Australian [Adelaide] Longitudinal Study of Aging, Waves 1 ...€¦ · additional clinical studies....

ICPSRInter-university Consortium for

Political and Social Research

Australian [Adelaide] Longitudinal Study of Aging,Waves 1–5 [1992–1997]

Wave 1 Data

Gary R. Andrews and George C. Myers

ICPSR 6707

AUSTRALIAN [ADELAIDE] LONGITUDINAL STUDY OF AGING, WAVES 1-5 [1992-1997]

(ICPSR 6707)

Principal Investigators

Gary R. Andrews and George C. Myers Flinders University of South Australia Centre for Ageing Studies

Third ICPSR Version April 2000

Inter-university Consortium for Political and Social Research P.O. Box 1248 Ann Arbor, Michigan 48106

BIBLIOGRAPHIC CITATION

Publications based on ICPSR data collections should acknowledge those sources by means of bibliographic citations. To ensure that such source attributions are captured for social science bibliographic utilities, citations must appear in footnotes or in the reference section of publications. The bibliographic citation for this data collection is:

Andrews, Gary R., and George C. Myers. AUSTRALIAN [ADELAIDE] LONGITUDINAL STUDY OF AGING, WAVES 1-5 [1992-1997] [Computer file]. 3rd ICPSR version. Adelaide, South Australia: Flinders University of South Australia, Centre for Ageing Studies [producer], 1999. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2000.

REQUEST FOR INFORMATION ON USE OF ICPSR RESOURCES

To provide funding agencies with essential information about use of archival resources and to facilitate the exchange of information about ICPSR participants' research activities, users of ICPSR data are requested to send to ICPSR bibliographic citations for each completed manuscript or thesis abstract. Please indicate in a cover letter which data were used.

DATA DISCLAIMER

The original collector of the data, ICPSR, and the relevant funding agency bear no responsibility for uses of this collection or for interpretations or inferences based upon such uses.

DATA COLLECTION DESCRIPTION

Gary R. Andrews and George C. Myers AUSTRALIAN [ADELAIDE] LONGITUDINAL STUDY OF AGING, WAVES 1-5 [1992-1997] (ICPSR 6707)

SUMMARY: The general purpose of the Australian Longitudinal Study of Aging (ALSA) is to gain further understanding of how social, biomedical, and environmental factors are associated with age- related changes in the health and well-being of persons aged 70 years and older. Emphasis is given to the effects of social and economic factors on morbidity, disability, acute and long-term care service use, and mortality. The aim is to analyze the complex relationships between individual and social factors and changes in health status, health care needs, and service utilization dimensions. Components of Wave 1 (1992-1993) (Part 1) included a comprehensive personal interview conducted via the Computer- Assisted Personal Interview (CAPI) system, a home-based assessment of physiological functions, self-completed questionnaires, and additional clinical studies. Wave 2 (1993-1994), Wave 3 (1994- 1995), Wave 4 (1995-1996), and Wave 5 (1996-1997) (Parts 2, 7, 8, and 10, respectively) included questions regarding changes in domicile, current health and functional status, new morbidity conditions, changes in medication, major life events, general life satisfaction, and changes in economic circumstances. For Wave 3 Clinical Data (Part 9) information about the health histories of the respondents was elicited, including information on medication, blood pressure, and physical and mental disabilities.

UNIVERSE: Persons aged 70 and older living in the metropolitan area of Adelaide, South Australia.

SAMPLING: The sample was randomly generated from within the Adelaide Statistical Division using the State Electoral Data Base as the sampling frame. The sample was stratified by gender and by the age groups 70-74, 75-79, 80-84, and 85 and older. Both community and institutionalized individuals were included. In addition, spouses aged 65 and older of specified persons also were invited to participate, as were other household members aged 70 years and older.

NOTE: The codebooks are provided as Portable Document Format (PDF) files. The PDF file format was developed by Adobe Systems Incorporated and can be accessed using PDF reader software, such as the Adobe Acrobat Reader. Information on how to obtain a copy of the Acrobat Reader is provided through the ICPSR Website on the Internet.

EXTENT OF COLLECTION: 6 data files + machine-readable documentation (PDF) + SAS data definition statements + SPSS data definition statements

EXTENT OF PROCESSING: CONCHK.PR/ MDATA.PR/ UNDOCCHK.PR/ DDEF.ICPSR/ REFORM.DATA/ RECODE/ SCAN

DATA FORMAT: Logical Record Length with SAS and SPSS data definition statements and SPSS export files

Part 1: Wave 1 Data Part 2: Wave 2 Data File Structure: rectangular File Structure: rectangular Cases: 2,087 Cases: 1,779 Variables: 1,586 Variables: approx. 395 Record Length: 9,222 Record Length: 2,386 Records Per Case: 1 Records Per Case: 1

Part 3: SAS Data Definition Part 4: SAS Data Definition Statements for Wave 1 Statements for Wave 2 Record Length: 80 Record Length: 80

Part 5: SPSS Export File Part 6: SPSS Export File for Wave 1 for Wave 2 Record Length: 80 Record Length: 80

Part 7: Wave 3 Data Part 8: Wave 4 Data File Structure: rectangular File Structure: rectangular Cases: 1,679 Cases: 1,504 Variables: 1,304 Variables: 461 Record Length: 7,193 Record Length: 3,624 Records Per Case: 1 Records Per Case: 1

Part 9: Wave 3 Clinical Data Part 10: Wave 5 Data Cases: 1,423 File Structure: rectangular Variables: approx. 165 Cases: 1,171 Variables: 393 Record Length: 7,202 Records Per Case: 1

RELATED PUBLICATIONS: Clark, M.S., and M.J. Bond. "The Adelaide Activities Profile: A Measure of the Lifestyle Activities of Elderly People." AGING CLINICAL AND EXPERIMENTAL RESEARCH 7, 4 (1995), 174-184. Andrews, G.R., L.K. Mawby, G.C. Myers, and S.J. Taylor. "Computer-Assisted Personal Interviewing (CAPI) in the Australian Longitudinal Study of Aging." Sydney, Australia: International Epidemiological Association 13th Scientific Meeting, 1993. Andrews, G.R., and C.M. Rungie. "Networks of Formal and Informal Support Amongst the Aging." New Orleans, LA: Gerontological Society of America, 1993.

F&w-.+,f.,.,.. .....F~~

QUEST IONNA1RE : SURVEY

B1aise 2.39 28-09-1992 00:25

1. Sequence Number —

2. I A6) Respondent - male or female?

{INTERVIEWER TO COMPLETE)

Male ..............................................................

female ............................................................

3. ( Al) Type of domicile?

{INTERVIEWER TO ANSWER)

Cmm.nityl ivi. g. ........ ............................. .... .....

Institution ............................................... . . ..

—

1

2

1

2

1

2

3

4

5

6

7

1

2

3

4

5

6

7

—

seqnum

sex

domicile

inst

Wmmun

commtyp

typcco

howmany

9. TABLE

The table contains the following 5 questions:

9.1

9.2

9.3

9.4

9.5

Guestion

Person

Person

Person

Person

Person

Person

Person

Person

Person

Person

10. (

11. (

12. (

13. (

. .

.

.

. .

.

?i5a)

Al)

What is their name?

See di splay cards number 1

What is their relationship to you?

what was their age last birthday?

What is their sex?

Male ............................................... .. . . . (1)

Female .................................................... . (2)

Are they registered .. the electoral roll?

Yes ... ...... . . . . .. ..

NO .........................

9.1

Please specify other

9.2

1 code

—

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (1)

. . . . . . . . . . .

9.3

—

—

—

—

9.4

Male Female

12

12

1 2

1 2

12

12

1 2

12

12

12

. . . . . . . . . . . (2)

9.5

Yes No

12

12

12

12

12

12

12

12

12

12

when were y.” born? (would y.” please give the exact date

dd, mm, yyyy) — —

A81 What was your age last birthday?

A9) Were y.” born in Australia?

14. see display cards number 2

(A1O) Inwhich country were you born? . . .. ... .. . . . . . ... .

15. lAIO. I Specify other country of birth?

16. ( All) In what year did you arrive in Australia?

17. ( A12) Which one of the following would YO” describe yourself

mmeO-name9

rekzfo-reld

thageO-thage9

Uzsexfl-thsefl

elecfO-eIecf9

ofhinst

birthday

age

birthcou

whichcou

yearauz

national

2

18. (A12a) Specify other nationality

Ye, No

19. ( A13) Do you {o= does .) speak a languaqe at home other than

English? 12

20. ( A14) Do you (or does ..) have any difficulty u.der.$tanding or

speaking English? 12

21. ( A15) Are YOU (or is . ) usually able to carry on a conversation

with a person who only spaks English? 12

22. ( 2.16) Which language do you prefer to use most of the time?

English ........................................................... 1

Other ............................................................. 2

1

2

3

4

5

6

7

8


( A191 who is your second interpreter? ............................ . . _

27. ( A20] What is your c“rr.nt marital stat., ?

Married ........................................................... 1

Othorig

otldang

d(ffundr

covrest

kzngpref

anyinmp

whointer

secinter

evrmar

maritst

3

28.

29.

A211 HOW l.a.g ha.. j.ou bee. $MARITST? (in YearSI

(INTERVIEWER - If 1.ss than one year, enter 0) ?

A22) 1s this your first marriage (live in relationship) ?

30. (A22. ) How long was your previous marriage? (in years)

(INTERVIEWER - If less than .“. yea,, enter 0]?

32. ( A24) 1 would now like to ask you some questions about your family

How many children do or did you have (including stepchildren and

adoPted children) ?

33. ( A25) How many so”, do or did you have?

34. ( A26) How many sons are still alive?

[INTERVIEWER - If only one ask - Is he still alive?]

35. { A27) How many sons are living with you?

[lNTERVIEI+ZR -If only one ask - Is he living with you?)

36. ( A28) How many live within one hours travel?

{INTERVIEWER -If only one ask - Does he live within one hour, travel?)

31. [ A29) How many live i. South Australia more than one hours travel

away ?

(INTERVIEWER - If only one ask - Does he live in SA] ?

38. ( A30) How many live elsewhere i. Australia?

(INTERVIEWER - If only one ask - Doe, he live in Australia?)

39. ( A31) How many live overseas?

IINTERVIEWER - If only’ one ask - Does he live oversea, ?)

40. ( A32) How many daughter. do or did you have?

41. ( A33) How many daughters are still alive?

{INTERVIEWER -If only one ask - Is she still living?}

42. ( A34) How many daughters are living with you?

{INTERVIEWER -If only one ask - 1s she living with you?}

43. ( A351 How many’ live 0.. hours travel?

(INTERVIEWER - If only o.. ask - Does she live within on. hours

travel? )

44. ( A36] How many live in South Aust Ialia more than one hours travel

—

—

—

—

—

—

—

hawmarr

marrbef

Ianfmarr

frmnml

chiLiren

showman

Sstlalv

slivyou

slivhor

slivsa

slivau2

sovemea

dhowman

dsflalv

dlivyou

dlivhor

dlivsa

4

.:,,

away?{INTERVIEWER - If only ... ask - Does she live in 5A?]

45. ( A37] How many live elsewhere in Australia?

[INTERVIEWER - If only one ask - Does she live in Australia?]

46. ( A38) How many live overseas?

{INTERVIEWER -If only o.. ask - Does she live overseas?)

47. (A38a) What is the age of your youngest living child? —

48. (A38b) What is the age of your eldest living child? —

49. IA38C1 What is your child-s age?

50. ( A39) Do You have anY qrand. hildren?

51.

52.

A40) How many qrandchildre” do you have?

A41) 1s your mother now living?

53. ( A42) How old is she (was she when she died)? (Years)

Yes No

54. 1 7+43) Is(w.as) she Your natural mother? 12

55. ( P.44) Is your father ... living? 12

56. ( A45) How old is he (was he when he died) ?

Yes No

51. ( A48) 1s (was) he your natural father? 12

58. {A48A) Did you have any brothers or sisters includinq step and

adopted brothers and sisters? 12

59. ( A49) How many brothers did y.. have while you were growing up,

including step a“d adopted brothers?

60. ( A50) How many of your brothers are “o’d living?

61. ( A52) How many brothers live in Adelaide II”terviewer if only o“e ask

- Does be live in Adelaide}?

62. (A49a) How many sisters did you have while you .. .. growing up,

including step a“d adopted sisters?

63. ( A51) How many of your sisters are no. li. in9?

64. ( A53) HOW many sisters live in Adelaide 11. ter. ie.er if o.lY O.. ask

- Does she live in Adelaide) ?

