==========================================================================================
Section BM: MEDICAL HISTORY - FOLLOW-UP VISIT (Respondent)
==========================================================================================
HHID HRS HOUSEHOLD IDENTIFIER
Section: BM Level: Respondent Type: Character Width: 6 Decimals: 0
This variable uniquely identifies an original HRS household across waves.
.................................................................................
252 010059-213468. Household Identification Number
==========================================================================================
PN HRS PERSON NUMBER
Section: BM Level: Respondent Type: Character Width: 3 Decimals: 0
Each HRS respondent has a Person Number, PN, unique within an original
household. In combination, HHID and PN uniquely identify a respondent across
all waves of the study.
.................................................................................
160 010. Person Number
6 011. Person Number
56 020. Person Number
1 021. Person Number
11 030. Person Number
17 040. Person Number
1 041. Person Number
==========================================================================================
ADAMSSID ADAMS SUBJECT IDENTIFIER
Section: BM Level: Respondent Type: Character Width: 5 Decimals: 0
This variable identifies an ADAMS subject in the ADAMS data files.
.................................................................................
252 00021-21311. ADAMS Subject Identification Number
==========================================================================================
BMCOMP WHETHER MEDICAL HISTORY COMPLETED
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MHDONE
MEDICAL HISTORY SECTION COMPLETED?
.................................................................................
247 1. YES
5 2. NO
==========================================================================================
BMSPAN MEDICAL HISTORY CONDUCTED IN SPANISH
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MHSPAN
Medical history interview conducted in Spanish: Otherwise Null
.................................................................................
1. YES
252 Blank. Inap
==========================================================================================
BM1 EVER SEEN DOCTOR FOR MEMORY PROBLEMS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH1
1. The next few questions are about (NAME'S) medical history. First, has (NAME)
ever seen a doctor for any of the memory problems we have discussed? (If no
memory problems endorsed, ask if subject has seen a doctor for any concerns with
her/his memory or thinking?).
.................................................................................
21 1. YES
223 2. NO
7. REFUSED
3 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM3 SPECIALTY OF DOCTOR IN AM1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH3
3. Specialty
.................................................................................
3 1. NEUROLOGIST
3 2. PSYCHIATRIST
12 3. FAMILY PRACTICE/INTERNAL MED
2 4. OTHER (specify)
7. REFUSED
1 8. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM4MO MONTH OF MEMORY PROBLEM EXAM
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH4MO
4. Date of Exam
.................................................................................
15 1-12. MONTH
6 98. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM4YR YEAR OF MEMORY PROBLEM EXAM
Section: BM Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: MH4YR
4. Date of Exam
.................................................................................
1930-1949. YEAR
1950-1969. YEAR
1970-1979. YEAR
1980-1989. YEAR
1990-1999. YEAR
20 2000-2003. YEAR
1 9998. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM5 WHAT DID DR SAY WAS CAUSE OF MEM TROUBLE
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH5
5. What did the doctor say was the cause of the memory trouble?
.................................................................................
7 1. NORMAL AGING
1 2. AD
2 3. STROKES OR TIAS
1 4. DEMENTIA
2 5. OTHER (specify)
6. PARKINSON'S DISEASE
1 9. DEPRESSION
97. REFUSED
7 98. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM6 EVER HAVE AN EXAM WITH SPECIALIST
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH6
6. If doctor in #2 is not a specialist ask: Did (NAME) ever have an examination
with a specialist such as a neurologist or psychiatrist for memory problems?
.................................................................................
1 1. YES
12 2. NO
7. REFUSED
1 8. DON'T KNOW
9. NA OR ERROR
238 Blank. Inap
==========================================================================================
BM8 SPECIALTY OF DOCTOR MENTIONED IN AM6
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH8
8. Specialty
.................................................................................
1. NEUROLOGIST
1 2. PSYCHIATRIST
4. OTHER (specify)
7. REFUSED
8. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM8MO MONTH OF SPECIALIST EXAM
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH8MO
8. Date of Exam
.................................................................................
1 1-12. MONTH
98. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM8YR YEAR OF SPECIALIST EXAM
Section: BM Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: MH8YR
8. Date of Exam
.................................................................................
1930-1949. YEAR
1950-1969. YEAR
1970-1979. YEAR
1980-1989. YEAR
1990-1999. YEAR
1 2000-2003. YEAR
9998. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM9 DIAGNOSIS SPECIALIST GAVE FOR MEM PXS
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH9
9. What diagnosis was given for the cause of the problems?
.................................................................................
1. NORMAL AGING
2. AD
3. STROKES OR TIAS
1 4. DEMENTIA
5. OTHER (specify)
6. PARKINSON'S DISEASE
9. DEPRESSION
97. REFUSED
98. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM10 IF HAD MEM EVALUATION, WAS LAB WORK DONE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH10
10. If memory evaluation done ask: Was any lab work (blood work, urinalysis,
EEG, etc.) done?
.................................................................................
6 1. YES
6 2. NO
7. REFUSED
5 8. DON'T KNOW
2 9. NA OR ERROR
233 Blank. Inap
==========================================================================================
BM10AMO MONTH OF LAB WORK
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH10AMO
a) Date of lab work
.................................................................................
5 1-12. MONTH
98. DON'T KNOW
247 Blank. Inap
==========================================================================================
BM10AYR YEAR OF LAB WORK
Section: BM Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: MH10AYR
a) Date of lab work
.................................................................................
1930-1949. YEAR
1950-1969. YEAR
1970-1979. YEAR
1980-1989. YEAR
1990-1999. YEAR
5 2000-2003. YEAR
9998. DON'T KNOW
247 Blank. Inap
==========================================================================================
BM10RES RESULTS OF LAB WORK
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH10RES
RESULTS
.................................................................................
3 1. NORMAL
2. ABNORMAL (specify)
7. REFUSED
3 8. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM11 EVER HAD A CT SCAN OR MRI OF THE HEAD
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH11
11. Has (s/he) ever had a CT scan or MRI of the head done?
.................................................................................
46 1. YES
190 2. NO
7. REFUSED
11 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM13MO MONTH OF CT SCAN OR MRI
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH13MO
13. Date of CT scan or MRI
.................................................................................
40 1-12. MONTH
6 98. DON'T KNOW
206 Blank. Inap
==========================================================================================
BM130YR YEAR OF CT SCAN OR MRI
Section: BM Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: MH13YR
13. Date of CT scan or MRI
.................................................................................
1930-1949. YEAR
1950-1969. YEAR
1970-1979. YEAR
1980-1989. YEAR
1 1990-1999. YEAR
45 2000-2003. YEAR
9998. DON'T KNOW
206 Blank. Inap
==========================================================================================
BM14 RESULTS OF CT SCAN OR MRI
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH14
14. What were the results of the CT scan or MRI?
.................................................................................
17 1. NORMAL
12 2. ABNORMAL (specify)
7. REFUSED
17 8. DON'T KNOW
206 Blank. Inap
==========================================================================================
BM14CODE CODE SPECIFY IF ABNORMAL FOR AM14
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH14CODE
.................................................................................
