0. No for shingles on the face, in the eyes, in the 1. Yes, in the body ears or on the scalp. 2. Yes, in the head 8. No answer 9. Not MEN SKIP TO Q482 ASK OF WOMEN ONLY Q480 Age of menopause is thought to be a risk factor for vascular dementia. Age of Q480 How old were you when you had last menstrual period is asked because it is your last menstrual period? more specific and therefore easier to Nn Age at last period pinpoint. Try to complete even if only an approximation. Answer with age of last period, even if it was brought forward by hysterectomy or extended by HRT Q481 For how long did you have (have you had) hormone replacement therapy? yy.mm Length of time 77.77 Don’t know 88.88 No answer 99.99 Not asked/Not applicable Q482 Have you had any medical problem that we haven't covered? 0. No 1. Yes (specify) 8. No answer 9. Not asked Q483 Other medical problem that we haven’t covered Specify…………………………… And now some questions about your Q484 Maternal age at birth is thought to be parents and your brothers and sisters. a risk factor for dementia. It is important that we collect this information as Q484 How old was your mother when you accurately as possible. were born? If the subject cannot remember, ask for Nn Age in years (roughly is ok) mother’s year of birth or year of death, and 77 Don’t know subject’s age at her death. If this still
0. No 1. Yes, in the body 2. Yes, in the head 8. No answer 9. Not for shingles on the face, in the eyes, in the ears or on the scalp. MEN SKIP TO Q482 ASK OF WOMEN ONLY Q480 How old were you when you had your last menstrual period? Nn Age at last period Q480 Age of menopause is thought to be a risk factor for vascular dementia. Age of last menstrual period is asked because it is more specific and therefore easier to pinpoint. Try to complete even if only an approximation. Answer with age of last period, even if it was brought forward by hysterectomy or extended by HRT Q481 For how long did you have (have you had) hormone replacement therapy? yy.mm Length of time 77.77 Don’t know 88.88 No answer 99.99 Not asked/Not applicable Q482 Have you had any medical problem that we haven't covered? 0. No 1. Yes (specify) 8. No answer 9. Not asked Q483 Other medical problem that we haven’t covered Specify…………………………… And now some questions about your parents and your brothers and sisters. Q484 How old was your mother when you were born? Nn Age in years (roughly is ok) 77 Don’t know Q484 Maternal age at birth is thought to be a risk factor for dementia. It is important that we collect this information as accurately as possible. If the subject cannot remember, ask for mother’s year of birth or year of death, and subject’s age at her death. If this still
CFAS-Questionnaire-part-IIv5-1110081.docx