Skip to main content
. 2020 Jun 8;4(6):e16371. doi: 10.2196/16371

Table 1.

Promote Independent Aging study visit information.

Assessment Baseline visit Final study visit (month 12)
Consent and authorization forms +a N/Ab
Demographics form + N/A
Socioeconomic and employment form + +
Physical assessment form + +
Mobility form + +
Personal and family health history + +
Modified Cumulative Illness Rating Scale [33,34] + +
Physical Activity Scale for the Elderly [43] + +
Pittsburg Sleep Quality Index [44] + +
Older Americans Resources and Services activities of daily living and IADLc [45] + +
Everyday Cognition Questionnaire self and informant [46,47] + +
Functional Activities Questionnaire [31] + +
Clinical Dementia Rating self and informant [30] + +
Habits form + +
Cognitive status form + +
Montreal Cognitive Assessment [29] + +
Neuropsychological examination (see text) + +
Generalized anxiety disorder 7-item [28] + +
Geriatric Depression Scale-15 item [27] + +
University of California, Los Angeles Loneliness Scale [48] + +
Lubben Social Network Scale [49,50] + +
RAND 36-Item Health Survey [51] + +

a+: measure is administered.

bN/A: not applicable.

cIADL: instrumental activities of daily living.