1. Alzheimer's Disease
2. Dementia
4 3. Stroke/possible stroke/TIA/mini-strokes
3 4. Hydrocephaly/brain damage/shrinkage/atrophy/deterioration
1 5. Brain tumor/brain cancer/lesion
6. Parkinson's Disease
2 7. White matter/white matter change
8. Aneurysm
2 9. Nasal/sinus/ear/throat issues, including cancer
10. Head injury/trauma
11. Spinal issues
12. Artery blockage/poor circulation/hardening, narrowing, or
inflammation of arteries/blood
clots/hematoma/infarcts/ischema/hemmorage/other heart or
cardiac related issues
13. Hematoma
14. Non-CNS cancer
15. Other (specify) use the text field as the specify
16. Inconclusive
240 Blank. Inap
==========================================================================================
BM16 EVER TOLD BY DR HAD PARKINSON`S DISEASE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH16
16. Has doctor ever told (NAME) that (s/he) has Parkinson's Disease?
.................................................................................
6 1. YES
240 2. NO
7. REFUSED
1 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM17 AGE WHEN TOLD HAD PARKINSON`S DISEASE
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH17
17. How old was (s/he) when (s/he) was told (s/he) had Parkinson's disease?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
1 60-69. AGE
3 70-79. AGE
1 80-89. AGE
90-99. AGE
100-109. AGE
1 998. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM18 EVER TAKEN PD MEDICATIONS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH18
18. Has (s/he) ever taken L-Dopa, Sinemet, Mirapex, Requip, Permax, Amantadine,
Symmetrel, Selegiline, Eldepryl, Comtan or Parlodel?
.................................................................................
6 1. YES
2. NO
7. REFUSED
8. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM19 DID PD SYMPTOMS IMPROVE WITH MEDICINE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH19
19. Did the symptoms improve after starting the medicine?
.................................................................................
4 1. YES
1 2. NO
7. REFUSED
1 8. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM20 EVER TAKEN ANY OTHER MEDICATION FOR PD
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH20
20. Has (s/he) ever taken any other medications for Parkinson's Disease?
.................................................................................
2 1. YES
4 2. NO
7. REFUSED
8. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM21 DID PD SYMPTOMS IMPROVE WITH MEDICINE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH21
21. Did the symptoms improve after starting the medicine?
.................................................................................
1 1. YES
2. NO
7. REFUSED
1 8. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM23 MEM PXS START BEFORE, DURING, AFTER PD
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH23
23. To the best of your recollection, did the memory problems start before,
during or after being told (s/he) has Parkinson's disease?
.................................................................................
1 1. BEFORE
2. DURING
3 3. AFTER
1 6. NA
7. REFUSED
8. DON'T KNOW
247 Blank. Inap
==========================================================================================
BM25 EVER TOLD BY DOCTOR HAD STROKE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH25
25. Has (NAME) ever been told by a doctor or nurse that (s/he) had a stroke?
.................................................................................
14 1. YES
229 2. NO
7. REFUSED
4 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM26 HAD MORE THAN ONE STROKE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH26
26. Has (s/he) had more than one stroke?
.................................................................................
1 1. YES
13 2. NO
7. REFUSED
8. DON'T KNOW
238 Blank. Inap
==========================================================================================
BM27 HOW MANY STROKES
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH27
27. How many strokes? NUMBER OF STROKES
.................................................................................
1 1-5. Number
6-10. Number
11-95. Number
998. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM28MO MONTH OF FIRST STROKE
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH28MO
28. When did the [first] stroke take place?
.................................................................................
8 1-12. MONTH
1 98. DON'T KNOW
243 Blank. Inap
==========================================================================================
BM28YR YEAR OF FIRST STROKE
Section: BM Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: MH28YR
28. When did the [first] stroke take place?
.................................................................................
1930-1949. YEAR
1950-1969. YEAR
1970-1979. YEAR
1980-1989. YEAR
1990-1999. YEAR
8 2000-2003. YEAR
1 9998. DON'T KNOW
243 Blank. Inap
==========================================================================================
BM28AGE AGE OF FIRST STROKE
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH28AGE
28. When did the [first] stroke take place?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
1 50-59. AGE
2 60-69. AGE
70-79. AGE
1 80-89. AGE
1 90-99. AGE
100-109. AGE
998. DON'T KNOW
247 Blank. Inap
==========================================================================================
BM29 WHETHER ADMITTED TO HOSPITAL FOR STROKE 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH29
29. Was (s/he) admitted to a hospital for this stroke?
.................................................................................
11 1. YES
3 2. NO
7. REFUSED
8. DON'T KNOW
238 Blank. Inap
==========================================================================================
BM31 DID ONE SIDE BECOME WEAKER WITH STROKE 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH31
31. Did one side of body, or one arm/leg become weaker than the other side, as a
result of the stroke?
.................................................................................
6 1. YES
8 2. NO
7. REFUSED
8. DON'T KNOW
238 Blank. Inap
==========================================================================================
BM32 WHICH SIDE BECAME WEAKER WITH STROKE 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH32
32. Which side?
.................................................................................
2 1. LEFT
4 2. RIGHT
7. REFUSED
8. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM33NUM DURATION (NUMBER) FOR SYMPTOMS IN AM31
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH33NUM
33. How long did the problem last?
.................................................................................
4 1-5. Number
6-10. Number
2 11-95. Number
998. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM33DUR DURATION (TIMEFRAME) FOR SYMPTOMS IN AM31
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH33DUR
33. How long did the problem last?
.................................................................................
1 1. HOURS
2 2. DAYS
2 3. MONTH
1 4. YEARS
6. NA
7. REFUSED
8. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM34 PXS WITH ANY OTHER PART OF BODY-STROKE 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH34
34. Did (s/he) experience problems with any other part of the body?
.................................................................................
2 1. YES
12 2. NO
7. REFUSED
8. DON'T KNOW
238 Blank. Inap
==========================================================================================
BM35 WHICH PART HAD PROBLEMS-STROKE 1
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH35
35. Which part?
.................................................................................
2 1. FACE
2. ARM
3. LEG
4. OTHER (SPECIFY)
5. MOUTH
6. THROAT/SWALLOWING
9. GENERAL WEAKNESS
10. TOTALLY UNRESPONSIVE
11. ONE OR BOTH EYES/VISION UNSPECIFIED
12. BLADDER/INCONTINENCE
13. LOWER BACK
97. REFUSED
98. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM36NUM DURATION (NUMBER) FOR SYMPTOMS IN AM34
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH36NUM
36. How long did these problems last?
.................................................................................
1-5. Number
6-10. Number
2 11-95. Number
998. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM36DUR DURATION (TIMEFRAME) FOR SYMPTOMS IN AM34
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH36DUR
36. How long did these problems last?
.................................................................................
1 1. HOURS
2. DAYS
3. MONTH
1 4. YEARS
6. NA
7. REFUSED
8. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM37 SPEECH/LANGUAGE PROBLEMS WITH STROKE 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH37
37. Did (s/he) experience any speech or language problems (slurring etc)
.................................................................................
11 1. YES
3 2. NO
7. REFUSED
8. DON'T KNOW
238 Blank. Inap
==========================================================================================
BM38NUM DURATION (NUMBER) FOR SYMPTOMS IN AM37
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH38NUM
36. How long did these problems last?
.................................................................................
