Table 5.

Sample cognitive items with double-barreled item stems

Sample item stems
Are you concerned that you have a memory or other thinking problem?
Do you have any difficulty in understanding or following spoken instructions?
Do you talk less because of memory or word-finding difficulties?
Compared to 10 years ago, I am much worse at remembering titles of books, films or plays.
I find it harder to remember street and city names.
Forgets appointments, dates, or where things are stored.
Organizing daily activities and keeping a schedule.
I have trouble finding things in my room, closet, or desk.
Following a story in a book, movie, or TV.
Recalling telephone numbers or zip codes that you use on a daily or weekly basis.
Have you sought evaluation or treatment for your memory problems?
My ability to search through my mind and recall names or memories I know are there is.
Do you find you forget whether you’ve turned off a light or a fire or locked the door?
Remembering what day/date/month it is?
I get lost or I follow the wrong directions on trips, strolls, or buildings that I have previously been in.