65. lA53a) what is the .qe of your y.au”.gest living brother fsister?

dlivaus

doversea

youngest

eldest

Oldyons

granch

hmgdcMn

mothliv

mothage

iwwtmo

fothIiv

fathage

sibs

bro

broliv

broadel

Sk

si21iv

youngbrs

5

‘1

66. (A53b) What is the age of your eldest living brother/sister? —

67. (A53c) What is your aqe of your brother/sister? —

Ye, NrJ

68. i h54) Are YOU a twin? 12

69. ( ASS) Ace you an identical twin? 12

10. ( B1) Does your wife, husband or partner have any illness or

health problems which limit his or her activities in any way? 12

72. ( B3) The followi.q questions concern the way you feel about

your health and your life:

How would you rate your 0..?..11 health at the present time?

Questions 13 through 76 :

meaning of the Labels:

Very likely . ....... ........ ...............................(1)

Likely ..... .. . .... . . .. . ..................................(2)

Unlikely . ... . .. ... . . . ..................................(3)

Very ””likely . . ... . .... . . .............................(4)

73. I B3al we would like to ask a few questions about various health

events in the f“t”re.

How likely do y.. think it is that yo” will need long-term care

in a nursi”q home at some point d“rinq your lifetime?

{INTERVIEWER - Show Prompt Card 2 ) 1234

74. ( B3c) How likely do you think it is that you will live for

another ten years?

[INTERVIEWER - Show P.ormpt Card 2 ) 1234

75. ( B3b) How likely do you think it is that your partner/spo.se

will “.ed long-term care in a nursing home at some point during

their lifetime?

{INTERVIEWER - Show Prompt Card 2) 1234

okiersis

brsisage

win

idenfwin

spousehl

likenh

Iveexp

Iiksnhsp

6

76. ( B3d) How likely do you think it is that your partner/spouse

will live for another ten years?

[INTERVIEWER - Show P rc=mpt Card 21 1234

77. ( B4) Would you say that your health is better, about the same,

or worse than most people your age?

Better ............................................................ 1

same ........................................................ ... . 2

Worse ............................................................. 3

Don, tK.ow ........................................................ 4

18. ( B51 1s your health now better, about the same, or not as good

as it was about twelve months ago?

Better”ow ........................................................ 1

About the same .................................................... 2

Notas good now .......................................... .. ..... 3

Do”at K”oW . ... . .. . . .. . . . ............................ . 4


Meaning of the labels:

Rarely or”oneof the time ........................................(1)

Some of the time ..................................................(2)

Quite abitof the time ...........................................(3)

Most orallof the time ...........................................(4)

79. ( B6) 1 am now going to read a list of statements describing how

People sometimes feel. Many of these statements may “or apply to

you but we have to ask them of everybody to get a comparison.

Please tell me how often you felt that way d“ri”g the past

week :

(INTERVIEWER - Show prompt card 3 }

1 was bothered by things that usually don Ot bother me

80. ( B7) 1 did not feel like eati”cj: my appetite was poor

81. ( B8) 1 felt that 1 could not shake off feeling lo. even with

help from my family and friends

82. ( B9) I felt that 1 was just as good as other people

83. ( B1O) 1 had trouble keeping my mind o. what 1 was doing

84. ( B1l I 1 felt depressed

85. ( B12) 1 felt that everthi”g 1 did was a“ effort

86. ( B131 1 felt hopeful about the future

81. ( B14) 1 thought my life had been a failure

88. i B15) 1 felt afraid

89. I B16) My sleep was restless

90. ( B17) 1 was haPPy

91. ( B18) lt seemed that 1 talked less than .s..1

92. ( B19) 1 felt lonely

93. I B201 People were .“friendly

1234

1234

1234

1234

1234

1234

1234

1234

1234

1234

1234

1234

1234

1234

1234

l~eexsp

hlthbtsm

btsm12m

cadl

c@sd2

cad?

c@sd4

C@sdscssd6

cesd7

cesdS

cesd9

a?sd10

cesdll

cesdJ2cesd13

cesd14

cesdlS

7

94.

95.

96.

97.

98.

B211 1 enjoyed life

B22) 1 had crying spells

B23) 1 felt sad

B24) 1 felt that people disliked me

B25) 1 could not get going

9’3. ( Cl) Now 1 have some questions about specific medical

conditions.

Have you ever had either pain/discc.mfort or pressure/heaviness

in y.”. chest lasting less than half an hour?

1234

1234

1234

1234

1234

cesd16cssdl 7

cesd18

cesd19

cesd20

102. ( C3) Do you get this pain . . discomfort, pressure or heaviness

when you walk at an ordinary pace on level ground?

Yes ...............................................................

No ................................................................

103. ( C4) If you ‘get this pain while you are walking, do you stop

or slow do.”, take an arginine, or co”ti”ue at the same pace?

Stop o. slowdown .. . . . .. . . .. .. .... . . .

Take a.a”ginine . . . . . . . . .. .. . . .. . .. .

Contin.ea. the same pace . . . . . . .. . . . . . . ..

1

2

1

2

3

1

2

3

4

1

2

1

2

3

1

2

1

2

wherepn

wkuphl

ordpace

whenpain

painreIv

howsoon

8

106.

107.

108.

109.

110.

111.

112.

113.

114.

115.

( c7) Have YOU had this pain or discomfort, pressure or

heaviness more than three times?

Yes .................................................... . . . . 1

No ................................................................ 2

see display cards number 4

( C8) About howoldwere yo. whe. you first had it? .................... _

( C9) Have you been bothered by this pain or discomfort,

p.e=ure OK heaviness in the past 12 months?

Yes ............................................................... 1

No ................................................................ 2

I C1O) In what year did you last experience this pain or

discomfort, pressure or heaviness? (Year)

Yes No

I C1l) Have you ever had a seve.e pain across the front of your

chest lasting half a“ hour or more? 12

( C12) Did you see a doctor because of this psi”? 12

( C14) How many of these attack* have you had?

( c16) How long was the ePi,ode of Pain in your last attack?

(Hours) - If less than one hour, e“te, 1 —

116.

117.

(c12a) What did the doctor say it was?

C13) Please specify what the doctor said it was?

c231 Do you get psi” in either leg when walking?

fnrethrs

howoldl

in.wtwlo

whenkzst

Painchst

docmr

howmanyQ

l.stlong

Usthosp

Whatsay

othcond

painleg

Stndstl

9

121. See display cards n.mher 4

( c27) About how old were you when you first had this pain? . ...

122.

123.

124.

125.

126.

127.

128.

129.

130.

131.

132.

( c28) Have you ever had a sudden 10SS of vision in either or both

eyes?

( C29) Did this condition last longer than 24 hours?

( c30) Have you ever had a sudden loss of speech, difficulty in

speaking, or slurred speech?

( C31) Did this condition last longer than 24 hours?

( c32) Have you ever had a sudden paralysis or weakness of an arm

andl.ar leg o. the sane side of the body?

I C331 Did this condition last longer than 24 hours?

( c341 Have you ever had a sudden numbness o. one side of the body?

{ c35) Did this condition last longer than 24 hours?

( c36) Do you usually cough? Exclude clearing your throat. Include

a cough with a first smoke or on first going out of doors.

I c371 Do you usually have a cough during the winter only?

I c38) DO you usually cough like this o. most days (or nights) for

.s much as three months each year?

133. I C391 Are you troubled by shortness of breath when hurrying on

1...1 ground or walking up a slight hill?

Yes . . . .... . ............................ . .. ....

. . .._

fes No

1

1

1

1

1

1

1

1

1

1

1

..

2

2

2

2

2

2

2

2

2

2

2

1

135. I C41) In the last 12 months has your chest sounded wheezy or

whi.stly frequently or only occasionally?

Frequently . . . . . . . . . . .. . 1

wkuphil

painrel

howld

vision

Ia2nel

speechO

tslhour

pamlys

hvlhrs

numbnes

Iwlvhrs

winton

shortbr

wheshvh

freqocc

10

only occasim.ally . .... ... ... .. .. ....................

136. I c42) 1. the last 12 months has it sounded wheezy Or whistlY

only when you have a cold or at other times as well?

O.lywhen has cold ..........................................

Atc.ther times ... . . . ........ .. ....................

137. See display cards number 4

( c43) Ab.a”t how old were you when you first had this

condition?

[INTERVIEWER - Read aqe categories if necessary) . . .. . ....

138. ( C44) In the last 12 months have you had an attack of wheezing

which made you feel short of breath?

139. ( C45) Have you had more than o“e such attack i“ the last 12

months?

140. I C461 Did You require medicine or treatment for that (those)

attacks?

141. ( C47) Have you had pain in your neck on most days for at least

one month in the past 12 months?

142. I c481 Have YOU had pain in your back on most day. for at le=t

one month i“ the past 12 nm”ths?

143. ( C49) Have you had pain or aching i“ any joints o“ most days for

at least one month in the past 12 months?

144. ( c521 Which joints are “s”ally involved whenever you have this

pain?

Hands ... .. . . . . .. . ...............................

. . . . .

. . . 1

.. . 2

....._

Yes No

12

12

12

12

12

12

1

abhowol

shrtbrea

mrethoa

reqmed

painneck

painback

painjoia

wh@maO-wh@jo7

145. ( C50) Have you had any Swollen joi”t$ which were painful when

touched .“ most days for at least one month i“ the last 12

months?

Yes .. .. .. . . . ........................... . .. . . 1

No .. .. . . . ........................... . .. . . . 2

146. I C531 Which j.ai”ts ace usually involved whenever you have this

swelling?

Hands . .. . . . . . ......... ............... .. . .. . 1

swo~oin

wh@wvO-wh@sw

11

147. ( C51) Have you had stiffness in your joints when first getting

out of bed .. most mornings for at least one month in the last

12 months?

Yes .................................................... .. .. 1

No ...... . .... . . . ............................ 2

148. ( C54) Which joints are usually involved whenever you have this

stiffness?

Feet . . . . .. . . ............................ .. .

1

2

3

4

5

6

7

8

14’3. ( C55) Did a doctor ever tell you that you had a cancer,

malignancy or turn... of any type? Exclude skin cancer but

include melanoma

Yes .................................................... 1

No .................................................... ... . . 2


I c56) Where was the cancer or what type of cancer was it?

[INTERVIEaR - lf more than one, enter the most recent one) . . . . _

151. Please specify other type of cancer?

152. ( c57) 1. what year were y.. first told that you had this cancer

(last one) ? (Year)

Yes No

153. I C58) Have y.. been hosPitalised overnight for this? 12

154. ( c59) Did . doctor ever tell you chat you had diabetes? 12

wh~’nstO-wh@!st7

cancer

whtcanc

spec~y3

whentold

hospitl

diabete

155. ( C60) When were you first told that you had diabetes? (Year)

12

156. ( c61) Are you currently receiving treatment for diabetes?

Yes .................................................... . . .

No ................................................................

157. I c621 What type of treatment are you receiving?

Insulin ...........................................................

Diet ..............................................................

Tablet sordr.gs ..................................................

158. I c63) Have you been hospitalised overnight for this condition?

Yes ...............................................................

No ................................................................

159. ( c64) 1 want you to tell me which of these medical conditions

YOU have ever suffered from and also tell me about any .ther

conditions YOU have had

(INTERVIEWER - Show Prompt card, 41

Enter total no. of conditions suffered from (note their names

.. paper)

160. TABLE


160, 1 Which condition?

[INTERVIEWER - Enter condition code from list by enterirg the 4

letters in brackets EXACTLY as shown o“ the card)

160.2 Pleas. specify other condition

160.3 1. what year were you first told that you had this condition?

160.4 ii... y.” stayed in hospital overnight for this condition?

1

2

1

2

3

1

2

Curtreat

Whattype

luqdtoo

J20conds

Yes ......................................................... (1)

No ......................................................... (2)

160.6 Are you now prevented in any way from doing any activities because

of this condition?

Yes ......................................................... (1)

No .......................................................... (2)

morbidl-morbid63

othmrb40-othrmrb

diagyrl-diagyr63hspl-hsp63

sqfferI-sflemf3

liml-lim63

Question 160.1 160.2 160.3 160.4 160.5 160.6

Yes No Ye, No Yes No

Disease 121212

Disease _ 121212

Disease 121212

Disease 121212

13

Disease

Disease

Disease

Disease .

Disease

Disease .

Disease

Disease

Disease .

Disease .

Disease .

Disease

Disease

Disease

Disease

Disease

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

. ..

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

. .

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

. . .

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

..

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

.. 1

1 swallow—

. .

162. I c66) what causes this? causes

Ye, N.

163. ( c67) Are you troubled by indigestion? 12

164. ( c68] DO you suffer from vomiting at least once a week? 12

165. ( C69) 0. you bruise easily? 12

indiges

bruise

ifchskin

Constip

diarh

bowelmv

14

173. I C771 About how many times per night? —

bloadmv

Wine

nighhu

urdmes

plu”nur

holdur

accdur

ream

15

178. ( C821 Do you suffer regular or frequent headaches?

Yes .................................................. .. ... . 1

No ................................................................ 2

179. ( C83) How often do you get a headache?

