Structured Assessment

Samples

Self Report Memory:

o This section is composed of 4 brief questions that the subject answered regarding his or her own memory.
o How would you rate your memory at the present time? Would you say it is excellent, very good, good, fair, or poor (ANSMEM1)?
o Compared to two years ago, would you say your memory is much better now, better now, about the same, worse now, or much worse now than it was then (ANSMEM2)?
o How is your memory compared to that of other people? Would you say excellent, very good, good, fair, or poor (ANSMEM3)?
o How often do memory problems interfere with your daily activities? Would you say rarely, occasionally, sometimes, often, or all of the time (ANSMEM4)?

Sample questions:

How often does your friend or relative use a computer?
􀂉 Daily or almost daily
􀂉 Several times a month
􀂉 Several times a year
􀂉 Rarely or never

How often does your friend or relative discuss current events or topics of general interest?
􀂉 Daily or almost daily
􀂉 Several times a month
􀂉 Several times a year
􀂉 Rarely or never


How would you rate your friend or relative in making judgments and decisions?
􀂉 Excellent
􀂉 Very good
􀂉 Good
􀂉 Fair
􀂉 Poor



Source:
Metadata Summary for The Aging, Demographics, and Memory Study (ADAMS)
http://hrsonline.isr.umich.edu/meta/adams/desc/adams1dd.pdf
HRS: Aging,Demographics, and Memory Study
http://hrsonline.isr.umich.edu/meta/adams/qnaire/InformantQnaire.pdf