Cognitive Decline |
1. Remember three words: Flower, door, rice (for example) |
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2. Orientation in time and space: What is the full date today? Where are you now (home, clinic, etc.)? |
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3. Recalls the three words? |
Limited Mobility |
Chair rise test: Rise from chair five times without using arms. Did the person complete five chair rises within 14 seconds? |
Malnutrition |
1. Weight loss: Have you unintentionally lost more than 3 kg over the last three months? |
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2. Appetite loss: Have you experienced loss of appetite? |
Visual Impairment |
Do you have any problems with your eyes: Difficulties in seeing far, reading, eye diseases or currently under medical treatment (e.g., diabetes, high blood pressure)? |
Hearing Loss |
Hears whispers (whisper test) or Screening audiometry result is 35 dB or less or Passes automated app-based digits-in-noise test |
Depressive Symptoms |
Over the past two weeks, have you been bothered by |
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• Feeling down, depressed or hopeless? |
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• Little interest or pleasure in doing things? |