Seve.altimes a week ... . .. ... .. .... ...................... 1

Once a week ............................................ . . . . 2

Several times a month .. . ... .. .... ....... .... .. ... . .. . 3

Once amo”th . ....... . . ... .. .......................... 4

Several times a year..... ......................................... 5

Once ayeaz or less ............................................... 6

Yes No

180. I C84) 1s your eyesight affected when you have the headaches? 12

181. ( c85) Do you suffer from dizziness or giddiness? 12

182. ( c86) Do your hands shake when you pick up an object? 12

183. ( c87) Is that always or sometimes?

Always .. ............. .. ............................ . . . 1

sometime. ................ ........................... . . . . . 2

184. ( C88) Do your hands shake at rest?

185.

186.

187.

Yes ...................................................... . . ... 1

No . .. .... ... . . ...... .. .. .. .... . ... ............ 2

Donst know .................................................... . . 3

Yes NO

188. ( c91) Have you had a fit in the last twelve months? 12

189. ( C93) Have you ever suffered from blackouts or loss of

co. scio. s”ess (other than due to trauma) ? 12

190. ( c941 Have you had a blackout or loss of conscio. s”ess in the

last twelve nm”ths? 12

191. ( Dl) The next few questions are about nv=dici. es.

headach

ojlnhed

eyeaff

dizdn

handsshk

shkprobe

shkrest

shkprob

fu

epil

fifhvmo

black

16

we are interested in any medicines prescribed by a doctor that

You have taken or were supposed to take in the last t.. weeks

we are also interested in all other medicines not prescribed by

a doctor such as aspirin, headache pills, laxatives, cold

medicine, cough medicine, etc.

could you please show me the medicines that y.. take.

[INTERVIEWER - CHECK CONTAINERS - Do not include ointments]

192. ( D3) Drug name?

[INTERVIEWER - Generic name prefer=edl

193. I D2) [INTERVIEWER - [NEXT I MEDIcINE)

194. ( D4) What stre.qth is it (or, if medicine, strength in single

dose) ?

(INTERVIEWER - CHECK LABEL)

Yes No

195. I D51 Have you taken this in the last two weeks? 12

196. [ D6) Did you take this yesterday? 12

197. ( D7) About how many days in the last two weeks did you take

this? —

198. ( D8) What is the .s..1 number of these caps.les/tablet s/doses

that you would take in a day?

[INTERVIEWER - If less than one, enter fraction]

199. ( D9) What do you take this for?

201. ( 011) How many’ $HWLONG[ll?

202. ( D12) Was this prescribed by a doctor?

Yes . . .. . . ... . . .......................... .. ...... 1

cOntseeO

hon.WrmO

I.wwk.so

yesterdO

dysli?wko

hmO

Whalforo

hwlongtl

hwmnyl

deco

17

No ................................................................ 2

203. ( D3] Drug name?

[INTERVIEWER - Generic “.anvepreferred)

204. ( D2) [INTERVIEWER - [NEXT] MEDICINE)

Container seen?

Ye, ................................................ . . . ...... . 1

No ................................................. . . .. . .. . 2

205. ( D4) What strength is it (or, if medicine, strength in single

dose) ?

(INTERVIEWER - CHECK LABEL I

Yes No

206. ( D5) Have you taken this in the last two weeks? 12

207. ( D6) Did you take this yesterday? 12

208. ( D7) About how many days i. the last two week-=.did you take

this?

209. i D8) what is the usual number of these caps.les/tablet s/doses


{INTERVIEWER - If less than one, enter fraction)

210. I D9) What do you take this for?

211. I D1O) How 10.c3 ha.. you been taking this?

Weeks . .. . . ............................ . ... . 1

Months . . . . . . ... . . . . ... .. .... ..... . 2

Years . . . ... . . . . . . . . . . .. ........ . .. . 3

212. ( DIII HOW UW7Y SHWLONG III?

213. [ D12) Was this prescribed by’ a doctor?

214 D3) DI.g name?

[INTERVIEWER - Ge”ecic name prefecredl

drugl

contseel

honsbml

lsf2wks1

dysli?wkl

hml

Wha(forl

hwlongl

hwmny2

docl

drug2

18



dose) ?

(INTERvIEwER - CHECK LABEL)

Yes No

217. ( D5) Have you take. this in the last two weeks? 12

218. I 06) Did you take this yesterday? 12


this-?

220. ( D8) What is the usual number of these capsule s/tablet sldoses


[lNTERVIEKER - If less than one, enter fractionl

221. ( D9) What do YOU take this for?

223. ( ml) How many $HWLONG[l]?

225. { D3) Druq name?

[INTERVIEWER - Generic name preferred)


c0ntsee2

honsfrm2

lst2wks2

yesterd2

dys12wk2

wha(f0r2

hwlong2

hwmny3

doc2

drug3

contsee3

19

227. I D4) what strength is it (or, if medicine, strenqth in single

dose) ?

{INTERVIEWER - CHECK LABEL)

228. ( D5) Have YOU taken this in the last two weeks?

229. ( D6) Did you take this yesterday?


this?

Ye, No

12

12

—

231. ( D8) What is the usual number of these capsules/tablets/doses

that you would take i. a day?

{INTERVIEWER - If less than one, enter fraction]

232. I D91 What do YOU take this for?

234. ( DIII HOW many $HWLONG II]?

236. ( D3) Dru’g ..*?

(INTERVIEWER - Generic name preferred)

237. ( D21 IINTERVIEWER - [NEXT I MEDICINE I

238. ( 04) What strength is it (or, if medicine, strength i. single

dose) ?

[INTERVIEWER - CHECK LABEL) —

honstnd

IW2wks3yestsr&

dys13wk3

hm3

whaf0r3

hwlong3

hwmny4

doc3

drug4

c0ntsee4

honstrm4

Yes No



241. ( D7) About how many days i“ the last two weeks did you take

this?

242. ( D8) What is the usual number of these capsules/tablets/doses

that y.” would take i. a day?

{INTERVIEWER - If less than one, entez fraction)

243.

244.

D9) what do y.” take this for?

D1OI How long have you been taking this?

246.

247.

{INTERVIEWER - Generic “me preferred)

248. ( D2) [INTERVIEWER - [NEXT I MEDICINE)

Container seen?

Yes . . . . . . . .............................. ... .. 1

No ................................................................ 2

249. ( D4) What strength is it (or, if medicine, strength i. single

dose) ?

(INTERVIEWER - CHECK LABEL)

Yes No



252. ( 07) About how many days i“ the last two weeks did you take

this?

Lw2w&4

dyslZwk4

hnd

hwlong4

hwmny5

dod

drug5

c0ntsee5

honstrm5

I!@wkss

yaterd5

21

253. f D8) What is the usual n.ml.er of these caps.les/tablet s/doses


{INTERVIEWER - If 1.ss than one, enter fraction)

hti

254. ( D9) What do YOU take this for?

256. ( D1l I How many $HWLONG[l I?

258. { D3) Dx3Y3 name?

{INTERVIEWER - Generic name preferred

259. I D2j (INTERVIEWER - INEXTI MEDICINE)

260. ( 04) What strength is it (or, if medicine, strength in single

dose) ?

[INTERVIEWER - CHECK LABEL)

261. ( D5) Ha”e YOU taken this i“ the last two weeks?

262. ( D6) Did y.. take this yesterday?


this?

264. 1 D8) What is the .s..1 number of the%. caps.les/tabl ets/doses

that YOU would take in a day?

{INTERVIEWER - If less than one, enter fraction}

Whngors

hwlong5

hwmny6

doc5

drug6

honstrm6

Yes No

12

12

lsf2wks6

ysstird6

dysl.Zwk6

265. ( D9) What do you take this for?

22

266. ( D1O) How long have you been taking this? hwIong6

267.

268.

D1l I How many $HWLONG[l I? —

D12) Was this prescribed by a doctor?


(INTERVIEWER - Generic name preferred)

270. ( D21 [INTERVIEWER - [NEXT I MEDICINE)

271. { D41 what strength is it (or, if medicine, strength i. si.91e

dose) ?

[INTERVIEWER - CHECK LABEL)

Yes No

272. ( D5) Have you taken this i“ the last two weeks? 12

273. ( 06) Did you take this yesterday? 12


this? —

275. I D8j What is the .s.?.1 number of these caps.les/tablet s/doses

that you would take i“ a day?


hwmny7

doc6

drug7

c0ntsee7

honstrm7

M2wks7

yes&rd7

dys12wk7

whalf0r7

hwlong7

23

278. ( D1l) HOW many $HWLONGIII? —


[INTERVIEWER - Generic name preferred]

281. I D2) IINTERVIEWER - [NEXT I f4En1c1NEt


dose) ?

[INTERVIEWER - CHECK LABEL I

Yes No

283. ( D5) Have you taken thiz in the last two weeks? 12

284. [ D6) Did you take this yesterday? 1 2


this?

286. ( D8) What is the .s..1 number of these capsules/tablets/doses



287. [ D9) What do you take this for?

289. I DII) HOW many $HWLONGI II?

hwmny7

doc7

drug8

lstzwkwsyestmf8

dyslZwk8

hm8

whafor8

hwlong8

hwmny9

doc8

24

291. ( El) Now 1 would like to ask you about accidents you may have

had both in and around your home or away from home.

Firstly, have you had any falls i. the past yea. - including

those falls that did not result i. injury as well as those that

did?

lf yes, how many?

292. ( E2) Did you receive medical treatment for injuries from any

of these falls or did you limit your usual activity for more

than two days due to inj. r’ie$ from any of these falls?

Medical treatment ................................................. 1

Limit activity .... . .. . . . .. .......................... 2

Both ................................................. . . . .. 3

Neither ............................................. . .. . .... 4

293. ( E3) In the last twelve months, how many falls did you have

with injuries that required medical attention or limited you in

doing your .s..1 activities for more than 2 days?

294. TABLE


294.1 I E41 For each of the falls please answer the following questions.

,Where were you when you were injured? (Please specify e.g. kitchen

of own home) ,

294.2 ( E5) What were you doing at the time you were injured? (Please

specify such as washing dishes, walking upstairs)

294.3 ( E6) What went wrong? (Please specify such as slipped on rug)

294.4 ( E6a) How exactly was the injury caused? leg Landed on floor)

294.5 ( El) What were your injuries?

(Please specify - include body parts and nature of injury such as

cut or fracture]

294.6 ( E8) Did you stay in a hospital overnight because of your

i“j. ries?

Yes . . . . . .. .......................... . . . (1)

No .. . . . . . . ............................ (2)

Question 294.1 294.2

acsdha

medtrtmt

hwmnyfls

whersfeO-wherefe9

wlmtdoiOO-whatdoi

cautiaOO-sm4@09

howexacOO-howem

injuryO-injury9

hospitO1-hospitIO

Falls ..

Falls ...

25

Falls . .

Falls . .

Falls . .

Falls .,.

Falls .

Falls ...

Falls ...

Falls .

Question

Fall, .

Falls ..

Falls ..

Falls ..

Falls ...

Falls ..

Falls ...

Falls ...

Falls .

Falls ..

Quest ion

Falls . .

falls .

Falls .

Falls . .

Falls ..

Falls .

Falls .

Falls .

Falls ..

Falls .

294.3

294.4 294.5 294.6

Yes No

12

12

12

12

12

12

12

12

12

12

Yes No

295. ( E9) Now 1 would like to ask you about other accidents and

injuries you may have had in the past year. These may include

motor vehicle accidents, .accide. ts or injuries while doing your

daily tasks, and other i.j. rie3.

Have you had a“y other accidents and i“j. ries in the past yea..?

12

296. ( E9A) Did you receive medical treatment for any of these kinds of

i“ju. ies?,

12

297. ( E1O) Did you limit your usual activities for more than 2 days

acclstyr

medtreat

lmtactvy

26

Question

Accdt s

Accdts

Accdts

Accdts

Accdts

Accdts

Accdts

Accdts

Accdts

Accdts

Question

Accdt,

Accdts

Accdts

Accdts

Accdts

P.ccdts

Accdts

Accdts

Accdts

Accdts

12

m12accia

because of any of these injuries?

298. I E1l) In the past 12 months, how many times did you have

injuries (accidents other than falls) that required medical

attention or limited you in doing your usual activities for more

than 2 days? —

299. TABLE


299.1 ( E12) where were you when you were injured? (Please specify such

as in kitchen of own home)

299.2 ( E13) What were y.” doing at the time you were injured? (Please

specify such as washing dishes, walking O. path)

299.3 ( E14) What went wrong? [Please specify such as slipped on rug)

299.4 (E14a) How exactly was the injury caused? I+ Landed on floor)

299.5 ( E15) What were your i.juries? (Plea-se specify and include body

parts and nature of injury such as cuts or fr.act”res)

299.6 ( E16) Did you stay in a hospital overnight because of Your

299.1 299.2

299.3

whereasll- whersac:

whtdng20-whtdng2

musfa10-sau@a19

excauseO-exu2use9

iajuryqo-iajulyq9

hospta10-hospta19

27

Question 299.4 299.5

Accdts .

