Table 3.

Sample items categorized by ability or change

Domain	Referent	Sample items
Ability (n = 374)	Severity	Please rate your current level of ability or functioning, or the severity of any problems: Ability to reason through a complicated problem 1 = above average ability; 2 = normal ability; 3 = mild disability; 4 = mild to moderate disability; 5 = moderate disability; 6 = moderate to severe disability; 7 = severe disability; not applicable How would you rate your memory in terms of the kinds of problems you have? 1, 2 = major problems; 3, 4, 5 = some minor problems; 6,7 = no problems
	Frequency	How often does remembering or doing the following things present a problem for you? Losing the thread of thought in conversation 1, 2 = always; 3, 4, 5 = sometimes; 6, 7 = never I forget details of what I did or what happened the day before. 0 = never or almost never; 1 = rarely; 2 = sometimes; 3 = often; 4 = always or most always
	Impact	Do you feel that your everyday life is difficult now due to your memory decline? 0 = no; 1 = yes; 2 = prefer not to answer How is your everyday life affected by the memory problems? 0 = not at all; 1 = a little; 2 = somewhat; 3 = highly
Change (n = 266)	Temporal	Compared to 10 years ago, has there been any change in verbally giving instructions to others? 1 = better or no change; 2 = questionable/occasionally worse; 3 = consistently a little worse; 4 = consistently much worse; don’t know My ability to pay attention to what goes on around me is: −4 = worse than ever before; −3, −2, −1, 0 = no change; 1, 2, 3, 4 = better than ever before
	Atemporal	Are you worried or concerned about a decline in your thinking abilities, more than normal aging? 0 = no; 1 = yes Do you feel your memory got worse suddenly or gradually? 1 = suddenly; 2 = gradually; 3 = other, specify