) / Anything else? / 0. No
1. Yes / { }
ev67m
Specify ______
68. / I'd like to ask you about some specific conditions which may have
affected your day-to-day routine in the last month.
For each conditions reported,
establish whether it prevented respondent carrying out day-to-day activities
(a) / Poor vision (with spectacles) / 0. No
1. Yes, disabling
2. Yes, not disabling / { }
ev68a
(b) / Poor hearing (with hearing aid) / 0. No
1. Yes, disabling
2. Yes, not disabling / { }
ev68b
(c) / Arthritis or rheumatism / 0. No
1. Yes, disabling
2. Yes, not disabling / { }
ev68c
(d) / Back pain / 0. No
1. Yes, disabling
2. Yes, not disabling / { }
ev68d
(e) / Chest pain / 0. No
1. Yes, disabling
2. Yes, not disabling / { }
ev68e
(f) / Shortness of breath / 0. No
1. Yes, disabling
2. Yes, not disabling / { }
ev68f
(g) / Marked weakness in arm or leg / 0. No
1. Yes, disabling
2. Yes, not disabling / { }
ev68g
(h) / Unsteady on feet / 0. No
1. Yes, disabling
2. Yes, not disabling / { }
ev68h
(i) / Tendency to fall / 0. No
1. Yes, disabling
2. Yes, not disabling / { }
ev68i
(j) / Trouble with nerves / 0. No
1. Yes, disabling
2. Yes, not disabling / { }
ev68j
(k) / Other not specified above / 0. No
1. Yes, disabling
2. Yes, not disabling / { }
ev68k
Specify ______
Record any important conditions mentioned but which remain uncoded
______
______
______
69. / How much do these problems interfere with your life? / 0. Not at all
1. Slightly
2. Moderately
3. Very much / { }
ev69
70. / Which of the things mentioned is most important?
Use numbers as follows. / { }
ev70
Poor vision (with spectacles)
Poor hearing (with hearing aid)
Arthritis or rheumatism
Back pain
Chest pain
Shortness of breath
Marked weakness in arm or leg
Unsteady on feet
Tendency to fall
Trouble with nerves
Other not specified above / 1
2
3
4
5
6
7
8
9
10
11
71. / Have you had to go into hospital to stay because of any of these difficulties in the last year? / 0. No
1. Yes / { }
ev71
72. / If so, for which ailment(s)?
Use response numbers as in question 70. / { }
ev72
73. / How many times have you been in hospital in the last year? / 0. None
1. Once
2. Two or more / { }
ev73
73a. / Did you attend the Casualty department of any hospital in the last year? (as a patient, discount if accompanying someone)
If so, how many times? / 0. None
1. Once
2. Two or more / { }
ev73a
73b. / Did you attend any hospital outpatient department
in the last year? (as a patient)
If so, how many times? / 0. None
1. Once
2. Two or more / { }
ev73b
74. / How long is it since you were last admitted to any hospital?
(In years) / Years / { }
ev74
75. / Have you had a general anaesthetic in the last year? / 0. No
1. Yes / { }
ev75
76. / How long ago was that/or the most recent?
(i.e. 1-12 months) / Months / { }
ev76
77. / How long is it since you last saw a GP?
(in months, round up). / Months / { }
ev77
ACTIVITIES OF DAILY LIVING
78. / Now I'd like to ask you some questions about how you cope with day-to-day tasks.
Note all helpers using list below. If more than one helper given, code highest professional level.
(a) / How do you manage with using a telephone i.e. looking up numbers, dialing etc?
Telephones independently: looks up numbers,dialling etc
Dials a few well-known numbers only
Answers telephone but does not dial
Cannot use telephone at all
No telephone within easy access / 0
1
2
3
9 / { }
ev78a
(b) / How do you manage with shopping?