Accdts ‘.

Accdts .

Accdt,

Accdts ..

Accdts ..

Accdts ..

Accdts ..

Accdts .

Accdts ..

300. ( E17) Are you now limited in any way in doing any activities

because of an injury at any time i. the past, other than those

we have already talked about?

Yes .. . .. . . . .... . .............................

299.6

Yes No

12

12

12

12

12

12

12

12

12

12

acclimit

. . . . . . 1

No. ...................... ......................................... 2

301. ( E18) What were your injuries?

(Please specify i“cl.dinq body part a“d “at. re of injury such

as cuts or fractures)

302. ( E19) What were you doing when you were injured? (Please

specify such as driving a car, playing football)

305. ( E22) 1“ the past twelve months, have you changed your driving

habits because of concerns related to your age or your health?

No change, Still drive .as before .......................... 1

Yes, drive less often .......................... . . . . . . . . 2

Yes, only local driving, shortdi stance ........ . . . . .....3

Yes, only dayl ight driving. . . . .. . ...........4

Yes, other .. . . . . ................... . . . . .. 5

306. [ E23] Please specify othez

whtinjry

doingwht

doyoudrv

hwoftndr

chngddrv

spec~j4

crstreet307. I E24) How often do you cross. the street as a pedestrian?

28

308.

309.

310,

311.

Atleast.ante.aday ...............................................

Once ortwice a week..... .......................... . .. . .....

Once ortwice a month .............................................

Less th.nonce .artwi.eanra.th .............................. ....

Never .............................................................

( E25) Are there any things about your home that make daily

living more difficult? (such as poor lighting, chair that is too

low)

Yes ...............................................................

No ................................................................

( E26) Please specify main difficulty

( E27) [INTERvIEWER - Show Prompt card 4A)

1 want y.. to indicate which, if any, of these bones YOU have

broke” one or more tines

TABLE

The table contains the following 4 quest io”$:

311.1

311.2

311.3

311.4

Question

Fracture

Fracture

Fracture

Fracture

Fract”ce

Fracture

Fracture

Fracture

[ E28) Which bone?

IINTERVIEWER - Enter the three characters in brackets 0. prompt

card ExAcTLY 1

( E29) HOW old were y.” when this happened?

( E30) How did this occur?

Fall at ground level ........................................

Fall from height ............................................

Motor .ehicle accident ......................................

Other accident ..............................................

Spontaneous break ...........................................

Other .. . . ... ... .. ................................

I E31) Did you have surgery for this?

Yes .........................................................

No ........

311.1 311.2

—

—

—

. . . . . . . . . .

311.3

1 code

123456

123456

123456

123456

123456

123456

123456

123456

. . . . . . . . . . . . . . . . . . . . . . . . .

311.4

Y*s No

12

12

12

12

12

12

12

12

—

(1)

(2)

(3)

(4)

(5)

(6)

(1)

(2)

1

2

3

4

5

1

2

spec(fy2

12afmcs

fmcbonO-Jmcbon

fmcageO-fmcage9frachowo-frachow

fracsu2Q-fiacsu29

1

2

1

2

3

4

5

6

1

2

1

2

3

1

2

1

2

3

Yes No

318. ( F9) Do you or have you ever used a heaci.g aid? 12

319. ( F1O) Do you use a hearing aid now? 12

320. ( F5) (With a hearing aid), do you find it difficult to follow a

conversation if there is background ooise, e.g. T.V.. Radio,

children playing? 12

321. ( F6) (With a hearing aid), do you have difficultly hearing what

a person says to you in a quiet room? 12

anywrg

hmsurg

hearing

ringnok

hwofring

asdhraidusehmid

backgrnd

diffqurm

30

322. ( F7) (With a hearing aid), can y.. make out what PeOPle are

saying on the telephone (with the receiver to your better ear) ?

Easily . .. . . . . . .. . . . . . .. . . .. . ..... ......

With some difficulty . . . . . .......................

With great difficulty . . . . . .............................

323. I F8) (INTERVIEWER - Do NOT a-k this question if NO hearing

difficulty at .11, but enter NA)

324. ( F1l) As an adult have you ever bee. to your own doctor about

problems with your hearing?

325. ( F12] As .“ adult have you ever bee. to your own doctor about

problems with noises in your head or ears?

326. ( F13) &s an adult have you ever visited a hospital about problems

with your hearing?

327. ( F14) As an adult have you ever vi. ited a hospital about problems

with noises in your head o. ears?

328. ( F15) Have you ever attended the National Acoustic Laboratory

with regard to your hearing or for fitting of a hearing aid?

329. ( F16) Have you ever worked in noisy places where you had to

shout to be heard?

[INTERVIEWER - If yes, for how long altogether?]

Never .......................... ... . . .. .. .. . .. ..

Forless than six months . . . . . . . . . . .. .. .. ..

heamnph

1

2

3

@-cfsOc

1

2

3

4

5

Yes No

1

1

1

1

1

..

.

330. ( F17] Now 1 am going to ask ‘f.. some q.estion, about your

sight :

Are you totally blind in either eye?

2

2

2

2

2

1

2

3

4

5

1

consdoch

dosnoise

hosphear

hospfwh

worknois

blind

Yes ........................ ..............

31

No .. ... . . . . . . . . ...................................... 2

333. ( F20) How old were YOU where you started wearing glasS~S or

contact lenses?

Yes No

334. [ F22) When wearing eye glasses or contact lenses can you see well

eno.qh to re.qnise the letter. in ordinary newspaper print? 12

335. ( F23) To recognise the letters in a headline? 12

336. I F24) To tell if a light is on or off i. a room? 12

331. ( F21) Do y.. use a magnifying glass for reading? 12

338. ( F25) Have you noticed that your eyesight is worsening in the

last 5 years? 12

Q.e5tions 340 through 348 :


Not Applicable . . . .. . . . . . . .......................... (1)

Not at all . . . . . . . . . . . .............................. [2)

A little . . ... . . ... .. . .................................(3)

Moderately . . ... . . . . . . ..............................(4)

A lot . . . . . . . . ...................................(5)

340. ( F27) Now I would like YOU to tell me to what extent does

vision interfere with your ability to do a number of things

[with glasses if applicable)

(INTERVIEWER - Show Prompt Card 5)

Firstly you= housework or retirement activities?

341. I F281 Your going outside in the bright sun?

342. I F291 Your ability to drive by day?

12345

12345

12345

whicheye

glfscoru

gkzmage

specread

rectdineIghronof

rnagglasswrsls5yr

Wtultdono-whddon

exosint

intirlsun

intdydrv

343. ( F301 Your ability to drive by night? 12345

344. ( F31) Your ability to recognize faces across the street? 12345

345. ( F32) Your ability to read? 12345

346. ( F33) Your ability to see in the distance? 12345

347. ( F34) Your ability to watch TV? 12345

349.

350.

351.

352.

353.

F35) Your ability to appreciate colors? 12345

F36) Do y.” have anything wrong with your speech?

Yes ..................................................... ......... 1

No ................. . ...... . ..................... ......... 2

F37) What condition causes this?

F38) Do you have full use of your arms and fingers?

Yes .......................... .. . . . .. .. . ... ........... 1

No ............................ . . .. . . .... .. ..... 2

F39) What condition causes this?

F401 Do you have full use of your feet and l.qs?

Yes ....................................................... . .... 1

No .............................. . . ... ........ .. . .... 2

354. ( F41) what condition causes this?

355. ( F42) Do you have any disfigurement or deformity caused by a.

illness or injury or that you have had from birth?

Yes .......................... .. . .. .. . .. . . .... .... .. 1

No ... .. .. . . . . . . .. . . . ................ 2

356. ( F43) What condition do y.. have?

351. ( f44) Do y.” have any condition that makes you S1OW at learning

or “ndersta”di”g things?

358.

359.

Pr..tice YOU U=.lly CJO tO h.. YOU .,. sick .. $+he. YOU ..ed

advice about your health?

‘f,, . .... . . . . . . . .. . . ... . . . 1

No . . .. . .... . . . . .................................. ... 2

360. ( G2) How many times ha.. you consulted a doctor in the last 2

33

in(faces

intreadg

intdstns

intcohr

speechl

cauzsppr

armfiigr

m-f

feetiegs

C4u@lg

di$ftffmt

whcondtn

slwleam

Causslln

regmedpr

hwmnydoc

More than10 ..........................................

361. I G3) In the last 12 months have you consulted any of the

following woP1e about your health?:

‘General Practione, ?,

362. Specialist DOCt O=?

363. Hospital Outpatients?

364. A Dietitian?

365. A Chemist for advice?

366. A. optician or Optometrist?

367. A Physiotherapist?

368. An occupational Therapist?

369. Speech Therapist?

370. A Chiropractor?

311. A Chiropodist or Podiatrist?

372. A Psychiatrist

373. A Psychologist?

374. A District, Home or Community Nurse?

375. A Social or welfare worker?

376. A Naturopath?

377. An Acupuncturist?

. . . . . 5

Yes No

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

318. ( G41 Have you consulted any other person about yo. z health other

than those 1 have already mentioned in the last 12 months? 1

379. ( G5) Please specify?

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

Ye, No

380. ( G6) Have you ever been a patienr in a n.rsin~ home? 12

381. { G7) Have you been a patient in a nursinq home in the last 12

months? 12

382. ( G8) HOW many different time$ were you in a nursing home in

the last 12 months?

383. ( G9) For about how many days. ..s that in total?

384. ( G1O) 1. the last 12 months, have you been in a hospital at

34

xpeclist

hospautp

dieticn

chemizt

opticianphysioth

accthpstspsechth

chiroprc

chirped

psychogdstnurse

socworti

m~~acupuns

consother

specconz

nurshm12

dysnrshm

hspon12m

385.

386.

387.

388.

389.

390.

391.

392.

393.

394.

395.

396,

least overnight because of illness or an accident?

Yes ....................................................... ..... 1

No .................................................... ... ..... 2

( G1l) How many different times were you in hospital in the last

12 months?

( G121 For about how many days was that in total?

( G13) Over the last 12 months have you spent more

in bed because of illness . . injury (other than $.

nursing home) ?

Yesillne.ss ........................ ......

Yes injury .............. . . ..............

No .......... ..... ... . . . . ..... . ....

( G14) For about how many weeks was that?

—

than a week

howital or a

. . . . . . . . . . . . . . . . . . . . 1

.......... ... ..... 2

.. ... ..... .. 3

—

( G15) Over the last 2 weeks have you stayed in bed .11 or most

of the day because of illness or injury (other than i. a

hospital or a nursing home)?

Yes .................................................... ... ...... 1

No ............ . .... . . ............................ ......... 2

( G16) What was the illness or injury that caused this?

( G17) (Apart from when you were in hospital) how many days did

y.. stay in bed in the last 2 weeks? —

( G18) (Apart from when you stayed i. bed) in the last 2 weeks

have you had to cut down on a.ythi”g you usually do becau=e of

illness or injury?

Yes .......................................................... .. 1

No ................................................. .. ...... .. 2

( G19) what was the illness or injury that caused this?

( G20) How many days did you cut down in this last 2 weeks (not

counting your days in bed) ?

( G21) DO you ever go to a day care c., day theraPy cent,. ?

Yes .. . . . . . .. . . . . ........................... . .. 1

No . . . . . . . .. . . . . ...................... .... .. .. . 2

I G22) How often do you go to the centrels)?

Daily . ... . . . . . . . . . . . 1

dyshsp12

dyshsptl

wkbed12

bsddys2w

iUinjry

IlObddysz

lmadwk

Iwdyslmt

dycrther

hwmnydyc

35

No ........................... .. .. . .. .. . ........ ..

398. ( H2) 1 would like to get some idea of how many natural teeth

Y.. ha,. in Your .PPer law. Including the wisdom teeth, there

are 16 teeth making “P a comP1ete set of teeth in the “PP.. jaw

Could y.” tell me the number of remaining teeth i. your “ppez

jaw?

399. ( H3) Do you have a denture or false teeth for your UP=, jaw?

400. ( H4) Have you lo, t all your teeth from y... lower jaw?

401. ( H5) I“cl”ding the wisdom teeth, there are 16 teeth making “p

a complete set of teeth i. the lower jaw (.1s.1

could you tell me the number of remaining teeth in your lower

jaw?

402. ( H6) Do you have a denture o. false teeth for your lower jaw?

403. ( H7) Are you ordinarily able to chew boiled vegetables?

404. ( H8) Are you ordinarily able to chew hamburger?

405. ( H9) Are y.” ordinarily able to chew fresh lettuce salad?

406. ( H1O) Are y.” ordinarily able to chew a piece of fresh carrot?

407. ( H1l] Are you ordinarily able to chew firm meat such as steak or

chops?

