1. Yes within the last year 2. Yes, more than 1 year ago Q185 Have you ever suffered from… attacks of dizziness in you seem to move? 0. No 1. Yes within the last year 2. Yes, more than 1 year ago IF Q183 = 0 AND Q184 = 0 AND Q185 = 0 SKIP TO Q188 Q186 Nowadays how much does the dizziness or unsteadiness worry, annoy or upset you? 0. Do not have problems with dizziness or unsteadiness 1. Not at all annoying 2. Slightly annoying 3. Moderately annoying 4. Severely annoying Q187 Has dizziness or unsteadiness ever stopped you working or carrying out your normal activities for more than one day? 0. No 1. Yes, for 1 day or more, but less than 1 week 2. Yes, for 1 week or more, but less than 1 month 3. Yes, for 1 or more 188 OBSERVATION INTERVIEWEE 188 This is a global rating concerning the LOOKS EMACIATED, FRAIL, OR conspicuous presence of physical illness PHYSICALLY ILL (examples would be extreme pallor, central 0. No cyanosis or breathlessness at rest) or 1. Mild handicap, including severe degrees of 2. Severe emaciation or frailty (for example, very 9. Not applicable weak). 189 OBSERVATION ONE OR MORE LIMBS APPEAR TO BE WHOLLY OR 189 A positive rating would normally PARTIALLY PARALYSED, OR ONE indicate the aftermath of a stroke.
1. Yes within the last year 2. Yes, more than 1 year ago Q185 Have you ever suffered from… attacks of dizziness in you seem to move? 0. No 1. Yes within the last year 2. Yes, more than 1 year ago IF Q183 = 0 AND Q184 = 0 AND Q185 = 0 SKIP TO Q188 Q186 Nowadays how much does the dizziness or unsteadiness worry, annoy or upset you? 0. Do not have problems with dizziness or unsteadiness 1. Not at all annoying 2. Slightly annoying 3. Moderately annoying 4. Severely annoying Q187 Has dizziness or unsteadiness ever stopped you working or carrying out your normal activities for more than one day? 0. No 1. Yes, for 1 day or more, but less than 1 week 2. Yes, for 1 week or more, but less than 1 month 3. Yes, for 1 or more 188 OBSERVATION INTERVIEWEE LOOKS EMACIATED, FRAIL, OR PHYSICALLY ILL 0. No 1. Mild 2. Severe 9. Not applicable 188 This is a global rating concerning the conspicuous presence of physical illness (examples would be extreme pallor, central cyanosis or breathlessness at rest) or handicap, including severe degrees of emaciation or frailty (for example, very weak). 189 OBSERVATION ONE OR MORE LIMBS APPEAR TO BE WHOLLY OR PARTIALLY PARALYSED, OR ONE 189 A positive rating would normally indicate the aftermath of a stroke.
CFAS-II-questionnaire-part-1-v5-1110081.docx