Takes care of all or nearly all shopping independently
Shops independently for small purchases only
Needs to be accompanied on any shopping trip
Does not shop at all / 0
1
2
3 / { }
ev78b
Who helps? Note helpers using codes below
If Other then Specify ______/ Code main helper / { }
ev78bhelp
(c) / How do you manage with finance/money matters?
Manages financial matters independently
Manages day to day purchases, needs help with banking
Incapable of handling money / 0
1
2 / { }
ev78c
Who helps? Note helpers using codes below
If Other then Specify ______/ Code main helper / { }
ev78chelp
(d) / How do you manage with preparing meals?
Prepares all or nearly all meals independently
Prepares snacks only or heats up meals prepared by others
All meals and snacks must be prepared by others
Meals have always been prepared by spouse or others / 0
1
2
3 / { }
ev78d
Who helps? Note helpers using codes below
If Other then Specify ______/ Code main helper / { }
ev78dhelp
CODENobody/none required00Friend/neighbour07Volunteer agencies13
Spouse01Care assistant08Meals on wheels14
Daughter02Home help09Cook chill delivery15
Daughter-in-law03Community nurse10Chiropodist16
Son04Private domestic help11Residential home staff17
Son-in-law05Warden12Other (specify)18
Other relative06
ACTIVITIES OF DAILY LIVING (continued)(e) / How do you manage with housework?
Independent apart from occasional help with heavy work
Performs only light daily tasks,
e.g. dish washing, dusting, etc (Cleanliness adequate)
Performs light daily tasks
but cannot maintain acceptable level of cleanliness
All housework must be done by others
Housework has always been done by spouse or others / 0
1
2
3
9 / { }
ev78e
Who helps? Note helpers using codes below
If Other then Specify ______/ Code main helper / { }
ev78ehelp
(f) / How do you manage with transport?
Travels independently on public transport
or drives own car or cycles
Arranges own travel via taxi only
Travels on public transport with assistance of others
Travel limited to taxi or with assistance of others only
Does not travel at all / 0
1
2
3
4 / { }
ev78f
(g) / How do you manage with laundry?
Independent apart from occasional help with heavy work
Lauders only small items, e.g. stockings, underwear
All laundry must be done by others
Laundry has always been done by spouse or others / 0
1
2
9 / { }
ev78g
Who helps? Note helpers using codes below
If Other then Specify ______/ Code main helper / { }
ev78ghelp
CODENobody/none required00Friend/neighbour07Volunteer agencies13
Spouse01Care assistant08Meals on wheels14
Daughter02Home help09Cook chill delivery15
Daughter-in-law03Community nurse10Chiropodist16
Son04Private domestic help11Residential home staff17
Son-in-law05Warden12Other (specify)18
Other relative06
ACTIVITIES OF DAILY LIVING (continued)(h) / How do you manage with walking?
Walks around town, suburb or village
Walks no further than one block away
Walks no further than gate
Walks only within house
Takes no more than a few steps
Bedridden / 0
1
2
3
4
5 / { }
ev78h
(iout) / Do you use a walking stick or other aid outdoors?
Independent
Walking stick(s)
Frame/tripod
Wheelchair
Other person / 0
1
2
3
4 / { }
ev78iout
(iin) / Do you use a walking stick or other aid indoors?
Independent
Walking stick(s)
Frame/tripod
Wheelchair
Other person / 0
1
2
3
4 / { }
ev78iin
IF NOT IN A WHEELCHAIR CODE QUESTION 78(j) AS 9
(j) / How do you manage with your wheelchair?
Gets in and out and can propel self without help
Gets in and out without help, can’t propel self
Needs help to get in and out, can’t propel / 1
2
3 / { }
ev78j
(k) / How do you manage with bathing or showering?
Independent in bath, shower or strip-wash
Needs help getting in or out of bath or shower
Can wash face and hands only
Needs major assistance / 0
1
2
3 / { }
ev78k
Who helps? Note helpers using codes below
If Other then Specify ______/ Code main helper / { }
ev78khelp
CODENobody/none required00Friend/neighbour07Volunteer agencies13