7 1-5. Number
6-10. Number
4 11-95. Number
998. DON'T KNOW
241 Blank. Inap
==========================================================================================
BM38DUR DURATION (TIMEFRAME) FOR SYMPTOMS IN AM37
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH38DUR
36. How long did these problems last?
.................................................................................
3 1. HOURS
6 2. DAYS
1 3. MONTH
1 4. YEARS
6. NA
7. REFUSED
8. DON'T KNOW
241 Blank. Inap
==========================================================================================
BM39 MEM PXS START BEFORE/DURING/AFT STROKE 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH39
39. To the best of your recollection, did the memory problems start before,
during or after the stroke?
.................................................................................
8 1. BEFORE
2. DURING
6 3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
238 Blank. Inap
==========================================================================================
BM41MO MONTH OF SECOND STROKE
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH41MO
41. When did the second stroke take place? (Month)
.................................................................................
1 1-12. MONTH
98. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM41YR YEAR OF SECOND STROKE
Section: BM Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: MH41YR
41. When did the second stroke take place? (Year)
.................................................................................
1930-1949. YEAR
1950-1969. YEAR
1970-1979. YEAR
1980-1989. YEAR
1990-1999. YEAR
1 2000-2003. YEAR
9998. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM41AGE AGE OF SECOND STROKE
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH41AGE
41. When did the second stroke take place? (Age)
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM42 WHETHER ADMITTED TO HOSPITAL FOR STROKE 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH42
42. Was (s/he) admitted to a hospital for this stroke?
.................................................................................
1 1. YES
2. NO
7. REFUSED
8. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM44 DID ONE SIDE BECOME WEAKER WITH STROKE 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH44
44. Did one side of body, or one arm/leg become weaker than the other side as a
result of the stroke?
.................................................................................
1. YES
1 2. NO
7. REFUSED
8. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM45 WHICH SIDE BECAME WEAKER WITH STROKE 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH45
45. Which side?
.................................................................................
1. LEFT
2. RIGHT
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM46NUM DURATION (NUMBER) FOR SYMPTOMS IN AM44
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH46NUM
46. How long did the problem last?
.................................................................................
1-5. Number
6-10. Number
11-95. Number
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM46DUR DURATION (TIMEFRAME) FOR SYMPTOMS IN AM44
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH46DUR
46. How long did the problem last?
.................................................................................
1. HOURS
2. DAYS
3. MONTH
4. YEARS
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM47 PXS WITH ANY OTHER PART OF BODY-STROKE 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH47
47. Did (s/he) experience problems with any other part of the body?
.................................................................................
1. YES
1 2. NO
7. REFUSED
8. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM48 WHICH PART HAD PROBLEMS-STROKE 2
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH48
48. Which part?
.................................................................................
1. FACE
2. ARM
3. LEG
4. OTHER (SPECIFY)
5. MOUTH
6. THROAT/SWALLOWING
9. GENERAL WEAKNESS
10. TOTALLY UNRESPONSIVE
11. ONE OR BOTH EYES/VISION UNSPECIFIED
12. BLADDER/INCONTINENCE
13. LOWER BACK
97. REFUSED
98. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM49NUM DURATION (NUMBER) FOR SYMPTOMS IN AM47
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH49NUM
49. How long did these problems last?
.................................................................................
1-5. Number
6-10. Number
11-95. Number
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM49DUR DURATION (TIMEFRAME) FOR SYMPTOMS IN AM47
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH49DUR
49. How long did these problems last?
.................................................................................
1. HOURS
2. DAYS
3. MONTH
4. YEARS
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM50 SPEECH/LANGUAGE PROBLEMS WITH STROKE 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH50
50. Did (s/he) experience and speech or language problems (slurring etc)?
.................................................................................
1 1. YES
2. NO
7. REFUSED
8. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM51NUM DURATION (NUMBER) FOR SYMPTOMS IN AM50
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH51NUM
51. How long did these problems last?
.................................................................................
1 1-5. Number
6-10. Number
11-95. Number
998. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM51DUR DURATION (TIMEFRAME) FOR SYMPTOMS IN AM50
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH51DUR
51. How long did these problems last?
.................................................................................
1. HOURS
2. DAYS
1 3. MONTH
4. YEARS
6. NA
7. REFUSED
8. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM52 MEM PXS START BEFORE/DURING/AFT STROKE 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH52
52. To the best of your recollection, did the memory problems start before,
during or after the stroke?
.................................................................................
1 1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM54MO MONTH OF THIRD STROKE
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH54MO
54. When did the third stroke take place? (Month)
.................................................................................
1-12. MONTH
98. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM54YR YEAR OF THIRD STROKE
Section: BM Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: MH54YR
54. When did the third stroke take place? (Year)
.................................................................................
1930-1949. YEAR
1950-1969. YEAR
1970-1979. YEAR
1980-1989. YEAR
1990-1999. YEAR
2000-2003. YEAR
9998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM54AGE AGE OF THIRD STROKE
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH54AGE
54. When did the third stroke take place? (Age)
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM55 WHETHER ADMITTED TO HOSPITAL FOR STROKE 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH55
55. Was (s/he) admitted to a hospital for this stroke?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM57 DID ONE SIDE BECOME WEAKER WITH STROKE 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH57
57. Did one side of body, or one arm/leg become weaker than the other side as a
result of the stroke?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM58 WHICH SIDE BECAME WEAKER WITH STROKE 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH58
58. Which side?
.................................................................................
1. LEFT
2. RIGHT
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM59NUM DURATION (NUMBER) FOR SYMPTOMS IN AM57
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH59NUM
59. How long did the problem last?
.................................................................................
1-5. Number
6-10. Number
11-95. Number
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM59DUR DURATION (TIMEFRAME) FOR SYMPTOMS IN AM57
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH59DUR
59. How long did the problem last?
.................................................................................
1. HOURS
2. DAYS
3. MONTH
4. YEARS
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM60 PXS WITH ANY OTHER PART OF BODY-STROKE 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH60
60. Did (s/he) experience problems with any other part of the body?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM61 WHICH PART HAD PROBLEMS-STROKE 3
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH61
61. Which part?
.................................................................................
1. FACE
2. ARM
3. LEG
4. OTHER (SPECIFY)
5. MOUTH
6. THROAT/SWALLOWING
9. GENERAL WEAKNESS
10. TOTALLY UNRESPONSIVE
11. ONE OR BOTH EYES/VISION UNSPECIFIED
12. BLADDER/INCONTINENCE
13. LOWER BACK
97. REFUSED
98. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM62NUM DURATION (NUMBER) FOR SYMPTOMS IN AM60
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH62NUM
62. How long did these problems last?
.................................................................................
1-5. Number
6-10. Number
11-95. Number
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM62DUR DURATION (TIMEFRAME) FOR SYMPTOMS IN AM60
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH62DUR
62. How long did these problems last?
.................................................................................
1. HOURS
2. DAYS
3. MONTH
4. YEARS
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM63 SPEECH/LANGUAGE PROBLEMS WITH STROKE 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH63
63. Did (s/he) experience and speech or language problems (slurring etc)?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM64NUM DURATION (NUMBER) FOR SYMPTOMS IN AM63
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH64NUM
64. How long did these problems last?
.................................................................................
