Items and Original Factor/Subscore	New Factor
MEMORY
1. How often do you forget something that has been told to you within the last day or two?	Memory - Forgetfulness
2. How often do you forget events which have occurred in the last day or two?	Memory - Forgetfulness
3. How often do you forget people whom you met in the last day or two?	Memory - Forgetfulness
4. How often do you forget things that you knew a year or more ago?	Memory - Forgetfulness
5. How often do you forget people whom you knew or met a year or more ago?	Memory - Forgetfulness
6. How often do you lose track of time, or do things either earlier or later than they are usually done or are supposed to be done?	Memory – Absent-Mindedness
7. How often do you fail to finish something you start because you forgot that you were doing it? (Include such things as forgetting to put out cigarettes, turn off stove, etc.)	Memory – Absent-Mindedness
8. How often do you fail to complete a task that you start because you have forgotten how to do one or more aspects of it?	HLC
9. How often do you lose things or have trouble remembering where they are?	Memory – Absent-Mindedness
10. How often do you forget things that you are supposed to do or have agreed to do (such as putting gas in the car, paying bills, taking care of errands, etc.)?	Memory – Absent-Mindedness
LANGUAGE
11. How often do you have difficulties understanding what is said to you?	HLC
12. How often do you have difficulties recognizing or identifying printed words?	HLC
13. How often do you have difficulty understanding reading material which at one time you could have understood?	HLC
14. Is it easier to have people show you things than it is to have them tell you about things?	Excluded
15. When you speak, are your words indistinct or improperly pronounced?	Excluded
16. How often do you have difficulty thinking of the names of things?	Language – Production
17. How often do you have difficulty thinking of the words (other than names) for what you want to say?	Language – Production
18. When you write things, how often do you have difficulty forming the letters correctly?	Language – Production
19. Do you have more difficulty spelling, or make more errors in spelling, than you used to?	Language – Production
MOTOR/SENSORY-PERCEPTUAL
20. How often do you have difficulty performing tasks with your right hand (including such things as writing, dressing, carrying, lifting, sports, cooking, etc.)?	Motor/Sensory-Perceptual
21. How often do you have difficulty performing tasks with your left hand?	Motor/Sensory-Perceptual
22. How often do you have difficulty feeling things with your right hand?	Motor/Sensory-Perceptual
23. How often do you have difficulty feeling things with your left hand?	Motor/Sensory-Perceptual
24. Lately, do you have more difficulty than you used to in seeing all of what you are looking at, or all of what is in front of you (in other words, are some areas of your vision less clear or less distinct than others)?	Excluded
HIGHER LEVEL COGNITIVE FUNCTIONS
25. How often do your thoughts seem confused or illogical?	HLC
26. How often do you become distracted from what you are doing or saying by insignificant things which at one time you would have been able to ignore?	Memory – Absent-Mindedness
27. How often do you become confused about (or make a mistake about) where you are?	HLC
28. How often do you have difficulty finding your way about?	HLC
29. Do you have more difficulty now than you used to in calculating or working with numbers (including managing finances, paying bills, etc.)?	HLC
30. Do you have more difficulty now than you used to in planning or organizing activities (i.e., deciding what to do and how it should be done)?	HLC
31. Do you have more difficulty now than you used to in solving problems that come up around the house, at your job, etc.? (In other words, when something new has to be accomplished, or some new difficulty comes up, do you have more trouble figuring out what should be done and how to do it)?	HLC
32. Do you have more difficulty now than you used to in following directions to get somewhere?	HLC
33. Do you have more difficulty now than you used to in following instructions concerning how to do things?	HLC

HLC = Higher Level Cognitive Functions

Likert Scale for each item (scale numbers used in this study):

• 6 almost always
• 5 very often
• 4 fairly often
• 3 once in a while
• 2 very infrequently
• 1 almost never

New Factor Scoring

Average responses across factor items to obtain the factor score (range 1–6):

• Memory – Forgetfulness: Items 1, 2, 3, 4, 5
• Memory – Absent-Mindedness: Items 6, 7, 9, 10, 26
• HLC: Items 8, 11, 12, 13, 25, 27, 28, 29, 30, 31, 32, 33
• Language Production: Items 16, 17, 18, 19
• Motor/Sensory-Perceptual: Items 20, 21, 22, 23