408. ( H12] Are you ordinarily able to bite off and chew a piece from a

whole fresh apple?

409. ( H13) How lonq ago did you see someone about your teeth,

de”t”res or gums?

,.. . 2

Yes No

12

i2

Yes N.

12

12

12

12

12

12

12

notthupp

natteeth

upperden

Iozaltu

ntthloj

lowerden

chwbveg

chwhamb

chwlttcs

chwfcrrtchwmeat

seedent

36

410.

411.

412.

413.

414.

415.

( H14) Would you say that you visit the dentist on a regular

basis, or do you only 5’0 when you are in discomfort or when you

need something fixed?

Regular basis . . .. . . ... . .. .. .......

Whe” in discomfort . . . . .. . . . ... .. . . . . ... .

Sornething.eeds to be fixed .......................................

I HIS) For your last course of dental treatment did you go to a

private dentist, a dental technician or . public hospital or

clinic?

Pri.ate dentist . . ... . . .. ..... . . . .. . . ........

Dental technician ...... . . . .. .. .. . ... .. . ....... ..

P.blic hospital .. . . . . . . . . . . . ... . ... ..

( H16) HOW old were you when you last had a tooth extracted?

[INTERVIEWER - If never enter 0)

( H17) If you needed to Pay a one hundred dollar dental bill

the next month, how much difficulty would that create

financially?

{INTERVIEWER - Show Prompt Card 6)

No difficulty . . . . . . . . .. . . .... . .. . .

in

. . . .....

( H19) If you needed co visit a dentist in the next month would

you face any other problems?

(INTERVIEWER - Show PromPt Card 7)

1

2

3

4

5

6

vstdeml

1

2

3

dnprpub

1

2

3

1

2

3

4

1

2

3

4

1

2

age;stex

@pybil

prbvsdnl

37

416. ( H20) What problems would you face?

417. ( 11) 1 am .OW qoing to ask you some .q.e*tio.s about your

weight. DO you wish to answer these questions i. stones and

pounds or kiloqrams?

Stones ............................................. ... .. . . . 1

Kilogram ............... . .......... .. . .. . .. . . .. . . . 2

418. I 12B) About how much do you weigh now? INTERVIEWER - For

example, if 10 stone 12 lbs, type 10.12 or if 8 sto.e 7 lbs,

type 8.7

419. [ 12A) About how much do you weigh now?

420. ( 13) Do you consider yourself now to be overweight,

underweight or about the right weight?

Overweight ..................................................... .. 1

Underweight .................................................... .. 2

About the lightweight . .. ... . . . .. .. ....................... 3

421. ( 14) Would 1’.. like to weigh more, less or stay about the same?

More .................................................. . . . . . 1

k,, .................................................... .. .. . 2

Stay about the same.... . . . . . .. ... . .. . . . . 3

Yes No

422. ( 15) During the past 12 nm.ths have you tried to lose weight? 12

423. ( 16) During the past 12 months have you changed what you eat

because of any medical reason or health condition? 12

424. ( 17) What was the nedical reason or health condition that

caused you to change what you eat?

Overweight oro&sity .......................... . . .. . . 1

High blood pressure or hypertension .......................... . .. 2

High blood cholesterol . . . .. . . . ........................ 3

Diabetes ................................................. . . .. 4

Heart disease ........................... ... ... . . . . . 5

Allergy ..... . ... . . .. . .. . .. .. . . 6

ulcer ........................... . ... .. ... .. . . 1

Other .........................

‘425. ( 18) Please SaPeCify?

426. I 191 Up to the present time, what

. . . . . . . . . . 8

s the most you have ever

natipmb

weightkp

weight

weight

ovundwgh

prefwghl

lstwt12m

chngeath

rsncheat

maxwghtweighed? (Females do not include any times when you were

pregnant)

38

427. ( 19a) Up to the present time, what is the most you have ever

weighed? (Females do not include any times when you were

pre.mant )

428. [ S1) The next series of question. relate to worn.?”o“lY:

At what age did your periods begin?

429. ( J2) At what age did you have your last period?

430. ( J3) Did your periods stop naturally, because of su=.gery or

for some other reason?

Naturally . .. .. . . .. . . .......................... 1

Surgery ... .. . .. .. . . . . ........................... ... 2

Other reason .. . . .. . ... . .. .............................. 3

431. ( J4) What was the reason?

Yes No

432. ( .J5) Do you still have your womb or uterus? 12

433. ( .76) Do you still have both your ovaries? iz

434. ( J7) Do you still have o“e ovary? 12

435. ( J8) How many times have you been pregnant includi”q any

miscarriages or still births?

436.

437.

438.

439.

440.

S9) HOW old were you when you had your first pregnancy?

J1O) Have you ever had a miscarriage?

Yes ... . . ... . .. . ........................... ... .... 1

No ... . . . .. .. .............................. .. .. 2

J1l) How many miscarriages have you had?

.712) HOW many live births have you had?

S131 How m.a”y children have y.” breast fed?

mmeght

prdbegin

mnpsslrt

otturesn

utrsintcovintct

noprgncy

frstpreg

misscn-g

nolnswg

nobirths

nobrstfd

39

q.estio.s we ask e.*rYOne t. get a comparison - What day of the

week is it?

(INTERVIEWER - code Response I

442. ( K2) What is the date - Day?

443. ( K3) What is the nm”th?

444. ( K4) What is the year?

445. ( K5) What season of the year is it?

446. ( K6) Without looking at a watch or clock, what is the time of

day ?

[INTERVIEWER - HO.CS a“d ~i”ute, .= 24 ho.= .lock .cceptable)

447. ( K7) What country are we i“?

448. ( K8) What city or tow. are we in?

449. [ K9) What is the name of the state . . Territory?

450. ( K1O) What is the “ante of this hospital, nursing home, hostel?

451. ( K1l) What is the name of this suburb?

452. ( K12) What floor of the building are we on?

453. ( K131 What are the names of 2 MAIN ROADS “ear your home?

454. ( K14) What is the name of the Prime Minister of this country?

455. ( K15) 1 am going to name three objects - After 1 have said them,

1 want you to rePeat them - Remember what they are becau,e 1 am

9.in9 t. ask Y.. t. name them a9. in in a few minutes:

...aPP1e. ..blbl e.. .penny ...

- Respondent remember, APPle?

456. ( K16) Respondent remembers Table?

451. ( K1l) ResPo”de”t remembers Penny?

458. ( K1O) [INTERVIEWER - After first trial repeat as often as

necessary until respondent can say’ all three (.P to 10 trials) .)

Try to remember these three Ehi”gs because 1 am going to ask you

to recall them i“ a little while

{INTERVIEWER - Record the nude= .f trials)

1234

1234

1234

1234

1234

1234

1234

1234

1234

1234

1234

1234

1234

1234

1234

1234

123.4

Q.esti.a”s 459 through 463 :


correct ..... .................. . . . . .. .... . ...(1)

week

date

month

year

CouJ@

city

state

namehosp

suburbjloor

pn”memin

thrthing

table

penny

maths

40

stop after five subtractions {INTERVIEWER - count only 1 error if

respondent makes subtraction error, but subsequent answers are 7

1,ss than the error).

,100 - 7 = 93?, 1234

460. 93 - 1 = 86? 1234

461. 86 - 7 = 79? 1234

462. 79 - 7 - 12? 1234

463. 72 - 1 = 65? 1234

464. ( K20) Now 1 am going to spell a word forwards and 1 want you to

spel 1 it backwards. The word is WORLD.

{INTERVIEWER - spell W-0-R-L-D aloud forwards)

Spell WORLD backwards - will you do this for me please?

Yes . . ....... . . . . ..................................... 1

No ... . .......... . . . . ...................................... 2



correct .... ..... ... .... . ....................................(1)

Incorrect . . .... .. . .... . . ..................................(2)

No codable reply, refusal .........................................(3)

Not asked .........................................................(4)

465. First letter - D? 1234

466. Second letter - L? 1234

461. Thicd letter - R? 1234

468. Fourth letter - 0? 1234

469. Fifth letter - W? 1234

410. i K211 Now what were the three things 1 asked you to remember?

Respondent remembers Apple? 1234

471. ( K221 Respondent remembers Table? 1234

412. ( K231 Respc.”de”t remembers Penny? 1234

413. ( K24) Please listen carefully to the following name and

address, then repeat it - .Joh” Brown, 42 West street, Kensington

John ?

eighsti

sevdne

sevehvo

Sf.rfjfv

spell

D

L

R

ow

rememb

tabl

penn

john

brown

41

415. Forty two?

correct .................................................... 1

Incc.rrec ........................................ .. . . .. .. . 2

476. West Street?

correct . . .. . . . . .... ........................... .. .. 1

Incorrec t................ . ... . . .. . . . ... ... .. .. .. 2

477. Kensington?

Correct .......................... . . . .. . . ... . 1

Incorrec t.......................................... .... .. ... 2

478. INTERVIEWER - Repeat add=ess until learned - up to 5 tries.

Then ask respondent to remember this name and address for

later.

please record the number of attempts taken to remember the

whole address.

Yes No

479. ( K25) 1 am going to say the names of some people who were famous

in the past and 1 would like you to tell me who they were o. why

they were farno”s.

,Charlie Chaplin? (Actor, comedian, film star, comic)

{INTERVIEWER - Any acceptable resPonse give”? ) 1

480. ( K26) JosePh Stalin? (Soviet, Russia., WW1l leader, communist

leader)

[INTERVIEWER - Any acceptable response give.?) 1

481. ( K27) Captain Cook? (ExP1o.. I, sailor, na. iqator, discoverer)

[INTERVIEWER - Any acceptable reqxmse given?) 1

482. ( K28) Adolf Hitler? (German, Nazi, WW1l leader)

{INTERVIEWER - Any acceptable response given?) 1

484. ( K31) What is the name and address 1 asked you to rememhec a

short time ago?

John ?

2

2

2

2

1

2

3

4

5

1

fonyhv

westsn

comes

ctum?e

joseph

captain

ado~

remember

Correct ...................................................... .

42

I“coc.ec .......................................................... 2

489. I K32) 1 want YOU to tell me, please, the meanin9s of some

words .

What does rePair ma” mea”?

Correct abstract definition such.. to fix ........................ 1

Partially correct, gives concrete example .s1”9 simile of repair .. 2

Incorrect, i“cl.di.g repetitic.” of word i“ sentence .. . . .. 3

Does”ot know, “ocodable rePly, refusal . ... .. . . . . . .. 4

Not asked .............. . ... . .. . .. .. . . . . . . . 5

4’30. ( X33) What does terminate mea”?

correct abstract de finiti.a” such.. stop ...................... ... 1

Partially correct, gives concrete example using simile of terminate 2

Incorrect, including repetition of word in sentence . . . . . . 3

Does”ot know, “ocodable reP1y, refusal ................. ........ 4

Not asked .......................................... . ..... . . . 5

491. { K34) What does compassion mean?

Correct abstraction such as pity, empathy or sympathy . ... . . ... 1

Partially correct, gives concrete example using simile of

compass ion.. ... . . . .............. .. .. ............2

Incorrect, i“cl.ding repetition of word i“ sentence . . . . 3

Does notknow,. o Cmdablereply, re fusal ......... . . . . . ..4

Not asked ........................................... . . . . . 5

492. ( K35) (INTERVIEWER - Po, the next 3 quest <.”., if resPonse is

vague, say - Could you tell me a bit more?)

ln what way are an apple and a banana .1 ike?

fort

wes

ksn

termin

banana

43

correct abstract io. s..chas both fruit .................. ... . . . 1

Paritally correct, gives concrete similarities such as both grow,

ca. eat both, both ha. epee l.... ..................................2

Incorrect .. . . . . . ... ................................ 3

Does not know, no codable reP1y, refusal ........................ . 4

Not asked ........................................... . ..... . . . 5

493. ( K36) In what way are a boat and a car alike?

correct abstraction such as both are a means of transport . . ... . 1

Partially correct, qi.es concrete similarities such .* both have

seat s........ . . . . . . . . . . ..........................2

lm. orrect, only mentioned ways different . ..... .. ............... 3

Does not know, no codable reP1y, refusal .................. . . . . 4

Not asked ......................................................... 5

494. [ K31) In what way’ are an egg and a seed alike?

correct abstraction such as beginnings of life, first stage of

development .... . .. . . . . . ........................... . 1

Partially correct, gives concrete similarities such as things grow

fr.mnbot h......................................... ... .......... 2

Incorrect -”ot alike ............................................. 3

Does not know, no codable reP1y, refusal .. . .. . . ............ 4

Not asked . . . .. .................... ... 5

495. I Lll Now 1 would like some information about how you sleep

HOW often do you have trouble falling asleep?

497. ( L3) Between the time you first fall asleep in bed at night

and the time you finally wake in the morning, how long on

average are you awake overnight?

tiblslp

waknight

hrsawkng

44

[INTERVIEWER - Enter number in minutes) —

499. ( L5) Where is the Pain?

