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. 2015 Mar 28;1(1):1–12. doi: 10.1016/j.trci.2015.01.001

Table 1.

Information collected in survey questionnaire and baseline screening in-person interview

Survey information
 Demographic data
Nature and frequencies of social, cognitive, and physical activities
Self-rated health
3-Item loneliness measurement [18]
Older Americans resources and services, activities of daily living, and instrumental activities of daily living [19]
Brief questions on Internet and personal computer usage: (1) “Do you use a personal computer?” (yes/no). If yes, the subject was asked where (check all that apply: at home, at the library, at a senior center/community center, at a friend's or relative's house, other [write in]); how often (less than once a year, a few times a year, a few times a month, a few times a week, almost every day); and for what (check all that apply: send/receive e-mail, make documents, browse websites for information, shopping, Facebook or other social network sites, games, video chat (Skype, etc.), and other [write in]).
Willingness (yes/no) to participate in the future clinical trial (after a brief explanation of the prevention study protocol) and provide contact information if willing to be contacted (described in detail in Dodge et al [20]).
Baseline interviews (subjects selected from those who had provided contact information in the survey)
 Demographic information (confirming answers listed in the survey questionnaire)
NEO Big-5 personality inventory [21]
Geriatric depression scale, 15-item scale [22]
Clinical dementia rating scale [23]
Informant contact information to complete the clinical dementia rating scale
List of current prescription and over the counter medications
Neuropsychological assessment (mini mental state examination [24], category and letter fluency tests [25], Consortium to Establish a Registry for Alzheimer's Disease word list learning and recall [26], trail making tests A and B [27], Stroop test [25], wide range achievement test-revised [28], computer assessment of mild cognitive impairment computerized test [29], 3 subitems from Cogstate computerized test [30])
Feedback on computerized tests (fatigue, easiness to follow, preference for Computer Assessment of Mild Cognitive Impairment versus Cogstate, after these tests)