Table 2.

Self-administered question items and additional questions for follow-up

Item	Answer
Have you unwillingly lost weight in the past year?	Yes	No
If yes, was the loss of weight above 3 kg/6 lbs?	Yes	No
How many different types of drugs do you take on a daily basis?	- 0
	- 1–4
	- 5–9
	- ≥ 10
Do you have vision problems?	Yes	No
Do you have hearing problems?	Yes	No
Has someone close to you expressed concern about your memory?	Yes	No
Do you receive home care support?	- Family
	- Friend
	- Professional
If yes, from whom?	Yes	No
Do you need help with your grooming (brushing teeth, hair, shaving, applying make-up)?	Yes	No
Do you need help with bathing or taking a shower?	Yes	No
Do you need assistance when getting dressed?	Yes	No
Do you use mobility aides for walking or transferring (cane, walker, wheelchair)?	Yes	No
Do you need help with your meals: Shopping for food, meal preparation, assistance in eating	Yes	No
Do you need help when using the telephone?	Yes	No
Do you need assistance when taking public transportation?	Yes	No
Do you need help for managing medications on your own?	Yes	No
Do you need help to pay your bills and manage your finances?	Yes	No
Are you incontinent (urine and/or stool)?	Yes	No
How do you feel today?	- Happy
	- Unhappy
	- Neither one nor the other
Do you feel energetic?	Yes	No
Do you do regular physical activity (walking, swimming, cycling, etc.) at least 1 h per week in the past month?	Yes	No
Have you fallen in the past year (at least one fall)?	Yes	No
Additional questions asked to the participants before completing the CESAM at M1, M2, and M3	Yes	No
Since you last filled out this questionnaire, have you visited your doctor?	Yes	No
If yes, was this visit unplanned?	Yes	No
Since you last filled out this questionnaire, have you been hospitalized?	Yes	No
If yes, was this hospitalization unplanned?	Yes	No
Did you visit the emergency room?	Yes	No