503. ( L9) If you take intentional daytime naps .. sleeps, how long

are they usually?

{INTERVIEWER - Enter number in minutes] —

504. ( L1O] How many days per week would you fall asleep

unintentionally (..9. while watching TV, reading, or riding in a

car) ?

No dayS . . . . .. . . .. . ........................... . . ... 1

Oneor two days ................................................... 2

Three or four days .......................... . . . . . .. 3

Five orrnore days ................................................. 4

505. ( L1l) compared to one year ago, do you have sleep problems more

now, less now, or is your sleeping pattern about the same?

More now .................................................. . ... 1

Less ”.. .. .. . . . . . ......................... . .. . 2

About thes.mne .................................................... 3

wakepaia

sitepaia

wakearly

s@eep

dayap

houmap

unintaap

slpcmlyr

45

506. ( L12) HOW often do you usually take ,? sedative or sleepinq pill

that has been prescribed by a doctor to hel P you sleeP?

Night ly ................ ..... . . . .. . ....... ... .. .. .. 1

Afewtimes per week .............................................. 2

Afewtimespernmnth .. ..... ... . .. ........ . .. ... .... .. 3

I,e,, ofte” ............... ... ..... .. .......... ... ... .. . 4

Never .............................................. . .. ... . 5

507. ( L13) [INTERVIEWER - For next 5 question,, use 24-hour clock)

What is the usual time you go to bed at night?

508. (L13a) What is the usual time you turn the liqhts off intending to

qo to ,leep?

509. ( 1.14) What is the “s”=1 time you fall as1eeP?

510. ( L15) What is the usual time you finally wake in the morning?

511. ( L16) What is the usual time you get out of bed in the morning?

514. ( L19) Have you been told that you stop breathing or gasp for

breath during your sleep?

Yes ......................... ... . . .... .... ... .. .. .. 1

No ............................ . . . .. .. .... .. ... .. ... 2

516. ( L21) Do you have periods during .51eeP in which you have

regular twitching movements? (This does not refer to a single

twitch or jerk that may’ occur at sleep onset)

pressedt

tmetobedhunaff

fimeawaketimerise

freqsnar

slapnoea

freqapno

nactwitc

46

Yes No

518. ( L23) Do y.. usually sleep with your P.rtne,lse..,e? 12

519. ( L24) 1s your sleep normally disturbed by’ your partner 12

Yes No

521. ( Ml) Are you able to walk up and down stairs to the second floor

without help? 12

522. ( 142) Are y.” able to walk half a mile without help? 12



Nodifficulty at all .......................... .. . . . . .... (1)

A little difficulty ...............................................(2)

Sornediffic”lty ...................................................(3I

Alotofdiffic”lty ............................................... [4)

Just .nableto do it ..............................................(5)

523. ( M3) Now 1 am .30ing to ask you how difficult it is, on the

average, to do similar kinds of activities.

{INTERVIEWER - Show PrmmPt Card 8)

HOW much difficulty, if any, do you have pulling or pushing

large objects like a living room chair?

12345

524. ( f44) What about stO.pinc3, cro.chi.9 or kneel i.9? 12345

525. ( MS) Lifting or carrying weights ovec 10 po”mds (4 kilograms)

like a heavy bag of groceries? 12345

526. ( M6) Reaching 01 exLendi.q your arm, above shoulder level? 1 2 3 4 5

527. ( M7) Either writing or handling or fingering small objects? 12345

528. ( M8) (INTERVIEWER - Show P.ompt Card 91

1 am “.. qoinq to ask you about some everyday activities.

Please tell me if you had any difficulties or have had any help

freqtwtc

sleepam

sleeppt

Slplis

Shs?flr

wlkh/fml

pshplflw

Stpaknl

fftlolbs

rchovshl

difsmobj

noadlprb

47

from either a Person or from some equipment or device in doing

any of these activities in the last 12 months (apart from when

Y.. m.v have been in a hOspital OK a n.r, iw hone).

[INTERVIEWER - Note dew” c.” paper which activities ...s. a

problem and enter TOTAL number I

529. TABLE


529.1 I M9) {INTERVIEWER - Enter activity code)

529.2 i M1O) 1“ doing this activity, have you received help from a

pers.n. special equipment O. both?

No Help .................................................... (1)

Person ...................................................... (2)

Special equipment ......................... ... .. . . .. . (3)

Both .................................................. . ... (4)

529.4 see display cards “umber 6

( M12) 1s this help provided by relatives or friends. If .5., who is

y.. r main helper?

529.5 See display cards number 7

( !413) Does any other relative .. friend help you?

(INTERVIEWER - Type a space before each code)


( M14) Do you receive .?”Y other help such as from a care

orga”isatio. ?

[INTERVIEWER - Read out categories)

529.9 [ M17) What is the main reason you are not receiving (more) help?

Need not import ante” ough now .......................... . . (1)

activZ-activ8

speceqZ-speceq8

hlpreql-hlpreq8

mainhlpl-mainhl.c

bathlpI-@anhlpl

batharl-tnmorl

diflil-diflc8

marehlpl-morehlb

rsnhlpl-rsnhIp8

48

529.10

Question

Activity

Activity

Act ivity

Activity

Activity

Activity

Activity

Activity

Quest ion

Activity

Activity

Activity

Activity

Activity

Activity

Activity

Activity

Quest ion

Activity

Activity

Activity

Act ivity

Activity

Activity

Activity

Activity

Question

Activity

Activity

Activity

Activity

Activity

Activity

Activity

( M18) Please specify main reason

529.1 529.2 529.3 529.4

1 code Yes No 1 code

123412

123412 —

123412 —

123412

123412

123412 —

123412

123412

529.5

ma. 24 codes

— — — . —— — — — — — —

— — — — — — — —

— — — — — —

— — — — — —

— — — —

— — — —

— — — — —

— — — — — — —

529.6 529.7 529.8 529.9

ma, 9 codes 1 code Yes No 1 code

123412 123456

123412 123456

123412 123456

123412 123456

123412 123456

123412 123456

123412 123456

123412 123456

529.10

spmnl-sprsn.$

49

Activity

530. ( Nll {INTERVIEWER - Show Prompt Card 10)

1 would now like to ask you about mme other activities. Please

tell me if you have had any difficulty 0. have had any help from

a PeKso. because of any problem in doing any of these activities

i. the last 12 months (except for when YOU have been in a

n“rsi”g home or i“ a hospital)

{INTERVIEWER - Note down on paper which activities C..=.. a

problem and enter TOTAL numberl

531. TABLE


531.1 I N21 [INTERVIEWER - Enter activity code}

531.2 I N2.31 Do you receive any help to assist you in this activity?

Y,, . . . .... . ... .. .......................... . ..... (1)

No . . . ... . . . ........................... ..... {2)

531.4 See disP1ay cards “umber 9

( N4) 1s this help provided by relatives or frie.ds? If so, who is

Y.., main helpe~?

531.5 s., display cards number 10

( N5) Does a“y other relative or friend help you?

[INTERVIEWER - Type a space before each code}


I N61 Do you receive any other help such as from a care

orga. isat i.”?

IINTERVIEWER - Read out categories)

iactivl-iaclivlohlpil-Idpi10

reqhIpl-rsqhlp10

imnhlpl-imnhlp10

launhlpl-shophlp3

launor.qI-shopor@

idyp-id~o

indtnrl-indmrl O

50

531.9 ( N9) What is the main reason you are not receiving (more) help? irsnl-zisnZO

531.10

Question

lADLAct .

IADLAct .

lADLAct

lADI.Act .

lADLAct

lADLAct

lADLAct .

IADLAct .

lADLAct .

lADLAct .

Question

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Need not important e“o”gh now ...................... .. ..... (1)

won~t ask-pride ........................... ...... .. . ... (2)

Cost -can, ta. ffordit ............................. .. . ... [3)

No-one to help ........................................ ..... (4)

Unable to arrange help.. service .................. ........ (5)

Other ................................................. .... (6)

[ N1OI Please specify main reason

531.1 531.2 531.3 531.4

Yes No Yes No 1 code

1212

1212

1212

1212

1212

1212

1212

1212

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1212

531.5

max. 24 codes

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531.7

1 code

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1234

531.8

Yes No

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12

12

12

12

12

12

12

12

12

531

531.9

1 code

123456

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51

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More than cmce Per week . .. ..... .... . ....................(1)

Once a week ............................ .. . .. ... .... ... .....(2)

Twoorthree times a month ........................................(3)

Almost once anmnth ...............................................(4)

Less tha”o”ce a month .... .. ... . . .. . .. ..............(5)

Never .............................................................(6)

532. ( 01) Think of your children andlor children-in–law who do

“ot live with you. In the past twelve month$, how often did

YOU have personal contact with at least one of them? 123456

533. ( 02) Again thinking of your child..” and/oc children-in-law

who do “ot live with you. 1“ the Past twelve months, how

oft. ” did you have phone contact with at least o“e of them? 1 2 3 4 5 6

534. ( 03) Again thinking of your children andlor children-in-law

who do not live with you. 1. the past twelve months, how

often did you receive mail from at least one of them? 123456

535. ( Q4) Would y.. say YOU were very happy, reasonably happy, a

little ““happy, or very unhappy with the contact you have with

YOU, children and/Or child ~e. -i. -1aw?

Very happy .. . ... . . .. . ... . .. ... ... .. . 1

Reaso”ablyhaPpy ............................ .. ... ... .. .. . . 2

A little unhappy ................................... .. . .... . 3

Very unhappy ............................ . . .. .. .. . .. . 4

Cant say . . . . . . . .. . . .. .. . .. . .. . . 5

536. ( 05) Do y.. agree or disagree with the following staterne”t?

,Older people should be able to depend o“ their adult children

for the help they need?,

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m~rchhi

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depchild

52

Strongly disagree . .. .. . ..... .... . ......................... 4

537. ( 06) If you and your h.sba.d or wife or partner had health

problems which made you very dependent o. others, do you think

you would want to: ?

Stay athomwith outside help .................................... 1

Move in with children ............................ . ... ....... 2

Move toahornefor the aged ....................................... 3

Move toa nursing home ............................................ 4

Not applicable ...........................................

538. I 07) .% You know, parents and children sometimes support each

other in different ways. DO YOU help your children and/or

children-in-law in any of the following ways?

(INTERVIEWER - Show Prompt Card 11)

Give gifts?

539. I 08) Help out with money?

540, I 09) Help out when someone is ill?

541. ( 010) Help keep house or fix things around the house?

542. { 011) Take care of Czrandchildren or babysit for awhile when

parents are out?

543. ( 012) D. your children .ami{.r children-in-law support you i.

any of the following ways

When you are ill (or when your husband or wife is ill)?

544. ( 013) Give gifts?

545. I 014) shop or ... errands for Y.. ?

546. ( 015) Help out with money?

547. ( 016) Help keep house o. fix things around the house f.. YOU?

548. I 017) Prepare meals for YOU?

549. ( 0181 Drive YOU places such as doctor, sh.PPi..3. ch. r.h?

......(5)

12345

12345

12’345

12345

12345

12345

12345

12345

12345

12345

12345

12345

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53

Nevex . ... . . . . . . ...................................(6)

550. ( 01a) Think of your grandchildren (who do not live with

YOUI. 1. the Past twelve months. h.. often did YOU have

p.r.Onal contact with at least one of them? 123456

551. ( 02. ) Aqai” thinking of your grandchild.e” (who do not live

with y.”) . In the past twelve mva”ths, how oft. ” did y.” have

phone contact with at least one of them? 123456

552. ( 03a) Again thi.king of your qrandchildre” (who do “ot live

with y.”) In the past twelve months. how often did y.”

receive mail from at least one of them? 123456

553. ( 04a) Would 1’.. say you were very happy, reasonably happy, a

little unhappy, or very unhappy with the contact you have with

your grandchild,en?

Very happy . . . . ... ... . .. .. .. .. 1

Reasonably happy . ... . . . . . ........................ 2

A1ittleu”haPPy . . . . . . . . . ........................ 3

Ve.y”nh.appy . . . . . . . ............................. 4

Cant say . . . . . . . . .................................. 5

554. ( 05. ] Do you agree or disagree with the following statement?

‘older people should be able to depend on their adult

grandchildren for the help they need? ,

Questions 555 and 556 :

see display cards number 12

555. ( 019) (Apart from any child or children, children-in-law, or

.qrandchildren) , about how often do you spend some time with family or

relatives who do not live with you?

{INTERVIEWER - Read .mt categories)

556. ( 020) (Apart from your children, children-in-law or grandchild.=”) ,

about how often do you talk with family or other relatives o“ the

telephone?

IINTERVIEWER - Read out categ’.?cie,t

557. ( 0211 1. general, would you like to see more of your famil Y and

celatives than y.” do, about the same, or less?