1-5. Number
6-10. Number
11-95. Number
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM64DUR DURATION (TIMEFRAME) FOR SYMPTOMS IN AM63
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH64DUR
64. How long did these problems last?
.................................................................................
1. HOURS
2. DAYS
3. MONTH
4. YEARS
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM65 MEM PXS START BEFORE/DURING/AFT STROKE 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH65
65. To the best of your recollection, did the memory problems start before,
during or after the stroke?
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM67MO MONTH OF FOURTH STROKE
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH67MO
67. When did the fourth stroke take place?
.................................................................................
1-12. MONTH
98. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM67YR YEAR OF FOURTH STROKE
Section: BM Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: MH67YR
67. When did the fourth stroke take place? (Year)
.................................................................................
9998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM67AGE AGE OF FOURTH STROKE
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH67AGE
67. When did the fourth stroke take place? (Age)
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM68 WHETHER ADMITTED TO HOSPITAL FOR STROKE 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH68
68. Was (s/he) admitted to a hospital for this stroke?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM70 DID ONE SIDE BECOME WEAKER WITH STROKE 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH70
70. Did one side of body, or one arm/leg become weaker than the other side as a
result of the stroke?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM71 WHICH SIDE BECAME WEAKER WITH STROKE 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH71
71. Which side?
.................................................................................
1. LEFT
2. RIGHT
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM72NUM DURATION (NUMBER) FOR SYMPTOMS IN AM70
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH72NUM
72. How long did the problem last?
.................................................................................
1-5. Number
6-10. Number
11-95. Number
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM72DUR DURATION (TIMEFRAME) FOR SYMPTOMS IN AM70
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH72DUR
72. How long did the problem last?
.................................................................................
1. HOURS
2. DAYS
3. MONTH
4. YEARS
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM73 PXS WITH ANY OTHER PART OF BODY-STROKE 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH73
73. Did (s/he) experience problems with any other part of the body?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM74 WHICH PART HAD PROBLEMS-STROKE 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH74
74. Which part?
.................................................................................
1. FACE
2. ARM
3. LEG
4. OTHER (SPECIFY)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM75NUM DURATION (NUMBER) FOR SYMPTOMS IN AM73
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH75NUM
75. How long did these problems last?
.................................................................................
1-5. Number
6-10. Number
11-95. Number
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM75DUR DURATION (TIMEFRAME) FOR SYMPTOMS IN AM73
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH75DUR
75. How long did these problems last?
.................................................................................
1. HOURS
2. DAYS
3. MONTH
4. YEARS
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM76 SPEECH/LANGUAGE PROBLEMS WITH STROKE 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH76
76. Did (s/he) experience and speech or language problems (slurring etc)?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM77NUM DURATION (NUMBER) FOR SYMPTOMS IN AM76
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH77NUM
77. How long did these problems last?
.................................................................................
1-5. Number
6-10. Number
11-95. Number
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM77DUR DURATION (TIMEFRAME) FOR SYMPTOMS IN AM76
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH77DUR
77. How long did these problems last?
.................................................................................
1. HOURS
2. DAYS
3. MONTH
4. YEARS
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM78 MEM PXS START BEFORE/DURING/AFT STROKE 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH78
78. To the best of your recollection, did the memory problems start before,
during or after the stroke?
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM80 EVER HAVE PROBLEMS WALKING
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH80
80. Has (s/he) ever had problems walking?
.................................................................................
121 1. YES
124 2. NO
7. REFUSED
2 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM81MO MONTH WALKING PROBLEMS BEGAN
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH81MO
81. When did this start? (Month)
.................................................................................
30 1-12. MONTH
2 98. DON'T KNOW
220 Blank. Inap
==========================================================================================
BM81YR YEAR WALKING PROBLEMS BEGAN
Section: BM Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: MH81YR
81. When did this start? (Year)
.................................................................................
1930-1949. YEAR
1950-1969. YEAR
1970-1979. YEAR
1980-1989. YEAR
2 1990-1999. YEAR
30 2000-2003. YEAR
9998. DON'T KNOW
220 Blank. Inap
==========================================================================================
BM81AGE AGE WALKING PROBLEMS BEGAN
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH81AGE
81. When did this start? (Age)
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
2 50-59. AGE
8 60-69. AGE
27 70-79. AGE
31 80-89. AGE
10 90-99. AGE
100-109. AGE
11 998. DON'T KNOW
163 Blank. Inap
==========================================================================================
BM83 HAS GAIT CHANGED IN RECENT YEARS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH83
83. Has (her/his) gait (pattern of walking) changed in recent years?
.................................................................................
84 1. YES
160 2. NO
6. NA
7. REFUSED
3 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM84 HAS DOCTOR SAID WHAT CAUSED GAIT CHANGE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH84
84. Has a doctor said what might have caused the change?
.................................................................................
38 1. YES
47 2. NO
6. NA
7. REFUSED
8. DON'T KNOW
167 Blank. Inap
==========================================================================================
BM87 EVER HAD PROBLEMS WITH FALLING
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH87
87. Has (s/he) ever had problems with falling?
.................................................................................
43 1. YES
202 2. NO
6. NA
7. REFUSED
2 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM88 HOW FREQUENTLY DOES SUBJECT FALL
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH88
88. How frequently does (s/he) fall?
.................................................................................
5 1. MORE THAN 1/MONTH
27 2. 1/MONTH OR LESS THAN 1/MONTH
10 3. LESS THAN 1/YEAR
7. REFUSED
1 8. DON'T KNOW
209 Blank. Inap
==========================================================================================
BM89MO MONTH WHEN FALLING PROBLEM BEGAN
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH89MO
89. When did this falling problem start? (Month)
.................................................................................
14 1-12. MONTH
98. DON'T KNOW
238 Blank. Inap
==========================================================================================
BM89YR YEAR WHEN FALLING PROBLEM BEGAN
Section: BM Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: MH89YR
89. When did this falling problem start? (Year)
.................................................................................
1930-1949. YEAR
1950-1969. YEAR
1970-1979. YEAR
1980-1989. YEAR
1990-1999. YEAR
14 2000-2003. YEAR
9998. DON'T KNOW
238 Blank. Inap
==========================================================================================
BM88AGE AGE WHEN FALLING PROBLEM BEGAN
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH89AGE
89. When did this falling problem start? (Age)
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
1 60-69. AGE
9 70-79. AGE
11 80-89. AGE
4 90-99. AGE
1 100-109. AGE
3 998. DON'T KNOW
223 Blank. Inap
==========================================================================================
BM90 HAS DOCTOR SAID WHAT MAY HAVE CAUSED FALLS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH90
90. Has a doctor said what might be causing the falls?
.................................................................................
15 1. YES
28 2. NO
7. REFUSED
8. DON'T KNOW
209 Blank. Inap
==========================================================================================
BM93 EVER HAD A SEVERE HEAD INJURY
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH93
93. Has (NAME) ever had a blow to the head, a head injury or head trauma that
was severe enough to require medical attention, to cause loss of consciousness
or memory loss for a period of time?
.................................................................................
11 1. YES
236 2. NO
7. REFUSED
8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM94 NUMBER OF HEAD INJURIES
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH94
94. How many times has this happened?
.................................................................................
11 1-5. Number
6-10. Number
11-95. Number
998. DON'T KNOW
241 Blank. Inap
==========================================================================================
BM95 AGE OF LAST HEAD INJURY
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH95
95. Now I want you to think about (her/his) last head injury or trauma. How old
was (s/he) at that time?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
1 60-69. AGE
2 70-79. AGE
3 80-89. AGE
4 90-99. AGE
1 100-109. AGE
998. DON'T KNOW
241 Blank. Inap
==========================================================================================
BM97 SEE DOCTOR OR GO TO HOSPITAL FOR HEAD INJ 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH97
97. Did (NAME) see a doctor or go to a hospital?
.................................................................................
1 1. SAW DOCTOR (record)
10 2. WENT TO HOSPITAL (record)
3. NO DR OR HOSPITAL
7. REFUSED
8. DON'T KNOW
241 Blank. Inap
==========================================================================================
BM99 DID SUBJECT LOSE CONSCIOUSNESS-HEAD INJ 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH99
99. Did (NAME) lose consciousness?
.................................................................................
3 1. YES
8 2. NO
7. REFUSED
8. DON'T KNOW
241 Blank. Inap
==========================================================================================
BM100 HOW LONG UNCONSCIOUS - HEAD INJ 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH100
100. How long was (s/he) unconscious? (If DK, read the choices)
.................................................................................
2 1. <5 MINUTES
2. 5-29 MINUTES
3. 30-59 MINUTES
4. 1-24 HOURS
5. >1 DAY
7. REFUSED
1 8. DON'T KNOW
249 Blank. Inap
==========================================================================================
BM101 SUBJECT HAVE PERIOD OF AMNESIA-HEAD INJ 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH101
101. Sometimes after a head injury, people experience amnesia or loss of memory.
Did (NAME) have a period of amnesia after the injury?
.................................................................................
3 1. YES
8 2. NO
7. REFUSED
8. DON'T KNOW
241 Blank. Inap
==========================================================================================
BM102 HOW LONG WAS MEMORY LOSS-HEAD INJ 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH102
102. How long did (s/he) have this memory loss?
.................................................................................
1 1. 1-24 HOURS
2 2. 2-6 DAYS
7. REFUSED
8. DON'T KNOW
249 Blank. Inap
==========================================================================================
BM103 ANY SKULL PENETRATION TO BRAIN - HEAD INJ 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH103
103. At the time of this injury was there any penetration of the skull to the
brain? (E.g. such as from shrapnel, a bullet wound, or other object)
.................................................................................
1. YES
11 2. NO
7. REFUSED
8. DON'T KNOW
241 Blank. Inap
==========================================================================================
BM104 MEM PXS START BEF/DUR/AFT HEAD INJURY 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH104
104. To the best of your recollection, did the memory problems start before,
during or after the head injury?
.................................................................................
5 1. BEFORE
2. DURING
3 3. AFTER
3 6. NA
7. REFUSED
8. DON'T KNOW
241 Blank. Inap
==========================================================================================
BM106 AGE AT TIME OF HEAD INJURY 2
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH106
106. Now I want you to think about the previous head injury or trauma. How old
was (NAME) at that time?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM108 SEE DOCTOR OR GO TO HOSPITAL FOR HEAD INJ 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH108
108. Did (NAME) see a doctor or go to a hospital?
.................................................................................
1. SAW DOCTOR (record)
2. WENT TO HOSPITAL (record)
3. NO DR OR HOSPITAL
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM110 DID SUBJECT LOSE CONSCIOUSNESS-HEAD INJ 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH110
110. Did (NAME) lose consciousness?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM111 HOW LONG UNCONSCIOUS-HEAD INJ 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH111
111. How long was (s/he) unconscious? (If DK, read the choices)
.................................................................................
1. <5 MINUTES
2. 5-29 MINUTES
3. 30-59 MINUTES
4. 1-24 HOURS
5. >1 DAY
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM112 SUBJECT HAVE PERIOD OF AMNESIA-HEAD INJ 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH112
112. Sometimes after a head injury, people experience amnesia or loss of memory.
Did (NAME) have a period of amnesia after the injury?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM113 HOW LONG WAS MEMORY LOSS-HEAD 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH113
113. How long did (s/he) have this memory loss?
.................................................................................
1. 1-24 HOURS
2. 2-6 DAYS
3. > 1 WEEK
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM114 ANY SKULL PENETRATION TO BRAIN - HEAD INJ 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH114
114. At the time of this injury was there any penetration of the skull to the
brain? (E.g. such as from shrapnel, a bullet wound, or other object)
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM115 MEM PXS START BEF/DUR/AFT HEAD INJURY 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH115
115. To the best of your recollection, did the memory problems start before,
during or after the head injury?
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM117 AGE AT TIME OF HEAD INJURY 3
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH117
117. Now I want you to think about the previous head injury or trauma. How old
was (NAME) at that time?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM119 SEE DOCTOR OR GO TO HOSPITAL FOR HEAD INJ 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH119
119. Did (NAME) see a doctor or go to a hospital?
.................................................................................
1. SAW DOCTOR (record)
2. WENT TO HOSPITAL (record)
3. NO DR OR HOSPITAL
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM121 DID SUBJECT LOSE CONSCIOUSNESS-HEAD 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH121
121. Did (NAME) lose consciousness?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM122 HOW LONG UNCONSCIOUS - HEAD INJ 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH122
122. How long was (s/he) unconscious? (If DK, read the choices)
.................................................................................
1. <5 MINUTES
2. 5-29 MINUTES
3. 30-59 MINUTES
4. 1-24 HOURS
5. >1 DAY
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM123 SUBJECT HAVE PERIOD OF AMNESIA-HEAD 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH123
123. Sometimes after a head injury, people experience amnesia or loss of memory.
Did (NAME) have a period of amnesia after the injury?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM124 HOW LONG WAS THIS MEMORY LOSS-HEAD 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH124
124. How long did (s/he) have this memory loss?
.................................................................................
1. 1-24 HOURS
2. 2-6 DAYS
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM125 ANY SKULL PENETRATION TO BRAIN - HEAD INJ 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH125
125. At the time of this injury was there any penetration of the skull to the
brain? (E.g. such as from shrapnel, a bullet wound, or other object)
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM126 MEM PXS START BEF/DUR/AFT HEAD INJURY 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH126
126. To the best of your recollection, did the memory problems start before,
during or after the head injury?
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM128 AGE AT TIME OF HEAD INJURY 4
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH128
128. Now I want you to think about the previous head injury or trauma. How old
was (NAME) at that time?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM130 SEE DOCTOR OR GO TO HOSPITAL FOR HEAD 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH130
130. Did (NAME) see a doctor or go to a hospital?
.................................................................................
1. SAW DOCTOR (record)
2. WENT TO HOSPITAL (record)
3. NO DR OR HOSPITAL
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM132 DID SUBJECT LOSE CONSCIOUSNESS-HEAD INJ 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH132
132. Did (NAME) lose consciousness?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM133 HOW LONG WAS SUBJECT UNCONSCIOUS-HEAD INJ 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH133
133. How long was (s/he) unconscious? (If DK, read the choices)
.................................................................................