More . . . .. . . . ......................... . ..... . 1

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54

558. ( 022) (Apart from any child or children, children-in-law ..

grandchildren), how many relatives do YOU have that you feel close to

(that is people you feel at ease with and talk to about private

matters or can ..11 0. for help) ?

559. ( 023) Of these close relatives, how many live in Adelaide?

Questions 56o and 561 :

See display cards “umber 12

560. ( 024) About how often do you spend some time with friends who do not

live with you. that is you ‘go to see them or they come to visit you or

YOU go OUt GO do things tOgether?

(1NTERV1EW2R - Read out categories)

561. ( 025) About how often do you talk with friends .. the telephone?

{INTERVIEWER - Read o“t c.ateqories )

562. ( 026) How many close friends do you have, that is people you feel at

ease with a“d talk to about private matters or can call on for help? _

563. ( 027) Of these .1. s. friends, how many live in Adelaide? —

564. ( 028) From all the people you know, including your (partner) ,

relatives and friends is there any one special person that you

feel very close and intimate with - someone you share

confidences and feelings with, some.”. you feel you can depend

0“ ?

Yes ............................................................... 1

No .................................................... .. .... .. 2


(029) What is Eheirrelationship to you? .............................. _

566. (028.3) Again, from all the people you know, is there any other

special person that you feel very close and intimate with -

someone else you share confidences and feelings with, someone

else y.” feel YOU C.” depend 0“?

Yes ............................................................... 1

No ............................................. . . . . . 2


(029a) What istheir relationship to y.”? .............................. _

568. ( 030) If You were sick, is there someone. either i. your

household or “et, y.” could ..11 on to help around the house or

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Yes No

570. ( 032) 1. an emergency is there someone YOU could call on to get

help for you right away? 12

571. ( 033) When you need some ext.. help can you count on anyone to

help with daily tasks like grocery shopping, house cleaning,

cooking, telephoning, taking you places? 12

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Other .. . . . .. . .. .. . .....................................

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1

2

3

4

5

6

7

8

573. ( 0351 1s there any-an.?who depends on you for help with things

like qetting around the house, or bathing?

Yes ... . . . .. . . . . ............................... ... .. 1

No ... . . . . . .. . . .......................... ........... 2

574. i 036) 1 now have a few questions about the person with whom you

have the greatest involvement in caring for.

careprov

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56

575. I 037) About how many hours a week do you usually spend caring

for him or her? —

576. ( 038) How stressful iS it for you to care for him or her or to

arrange for his or her care?

very stressful .................................................... 1

Q.ite stressful ................................................... 2

Somewh.atstressf.l ................................................ 3

Notat all stressful .............................................. 4



Extremely satisfied ...............................................(1)

Very satisfied ....................................................(2)

satisfied . . . . . . . . . ................................(3)

Somewhat dissatisfied .............................................(4)

Very dissatisfied .................................................(5)

577. (038a) The next few questions are about your qe”eral

satisfaction with life. Could you choose a category from this

card which best applies to you.

[INTERVIEWER - Show PmrnPt Card 12)

A., you satisfied with the area where you live? 12345

518. 1038bl Are YOU satisfied with your own health and physical

condition? 12345

579. 1038. ) Ace you satisfied with your financial situation? 12345

580. (038d) Are you satisfied with your friendships? 12345

581. (038e] Ace you satisfied with your marriage? 12345

582. {Cnt!f) A.. you satisfied with your family life? 12345

583. 1038@ Are you satisfied with the way y.” handle problems that

come up in your life? 12345

584. (038h) Are yo” satisfied with your life i. ‘general? 12345

586. (038j) When it comes to makinq major family decisions, who has

the final say?

(Major decisions mea. things like when to retire, where to live

and how much money to spend on major purchases)

You .................................................... .. . . . . 1

Yo”rpart.erfspo”se ............................................... 2

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57

Youandyour partner/spouse equally ............................ . 3

588. ( 040) Specify type of pets

591. ( PI) The next few questions are about major events that

sometimes take place during . persons life:

Have you ever been a victim of a serious physical attack or

assault at any time in your life?

592. ( P21 In what year was the most recent occurrence?

593. ( P3) And in what month did it happen?

596. ( P6j 1. what year did that h.appe. most recently?

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58

597. I P7) And in what month did it happen?

598. ( P8) UP to now, how well do YOU feel YOU hav, dealt with this

life-threatening illness or injury and any changes or problems

that may have resulted from it?

Very Well ...................................................... . 1

Q.ite well ........................................................ 2

Somewhat well .................................................... 3

Notto. well ...................................................... 4

599. ( P9) Did you have any other serious, but not life-threatening

illness or accidental injury that occurred or got worse in the

last 3 years?

600.

601.

P1O) In what year did that happen most recently?

P1l) A“d i. what month did it happen? —

602. I P121 up to now, how well d. YOU feel YOU ha.e dealt with this

illness or injury and any changes or problems that may have

resulted from it?

Very Well ......................................................... 1

Guite well ........................................................ 2

Somewhat well ............ ......................................... 3

Not too well .................................................... 4

603. ( P131 Have you moved to a new residence duri”q the past 3 years?

Yes ............................................................... 1

No ................................................................ 2

604. ( P141 1. what year was your most recent m.,.?

605. I P15) And in what month?

606. ( P16) 1“ what city or country a“d state did you live before you

moved here?

607. ( P17) So far, have the changes brought about in Your life by

this n.”,, bee”?

E“tirely good ......................................... .. . 1

Mo,tlygOOd ....................................................... 2

Mo*tly bad ............. .................................... .. 3

E“tirely bad . . . . . . . . . ........................... 4

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59

610. ( P20) In what year did that happen most recently?

611. I P211 find in what month did it happen?

612. I P221 Up to now, how well do you feel you have dealt with this

burglary or robbery and any changes or problems that might have

resulted from it?

Very Well . . . . . . . . ... .. . .............................. 1

Q.ite well .. . . . . . . .. ... . ........................... 2

Soroewhat well . . . . . . . . ... . ... .. .. ... ...... ..... 3

Not too well . . . . . ......................... . 4

615. ( P25) 1. what year was the most recent occurrence?

616. ( P26) And in what month did it happen? —

617. I P211 up to now. how well do Y.. feel You have dealt with this

experience and any changes or problems which may have resulted

from it?

Very Well . . . . .. . . . . . 1

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2

3

4

1

2

1

2

3

4

5

6

7

1

2

—

622. ( P321 In what year did that happen?

623. ( P33) And in what month did it happen?

624. ( P3.YI up to now, ho. well do Y.. feel YOU have de.lt with this

event a“d any changes or problems that might have resulted from

it?

Very Well ............................................... ... ..... 1

Quite well ................................................ ...... 2

Somewhat well .............................................. . . .. 3

Not too well .......................... . .. .. . .. .... .. 4

625. ( Q1) The next few q.estio”s are about ~mokinq

Do YOU currently mmke cigarettes?

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61

626. ( Q2) How many cigarettes do you .s.ally smoke a day? —

627. ( Q3) How old were YOU when YOU first smoked cigarettes ~e9.larly?

629. ( Q5) Before you qave up smoking, how many cigarettes a day did

YOU usually smoke?

630. [ Q6) How old were you when you last smoked cigarettes

regularly?

631. ( Q71 Do YOU regularly smoke a Pipe or .i9ars?

632. ( Q8) Have YOU ever regularly smoked . PiPe or cigar, ?

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Yes No

12

12

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633. ( Q9) The next few que,tions are .abo”t beverages that contain

alcohol

HOW often do y.” have a drink containing alcohol?

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62

HOW often do you have six or more drinks on one occasion? 12345

636. ( 012) How often during the last yea. have you found that YOU

were mot able to stop dri”ki”g c.”ce y.. had started? 12345

637. ( Q13) How often during the last year have you failed to do

what was normally expected from you because of drinking? 12345

638. ( Q14) How often during the last year have you needed a drink

i“ the morning to get yourself goinq after a heavy drinking

session? 12345

639. I Q15) How often during the last Year have y.. had a feelin9 of

guilt or remorse after drinking? 12345

640. I Q161 How often du=inq the last year have You bee. unable tO

remember what happened the night be fore because you had been

drinking? 12345


Ffeani”q of the labels:

No ................................................................(1)

Ye%, b“t “m in the last year .....................................(2)

Yes. d.rinq the last year . . . ..... ............................(3)

641. I Q17) Have you or someone else been injured as a result of your

dri”ki”g? 123

642. ( 018) Has . relative, a friend, a doctor or other health worker

bee” concerned about y.”. dri.king or suggested you cut down? 123

645. I RI) N.aw 1 have some questions about how you spend your

leisure time.

1. the past two weeks did you engage i“ vigorous exercise

(exercise which made you breathe harder or puff or pant such as

ten. is< j.99in9 etc. ?

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646. ( R2) How many sessions of vigorous exercise did you engage in

over the Past two weeks?

647. ( R3) How much time did you spend exercising vigorously during

the Past 2 weeks?

[INTERVIEWER - Enter number of minutes) —

648. [ R4) In the Past two weeks, did you enqaqe in less vigorous

exercise for recreation, sport or health-fitness purposes which

did not make you breathe harder or puff and pant?

Yes ........................................................ ..... 1

No ................................................................ 2

649. ( R5) How many se$sions of less vigorous exercise did you

engage in over the past two weeks? —

651, ( R71 How many times did you walk for recreation or exercise i.

the Past two week. ?

652. ( R8) 1“ the PaSt two weeks, in the course of your tasks around

the house, were you involved in moderate to heavy physical

exertion which made you breathe harder or puff and pant?

Yes ... . . . . ..................................... 1

No .. . . . . . . . ................................. .... 2

653. ( R9) How much time were you involved in moderate to heavy

physical exertion in tasks at (work or) home during the Past two

weeks?

[INTERVIEWER - Enter “umber of ho”., )

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655. i Rlll How many ‘group. do you belong to altogether? nogmups

656. TABLE

64

,,

The table contains the

656.1 What are they?

Question

Names ...

following 1 questions:

656.1

I

namesO-m7mes4

Names ...

Names ...

Names ..

Names ..

657.

658.

659.

660.

661.

662.

663.

( R12) How many qroup meetings or .gatheri”gs did you go to in

the past month?

( R131 Are YOU presently an officer of .anY of the cl.b, You

belong to such as president, secretary, treasurer?

Ye, .................................................... . . . ... 1

No ..................................................... . . .. ... 2

( R14) How many different offices do you hold (i. different

clubs) ? —

iR15a) Please specify other religion

( R16) In guiding your life, would y.” say that religion is very

important, somewhat important or not at all important?

very important . . . . . .. .......................... . 1

Somewhat important ................................................ 2

Notatallirpartant ........................... .. .. . . . .... 3

Do”, t know ........................................................ 4

( R17) 1 am 9oinq to ask you some q“estio”s about a n“mher of

activities in which you may participate, some of which 1 have

mentioned before. 1 now want you to tell me how oft.. y.”

Participate in each activity in a typical 3 month period. If you

like, you could think about the last 3 months.

How often have you prepared a main meal?

(Needs to play a s“bsta. tial part i. the organisation,

preps.atio. a.d .o.kin9 of a main meal, not j.st snacks)

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65

664. ( R18) How often have y.. washed the dishes?

(Must do it all or share equally eg. washing c.. wiping and

putting away, not just rinsing occasional items)

Less than o.ce a week ............................................. 1

Oneortwodays a week ............................................ 2

Most days .................. .. . . ... . .. .... .. . .......... . 3

Everyday ......................................................... 4

665. ( R19) How often have you washed clothes?

(organisation of washing and drying of own clothes, whether in

a washing machine, by hand or at a la.”drettel

Never .. . .. . . .... ... . . . ... . .. .. .... . . ........ . 1

About .ance a month . .. . .. . . . ... . .. .... ...... ........ . 2

Abo”tonce a fortnight . . . . . ... . .... .. .. . . .. ..... . 3

Once aweek or more .. . .. .. . . .... .. .... .. . . .......... 4

666. ( R20) How often have you done light housework?

(Such as dusting, Poli$hi”q, sweePinq, tidyi”q “p)

Never ........................................... .. . . . .. ..... 1

Once a fortnight or less . .. . .... . .. . . .. . . .. . ... . 2

About once a week . . . .. . . . .. . .. . .. .. .. . ..... . 3

Several days a week .. .... ..... . .. . .. .... .... . . ...... . 4

667. ( R21) How often h~”e YOU done heavy housework?

(Taking out the garbage, cleaning floors, vacuuming, washing

windows, moving chairs)

668. ( R22] How many hours of voluntary or paid employment have you

done ?

None .. . . . . .... . .. . . ... .. .. . .. .. . . . .. ... 1

Uptoten hours aweek ... . . . . . .. .. .... ............... 2

Tentothirty hours a week . . . . . . .... .. ................ 3

More than thirty hours a week . . . . . .... .. .. ............. 4

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Never . . . . . . . . . . . .... . .. ... .. ., ...(1)

66

About .mce a month ......................................... .. .(2)

About once. fortnight ............................................(3)

Once aweek or more ....................................... ... . (4)

669. ( R23) How often have y.. cared for other family members?