1. <5 MINUTES
2. 5-29 MINUTES
3. 30-59 MINUTES
4. 1-24 HOURS
5. >1 DAY
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM134 SUBJECT HAVE PERIOD OF AMNESIA-HEAD INJ 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH134
134. Sometimes after a head injury, people experience amnesia or loss of memory.
Did (NAME) have a period of amnesia after the injury?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM135 HOW LONG WAS THIS MEMORY LOSS-HEAD INJ 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH135
135. How long did (s/he) have this memory loss?
.................................................................................
1. 1-24 HOURS
2. 2-6 DAYS
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM136 ANY SKULL PENETRATION TO BRAIN - HEAD INJ 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH136
136. At the time of this injury was there any penetration of the skull to the
brain? (E.g. such as from shrapnel, a bullet wound, or other object)
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM137 MEM PXS START BEF/DUR/AFT HEAD INJURY 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH137
137. To the best of your recollection, did the memory problems start before,
during or after the head injury?
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM139 EVER HAD OTHER BRAIN INJURY
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH139
139. Has (NAME) ever had any other brain injury such as a blast injury or
hematoma (bleed or blood clot on the brain)?
.................................................................................
1. YES
246 2. NO
7. REFUSED
1 8. DON'T KNOW
9. NA OR ERROR
5 Blank. Inap
==========================================================================================
BM140 TYPE OF OTHER BRAIN INJURY
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH140
140. What type of injury?
.................................................................................
1. BLAST INJURY
2. HEMATOMA
3. ANEURYSM
4. OTHER (SPECIFY)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM141 AGE AT TIME OF OTHER BRAIN INJURY
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH141
141. How old was (s/he) when this happened?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM143 MEM PXS START BEF/DUR/AFT BRAIN INJURY
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH143
143. To the best of your recollection, did the memory problems start before,
during or after the brain injury?
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM144 EVER HAD EPILEPTIC SEIZURES OR FITS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH144
144. Has (s/he) ever had epileptic seizures or fits?
.................................................................................
6 1. YES
240 2. NO
7. REFUSED
1 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM145 AGE AT TIME OF FIRST SEIZURE
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH145
145. How old was (s/he) when (s/he) had her/his first seizure?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
1 40-49. AGE
50-59. AGE
2 60-69. AGE
70-79. AGE
2 80-89. AGE
1 90-99. AGE
100-109. AGE
998. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM146 DID SUBJECT TAKE MEDICINE FOR SEIZURE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH146
146. Did (s/he) take medication for this?
.................................................................................
6 1. YES
2. NO
7. REFUSED
8. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM147NUM DURATION (NUMBER) FOR SEIZURE MEDS
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH147NUM
147. How long was (NAME) on the seizure medication?
.................................................................................
2 1-5. Number
2 6-10. Number
2 11-95. Number
998. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM147DUR DURATION (TIMEFRAME) FOR SEIZURE MEDS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH147DUR
147. How long was (NAME) on the seizure medication?
.................................................................................
1 1. MONTHS
5 2. YEARS
6. NA
7. REFUSED
8. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM148 MEM PXS START BEF/DUR/AFT SEIZURE/FITS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH148
148. To the best of your recollection, did the memory problems start before,
during or after the seizures or fits?
.................................................................................
2 1. BEFORE
2. DURING
3 3. AFTER
6. NA
7. REFUSED
1 8. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM150 EVER TOLD BY MED PERSONNEL HAD HBP/HTN
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH150
150. Has (NAME) ever been told by medical personnel that (s/he) had high blood
pressure or hypertension?
.................................................................................
150 1. YES
85 2. NO
7. REFUSED
12 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM151 AGE WHEN TOLD HAD HBP OR HTN
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH151
151. How old was (NAME) when medical personnel first told her/him that they had
high blood pressure?
.................................................................................
1-19. AGE
1 20-29. AGE
1 30-39. AGE
12 40-49. AGE
14 50-59. AGE
27 60-69. AGE
38 70-79. AGE
18 80-89. AGE
90-99. AGE
100-109. AGE
39 998. DON'T KNOW
102 Blank. Inap
==========================================================================================
BM152 DID DOCTOR PRESCRIBE MEDICINE FOR HBP
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH152
152. Did a doctor prescribe medication for the high blood pressure?
.................................................................................
149 1. YES
1 2. NO
7. REFUSED
8. DON'T KNOW
9. NA OR ERROR
102 Blank. Inap
==========================================================================================
BM153 IS SUBJECT CURRENTLY TREATED FOR HBP
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH153
153. Is (NAME) currently being treated for high blood pressure?
.................................................................................
143 1. YES
5 2. NO
7. REFUSED
1 8. DON'T KNOW
103 Blank. Inap
==========================================================================================
BM154 DID DR DX HIGH CHOLESTEROL/TRIGLYCERIDES
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH154
154. Has (NAME) ever been told by medical personnel that (s/he) has high
cholesterol or high triglycerides?
.................................................................................
86 1. YES
145 2. NO
7. REFUSED
16 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM155 AGE TOLD HIGH CHOLESTEROL/TRIGLYCERIDES
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH155
155. How old was (s/he) when first told that (s/he) had /has high cholesterol or
high triglycerides?
.................................................................................
1-19. AGE
20-29. AGE
1 30-39. AGE
2 40-49. AGE
1 50-59. AGE
18 60-69. AGE
31 70-79. AGE
16 80-89. AGE
90-99. AGE
100-109. AGE
17 998. DON'T KNOW
166 Blank. Inap
==========================================================================================
BM156 EVER HAD HRT ATTACK/MI/ COR THROMBOSIS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH156
156. Has (NAME) ever had a heart attack, a myocardial infarction, or a coronary
thrombosis?
.................................................................................
3 1. YES
243 2. NO
7. REFUSED
1 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM157 HOW MANY HEART ATTACKS HAS SUBJECT HAD
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH157
157. How many heart attacks has (s/he) had?
.................................................................................
3 1-5. Number
6-10. Number
11-95. Number
998. DON'T KNOW
249 Blank. Inap
==========================================================================================
BM158 AGE AT TIME OF FIRST HEART ATTACK
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH158
158. How old was (NAME) when (s/he) had her/his first heart attack (coronary)?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
1 70-79. AGE
2 80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
249 Blank. Inap
==========================================================================================
BM159 IF MULTIPLE, AGE AT LAST HEART ATTACK
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH159
159. If more than one, how old was (NAME) when (s/he) had (her/his) last heart
attack (coronary)?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM160 MEM PXS START BEF/DUR/AFT HEART ATTACKS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH160
160. To the best of your recollection, did the memory problems start before,
during or after the heart attack(s)?
.................................................................................
2 1. BEFORE
2. DURING
3. AFTER
2 6. NA
7. REFUSED
8. DON'T KNOW
248 Blank. Inap
==========================================================================================
BM162 EVER HAD ANY OTHER HEART PROBLEMS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH162
162. Has (NAME) ever had other problems?
.................................................................................
62 1. YES
179 2. NO
7. REFUSED
6 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM163A EVER HAD ANGINA
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163A
163. What type of problems: ANGINA
.................................................................................
11 1. YES
51 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163B EVER HAD ATRIAL FIBRILLATION
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163B
163. What type of problems: ATRIAL FIBRILLATION
.................................................................................
2 1. YES
60 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163C EVER HAD VENTRICULAR FIBRILLATION
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163C
163. What type of problems: VENTRICULAR FIBRILLATION
.................................................................................
1 1. YES
61 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163D EVER HAD ARRHYTHMIA DUE TO UNCLEAR ETIOLOGY
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163D
163. What type of problems: ARRHYTHMIA DUE TO UNCLEAR ETIOLOGY
.................................................................................
16 1. YES
46 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163E EVER HAD CABG
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163E
163. What type of problems: CABG
.................................................................................
4 1. YES
58 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163F EVER HAD ANGIOPLASTY OR STENT PLACEMENT
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163F
163. What type of problems: ANGIOPLASTY OR STENT PLACEMENT
.................................................................................
4 1. YES
58 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163G EVER HAD CONGESTIVE HEART FAILURE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163G
163. What type of problems: CHF
.................................................................................
17 1. YES
45 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163H EVER HAD BRADYCARDIA
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163H
163. What type of problems: BRADYCARDIA
.................................................................................
4 1. YES
58 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163I EVER HAD TACHYCARDIA
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163I
163. What type of problems: TACHYCARDIA
.................................................................................
3 1. YES
59 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163J EVER HAD PACEMAKER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JA
163. What type of problems: PACEMAKER
.................................................................................
8 1. YES
54 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163K EVER HAD ARTERIOSCLEROSIS/CAD
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JB
163. What type of problems: ARTERIOSCLEROSIS/HARDENING OF THE ARTERIES/CAD
.................................................................................
2 1. YES
60 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163L EVER HAD AORTIC ANEURYSM
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JC
163. What type of problems: AORTIC ANEURYSM
.................................................................................
1. YES
62 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163M EVER HAD VALVE REPLACEMENT/OTHER VALVE ISSUES
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JD
163. What type of problems: VALVE REPLACEMENT/OTHER VALVE ISSUES
.................................................................................
1 1. YES
61 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163N EVER HAD CARDIAC ABLATION
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JE
163. What type of problems: CARDIAC ABLATION
.................................................................................
1. YES
62 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163O EVER HAD CARDIAC MYOPATHY/CARDIOMEGALY
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JF
163. What type of problems: CARDIAC MYOPATHY/CARDIOMEGALY
.................................................................................
1 1. YES
61 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163P EVER HAD 2ND CABG
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JG
163. What type of problems: 2nd CABG
.................................................................................
1. YES
62 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163Q EVER HAD HEART MURMUR
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JH
163. What type of problems: HEART MURMUR
.................................................................................
4 1. YES
58 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163R EVER HAD DEFIBRILLATOR
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JI
163. What type of problems: DEFIBRILLATOR
.................................................................................
2 1. YES
60 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163S EVER HAD CARDIAC ARREST
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JJ
163. What type of problems: CARDIAC ARREST
.................................................................................
1. YES
62 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163T EVER HAD 2ND ANGIOPLASTY
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JK
163. What type of problems: 2ND ANGIOPLASTY
.................................................................................
1. YES
62 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163U EVER HAD CARDIAC CATHETERIZATION
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JL
163. What type of problems: CARDIAC CATHETERIZATION
.................................................................................
1. YES
62 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163V EVER HAD 2ND CARDIAC CATHETERIZATION
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JM
163. What type of problems: 2ND CARDIAC CATHETERIZATION
.................................................................................
1. YES
62 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163W OTHER TYPE OF HEART PROBLEM 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163J
163. What type of problems: OTHER (SPECIFY)
.................................................................................
1. YES
62 2. NO
7. REFUSED
8. DON'T KNOW
190 Blank. Inap
==========================================================================================
BM163X OTHER TYPE OF HEART PROBLEM 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163K
163. What type of problems: OTHER (SPECIFY)
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM163Y OTHER TYPE OF HEART PROBLEM 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163L
163. What type of problems: OTHER (SPECIFY)
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM164A AGE FIRST DX WITH ANGINA
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163AAGE
164. If [ANGINA] endorsed, how old was (s/he) was told had [ANGINA]
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
3 60-69. AGE
1 70-79. AGE
3 80-89. AGE
1 90-99. AGE
100-109. AGE
3 998. DON'T KNOW
241 Blank. Inap
==========================================================================================
BM164B AGE FIRST HAD ATRIAL FIBRILLATION
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163BAGE
164. If [ATRIAL FIBRILLATION] endorsed, how old was (s/he) when told had [ATRIAL
FIBRILLATION]
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
1 50-59. AGE
1 60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM164C AGE FIRST HAD VENTRICULAR FIBRILLATION
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163CAGE
164. If [VENTRICULAR FIBRILLATION] endorsed, how old was (s/he) when (s/he)
learned had [VENTRICULAR FIBRILLATION]
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
1 80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM164D AGE FIRST HAD ARRHYTHMIA
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163DAGE
164. If [ARRHYTHMIA DUE TO UNCLEAR ETIOLOGY] endorsed, how old was (s/he) when
(s/he) learned had [ARRHYTHMIA DUE TO UNCLEAR ETIOLOGY]
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
2 50-59. AGE
1 60-69. AGE
4 70-79. AGE
4 80-89. AGE
1 90-99. AGE
100-109. AGE
3 998. DON'T KNOW
237 Blank. Inap
==========================================================================================
BM164E AGE FIRST HAD CABG
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163EAGE
164. If [CABG] endorsed, how old was (s/he) when (s/he) had [CABG]
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
1 60-69. AGE
70-79. AGE
2 80-89. AGE
1 90-99. AGE
100-109. AGE
998. DON'T KNOW
248 Blank. Inap
==========================================================================================
BM164F AGE OF ANGIOPLASTY
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163FAGE
164. If [ANGIOPLASTY OR STENT PLACEMENT] endorsed, how old was (s/he) when
(s/he) had [ANGIOPLASTY OR STENT PLACEMENT]
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
3 70-79. AGE
1 80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
248 Blank. Inap
==========================================================================================
BM164G AGE FIRST HAD CONGESTIVE HEART FAILURE
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163GAGE
164. If [CHF] endorsed, how old was (s/he) when (s/he) learned had [CHF]
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
6 70-79. AGE
6 80-89. AGE
2 90-99. AGE
2 100-109. AGE
1 998. DON'T KNOW
235 Blank. Inap
==========================================================================================
BM164H AGE FIRST HAD BRADYCARDIA
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163HAGE
164. If [BRADYCARDIA] endorsed, how old was (s/he) when (s/he) learned had
[BRADYCARDIA]
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
3 80-89. AGE
90-99. AGE
100-109. AGE
1 998. DON'T KNOW
248 Blank. Inap
==========================================================================================
BM164I AGE FIRST HAD TACHYCARDIA
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163IAGE
164. If [TACHYCARDIA] endorsed, how old was (s/he) when (s/he) learned had
[TACHYCARDIA]
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
2 70-79. AGE
1 80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
249 Blank. Inap
==========================================================================================
BM164J AGE FIRST HAD PACEMAKER
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163JAAGE
164. If [PACEMAKER] endorsed, how old was (s/he) when (s/he) [ PACEMAKER]
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
60-69. Age
4 70-79. Age
4 80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
244 Blank. Inap
==========================================================================================
BM164K AGE FIRST HAD ARTERIOSCLEROSIS/CAD
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163JBAGE
164. If [ARTERIOSCLEROSIS/HARDENING OF THE ARTERIES/CAD] endorsed, how old was
(s/he) when (s/he) learned had [ARTERIOSCLEROSIS/HARDENING OF THE ARTERIES/CAD]
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
1 60-69. Age
1 70-79. Age
80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM164L AGE FIRST HAD AORTIC ANEURYSM
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163JCAGE
164. If [AORTIC ANEURYSM] endorsed, how old was (s/he) when (s/he) learned had
[AORTIC ANEURYSM]
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
60-69. Age
70-79. Age
80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM164M AGE FIRST HAD VALVE REPLACEMENT/OTHER VALVE ISSUES
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163JDAGE
164. If [VALVE REPLACEMENT/OTHER VALVE ISSUES] endorsed, how old was (s/he) when
(s/he) had [VALVE REPLACEMENT/OTHER VALVE ISSUES]
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
60-69. Age
70-79. Age
1 80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM164N AGE FIRST HAD CARDIAC ABLATION
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163JEAGE
164. If [CARDIAC ABLATION] endorsed, how old was (s/he) when (s/he) had [CARDIAC
ABLATION]
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
60-69. Age
70-79. Age
80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM164O AGE FIRST HAD CARDIAC MYOPATHY/CARDIOMEGALY
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163JFAGE
164. If [CARDIAC MYOPATHY/CARDIOMEGALY] endorsed, how old was (s/he) when (s/he)
learned had [CARDIAC MYOPATHY/CARDIOMEGALY]
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
1 60-69. Age
70-79. Age
80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM164P AGE FIRST HAD 2ND CABG
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163JGAGE
164. If [2nd CABG] endorsed, how old was (s/he) when (s/he) had [2nd CABG]
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
60-69. Age
70-79. Age
80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM164Q AGE FIRST HAD HEART MURMUR
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163JHAGE
164. If [HEART MURMUR] endorsed, how old was (s/he) when (s/he) learned had
[HEART MURMUR]
.................................................................................