(caring for a sick relative, baby sitting, caring for a spouse

et. ) 1234

670. ( R241 How often have YOU done household sh0pPin9?

(Must play a substantial role in the oz.qanisation and b“yin.g of

the shoppimg eg. groceries, fruit a“d vegetables - Also includes

payimq household bills) 1234

671. ( R25) How often have you done personal shoppinq?

(must play a substantial role i. the organisation and buying of

the shopping .9. clothing, toiletries, gifts)

Never .................................................... ... ... 1

Once inthreemo”ths .............................................. 2

About once arm”th ................................................ 3

once. fortnight or more .......................................... 4

CNIestio”s 672 a“d 673 :


Never .............................................................(1)

Abcmto”ce a month ................................................(2)

Abo”tonce a fortnight ............................................(3)

O“ceaweek or more ...............................................(4)

672. ( R26) How often have you done light gardening? (Weeding,

watering, sweepi”q paths, potting) 1234

673. ( R27) How often have you done heavy gardening?

(Digging garden beds pr.ni”g, mowing lawns) 1234

614. ( R28) How often have you done household andlor car mai”te”ance?

675. ( R29) HOII often have you needed to drive a car or orqa”ise your

OW” transport?

(The emphasis is c.” r-he or%a”isatio” of transport, not the

jo. r.ey itself, i.eludes drivifw 0.. car, .at.hiw bus O, train.

calling taxi etc. Excludes transport for the person organised by

someone else. )

Never .. . .. . .......................... . 1

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67

‘1

676. I R33) How often have you invited people to your home?

(lmplies either casual or formal social co”t.act e.q. having

People t. dinner, inviting people for a cup of tea, card

evenings - l“cludes standing i“vltatio”s to family a“d close

friends. 1

Less tha” oncea f.art”ight ...... . .. ..... .... . .. . ... 1

About o”ceafortni.ght ........................... . .. .. . . 2

About o”ce. week ........................... ..... ...... . .... 3

More tha”o”cea week ............................. ... ... ..... 4

617. ( R30) How often have you spent some time on a hobby?

[Must require some active participation and thought ..9.

k“ittimg, crosswords, painting, garde”i”g, games, letter

writing, “ot just wat.hi”g television)

Never .............................................. .. ... .... 1

Abo”to”cearno”th ...... . . . . .. .. .... ...................... 2

About o“cea fc.rt”iqht . . . . ..... ..... ......... ... ... 3

Once aweekormcme ... . . . . . . .. ...... ..... ... ... .... 4

678. ( R31) How many hours have you spent reading books, magazines or

newspapers ?

Less tha. twohours a week .......................... .. ... .... 1

Twotofive hours a week . . . . .... ... .. . .... 2

Fi”etoten ho”r% a week . . ... .. . ... .... ................ 3

O.erte”hours a week ............................................. 4

679. ( R32) How many telephone calls have you made to friends or

family?

(Emphasis is on making calls NOT receiving calls)

Nom, ................................... .... .. .. ... ... 1

UPtothree calls a week . .. .... .. ... . ... .. ..... ... 2

Four tote” calls aweek .. . . . .. .. ..... . .. . .... ... 3

Over tencalls a week ... . . . . .. . ... ... . . ... .. 4

680. ( R34) How much time have you spent watching television or

listening to the radio?

(Emphasis is on watching/listening, “ot j“$t h.avi”g the

TV/radio o“ i“ the backqro”.d while doing other things)

Less tha”oneho. ra day . .... ..... .... . . .. ... 1

Onetothree ho. cs a day . . .... . .. ...................... 2

Three to five hours a day . .. . . 3

Over five hours a day ........................ . .. 4

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68

681. ( R35) How often have you participated in social activities at a

centre such as a club, a church, or a community centre?

(Bingo, senior citizens, RSL, a hotel, self-education courses]

Less th.nc.nce a month .......................... .... ........... 1

About .ance a month .......................... ... .... .. ........ 2

Abcmtonce a week .. ..... .. .... . .............................. 3

More than c.nce a week ........................... .... ... ....... 4



Never .............................................................[1)

Abcmtonce a month ... ...... .. .. .... ..........................(2)

About .“.. , fortnight ............................................ {3)

Once aweek or more ...............................................(4)

682. ( R36) How often have you attended religious services or meetings? 1 2 3 4

683. ( R31) How often have you participated in an outdoor social

activity?

(BBQs, picnics, spectator sports etc. ) 1234

684. ( R38) HOII often have you spent some time outdoors participating

in a recreational or sporting activity?

(Bowls, fishing, golf etc. Excludes spectator sports)

Never ................................................ .. . ..... 1

About once amo”th .............................. .... .. . .. . 2

Abo”to”ce a week .... . . . . ... . ........................... 3

More than once a week . . . .. . . . . .. ..... ..... ... . .. .. 4

685. ( R39) How oft.” have you walked outdoors for 15 minutes or

mare?

(sustained walking for about 1 mile. short stops for breath are

allowed. Can include walking to the shoP,, provided it is far

enough. )

About o“ceamo”thor less ........................................ 1

About cmce a fortnight .. . . ............. . ....... .. .. .. .. 2

About once a week . . . . . . . .... .. . . .. . .. . . .. 3

Most days .. .. . . . . . ..... . .... . . . .. .. 4

686. ( R40) How often have you gone for a drive or been o. an

OUtin.g?

(The comon factor is an outing for pleasure e.g. by bus, train

or car, excludes routine trips for a purpose such as shopping or

visiting friends)

Never .......................... .. . ..... . .... ... . . .. .. 1

About’ance a month ................................................ 2

Abe. tonce a fortnight ............................................ 3

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Once aweekorrnore ............................................... 4

Ye, No

687. ( R41) Do YOU own a car? 12

688. { T1) Now I would like to ask You about YOU. housing .~d

fina..es.

IS this house, flat or unit being rented by you or any other

.s..1 resident of the household?

12

689. ( T2) Who is the rent paid to?

South Australian Housinq Trust .......................... . .. .. . 1

Person l. dwell ing ................................................ 2

Landlord Or Real Estate Age”t ......................... . . .. .... 3

other. ................. ........................................... 4

690. ( T3) What is the total refit each week (total dollars) ? —

691. ( T4) 1s this house, flat or unit being paid off by y.. or is

it owned by you or any other “s”.1 resident of the household?

Yes, bei”gp.id off .. . ... . ........................... . .. ... 1

Yes, owned ................................ .. . . .. . . .. ... 2

No .................................................... . .. . .... 3

692. ( T5) What is the total repay rne”t each week (total dollars)? —

693. ( T6) In which of these categories does the market value of

your house, flat or unit fall?

(INTERVIEWER - Show Prompt Card 15 t

Upto seven tyfour thousand ........................... . . . .. ...

From Seve. tyfive thousand to one h“mdred thousand .. . . ......

From o.ehundred a“d o“e thousand to one hundred and fifty thousand

More tha”one hundred and fifty thousand ..........................

Not answered . . . . .. . . . . .............................

694. ( T7) When did y.” move into this house, flat or .“it?

Be fore 1910 . . . . .. . ......................... . ..

1970-1974 . .. .. . .. ............................ ...

1975-1919 . . . . . . . . . . . ......................... ...

After 1979 . . . . . . ......................... ...

695. ( T8) Please VPecify which year you moved into this house, flat

or ““it?

696. ( T91 How many main rooms do y.a” have in this house, flat or

70

1

2

3

4

5

1

2

3

4

OwnCar

renthous

landlord

wklyenl

ownpayof

Wwyrpay

mrktvafu

whenoccp

yearoccp

nroom.r

unit? (Do not include bathrooms, porches, balconies or f.Yers

697. [ TIO) Would you say that you find living i. this house, flat or

u.it very comfortable, comfortable or uncomfortable?

Very cc.nfortable ..................................................

comfortable .......................................................

U“cc.mfortable .....................................................

700. ( T13) For what reason do You intend t. move (again) ?

More or better personal care at new home ..........................

Closer tothi”gs or people ........................................

Better neiqhbo”rho’od ..............................................

Cost of rent or n!ort%ge or upkeep and repairs too high ...........

Modified or better designed or more suitable dwelling ...... .. ..

Family changes such as bereavement or to live with family . .. ...

Othex ..................................................... .. .. .

103. [T13c) Please specify other?

L

2

3

1

2

3

1

2

1

2

3

4

5

6

7

1

2

1

2

3

4

704, ( T14) [INTERVIEWER - Do not ask this qUeSti On at Retirene.t

villages]

Have you put your name dew” for any special aged accommodation

or retirement village?

Ye s........ . . . . . ...............................1

No . . .. . . . . . .......................... . . . .. 2

comfort

condreso

platiomv

reasmove

sechome

reashome

specrea8

mvspecac

71

705. ( T16] [INTERVIEWER - Show PmnPt Card 161

This card list. various social security cards.

Which of these do you (or your h.sband/wifel currently hold?

[INTERVIEWER - Prompt for .11 types]

Pensioner health benefits and concession card .................... 1

Pharmaceutical benefits card ...................................... 2

Health Bemefits card .............................................. 3

Health Care card .................................................. 4

Other ............................................................. 5

Nc.neof the above ................................................. 6

706, IT16a) {INTERVIEWER - Only ask if one of the answers to social

security cards is Other, otherwise enter NAI


( T151 [INTERVIEWER - Show PromPt Card 111

This card lists various source. of income. Which of these do

YOU or YOU, husband or wife cur,ently receive as income?

List all SO” ZC=S of income.

IINTERVIEWER - Type a space be fore each code)

.. . . .............. .. . ..... . .. . ---- ---- ---

108. I T1l) If we include the income from all these so. xces, a“d add

.s11 of your (and y.”. spouse, s) earnings, in which of these

9r0.P, wOuld YOU, total income be before tax O, anythinq else iS

take” out?

(INTERVIEWER - Show Prompt card 18 and enter relevant code)

709. I T20) How many people altogether live .“ this Income (that is

it provides at least half of their i.coms)?

710. I T18) What percentage of this total did you yourself receive?



Very Well .........................................................(1)

Fairly Well .... .. . . . .. ............................... (2]

Poorly ............................................................(3)

711. ( T21) How well doe, the amount of money you have take caze of y.”,

needs? 123

112. ( T22) How well does the amo””t of money you have take care of you,

large annual expenses? 123

Othbqfl

sOurciOO-s0urc

nsupinc

percurec

needsmet

Ii-gannds

713. ( T23) Do YOU usually have enouqh co buy those little extras

i.e. small luxuries?

72

114. I T24) suppose y.. needed money quickly, and you cashed in .11

of your (and your spouse- s) cheque and savings accc.u”ts, any

stocks a“d bonds, and real estate (other than your principal

home) .

About how m“ch would this arno””t to?

{INTERVIEWER - Show Prompt card 19 and enter relevant code)

715. ( U1l Now 1 have some background q.estio”s about topics such as

schooling and work experience.

716. ( U2) Since leaving school have you obtained a certificate,

diploma, degree or any other qualification?

Yes ............................................................... 1

No ................................................................ 2


{ U3) [INTERVIEWER - Show PrornPt Card 20)

Which of these groups best describe, your highest qualific.atio”? ....... _

718. [ U4) Please specify other

Yes No

719. { U5) Do you currently work in a job, business or farm? 12

120. ( U6) Have you ever worked in a job, business or farm? 12

721. I U7) How long ago did you last work? (in years)

tthmset

school

qualif

typqual

cumvorkevenvork

whenZO

reh”reo

723. ( U9) 1. what year did you retire?

7’3

726. ( U12) Specify what kind of work

727. ( U131 Did you work -

Fc.ra. employ er ................................................... 1

For wages or salary in your own business with employees ..... .. 2

For waqes or salary in your own business with no employees ..... .. 3

without pay in. family business ........................... . ... 4

Fc.rpayment in king.... ........................................... 5

Unpaid voluntary work ............................................. 6

Yes No

729. I u15) Did that job require You to perform heavY Physical work? 12

730. ( u16) Did you serve in the armed services overseas or in Northern

Australia during war time? 12

731. { U17) What kind of work did your hu,bandlwi f, do for most of

hi, /her life?

Worked at job, b.si.ess or farm ................................... 1

Never employ Ed .................................................... 2

Housewife . . .. . . . . . ........................... . .. 3

732. ( U18) Please specify kind of work

733. ( u19) Was he or she working -

For an employer ................................................... 1

For wages or salary i. your own business with employees . . 2

For wages or salary i. your own business with no employees . . 3

Witho.t payinafami lyb.siness .. . ..................... . 4

course

whatwork

Whatkind

forwhom

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heavy

armedser

spouse

spec~y5

paid

74

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75

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77

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