1 1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
60-69. Age
1 70-79. Age
1 80-89. Age
90-99. Age
100-109. Age
1 998. DON'T KNOW
248 Blank. Inap
==========================================================================================
BM164R AGE FIRST HAD DEFIBRILLATOR
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163JIAGE
164. If [DEFIBRILLATOR] endorsed, how old was (s/he) when (s/he) had
[DEFIBRILLATOR]
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
60-69. Age
1 70-79. Age
1 80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM164S AGE FIRST HAD CARDIAC ARREST
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163JJAGE
164. If [CARDIAC ARREST] endorsed, how old was (s/he) when (s/he) had [CARDIAC
ARREST]
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
60-69. Age
70-79. Age
80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM164T AGE 2ND ANGIOPLASTY
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163JKAGE
164. If [2ND ANGIOPLASTY] endorsed, how old was (s/he) when (s/he) had [2ND
ANGIOPLASTY]
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
60-69. Age
70-79. Age
80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM164U AGE FIRST CARDIAC CATHETERIZATION
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163JLAGE
164. If [CARDIAC CATHETERIZATION] endorsed, how old was (s/he) when (s/he) had
[CARDIAC CATHETERIZATION]
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
60-69. Age
70-79. Age
80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM164V AGE 2ND CARDIAC CATHETERIZATION
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163JMAGE
164. If 2ND CARDIAC CATHETERIZATION] endorsed, how old was (s/he) when (s/he)
had [2ND CARDIAC CATHETERIZATION]
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
60-69. Age
70-79. Age
80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM164W AGE FOR OTHER 1
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163JAGE
164. If [OTHER SPECIFIED] endorsed, how old was (s/he) when (s/he) learned had
[OTHER SPECIFIED]
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM164X AGE FOR OTHER 2
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163KAGE
164. If [2ND OTHER SPECIFIED] endorsed, how old was (s/he) when (s/he) learned
had [2ND OTHER SPECIFIED]
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
60-69. Age
70-79. Age
80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM164Y AGE FOR OTHER 3
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH163LAGE
164. If [3RD OTHER SPECIFIED] endorsed, how old was (s/he) when (s/he) learned
had [3RD OTHER SPECIFIED]
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
60-69. Age
70-79. Age
80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM165A MEM PX BEF/DUR/AFT ANGINA
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163ABEF
165. If [ANGINA] endorsed: To the best of your recollection, did the memory
problems start before, during or after the [ANGINA}
.................................................................................
4 1. BEFORE
2. DURING
5 3. AFTER
1 6. NA
7. REFUSED
1 8. DON'T KNOW
241 Blank. Inap
==========================================================================================
BM165B MEM PX BEF/DUR/AFT ATRIAL FIB
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163BBEF
165. If [ATRIAL FIBRILLATION] endorsed: To the best of your recollection, did
the memory problems start before, during or after the [ATRIAL FIBRILLATION]
.................................................................................
1. BEFORE
2. DURING
2 3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM165C MEM PX BEF/DUR/AFT VENT FIB
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163CBEF
165. If [VENTRICULAR FIBRILLATION] endorsed: To the best of your recollection,
did the memory problems start before, during or after the [VENTRICULAR
FIBRILLATION]
.................................................................................
1 1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM165D MEM PX BEF/DUR/AFT ARRHYTHMIA
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163DBEF
165. If [ARRHYTHMIA DUE TO UNCLEAR ETIOLOGY] endorsed: To the best of your
recollection, did the memory problems start before, during or after the
[ARRHYTHMIA DUE TO UNCLEAR ETIOLOGY]
.................................................................................
4 1. BEFORE
1 2. DURING
7 3. AFTER
2 6. NA
7. REFUSED
1 8. DON'T KNOW
237 Blank. Inap
==========================================================================================
BM165E MEM PX BEF/DUR/AFT CABG
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163EBEF
165. If [CABG] endorsed: To the best of your recollection, did the memory
problems start before, during or after the [CABG]
.................................................................................
2 1. BEFORE
2. DURING
2 3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
248 Blank. Inap
==========================================================================================
BM165F MEM PX BEF/DUR/AFT ANGIOPLASTY
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163FBEF
165. If [ANGIOPLASTY OR STENT PLACEMENT] endorsed: To the best of your
recollection, did the memory problems start before, during or after the
[ANGIOPLASTY OR STENT PLACEMENT]
.................................................................................
4 1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
248 Blank. Inap
==========================================================================================
BM165G MEM PX BEF/DUR/AFT CHF
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163GBEF
165. If [CHF] endorsed: To the best of your recollection, did the memory
problems start before, during or after the [CHF]
.................................................................................
8 1. BEFORE
1 2. DURING
3 3. AFTER
3 6. NA
7. REFUSED
1 8. DON'T KNOW
236 Blank. Inap
==========================================================================================
BM165H MEM PX BEF/DUR/AFT BRADYCARDIA
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163HBEF
165. If [BRADYCARDIA] endorsed: To the best of your recollection, did the memory
problems start before, during or after the [BRADYCARDIA]
.................................................................................
3 1. BEFORE
2. DURING
3. AFTER
1 6. NA
7. REFUSED
8. DON'T KNOW
248 Blank. Inap
==========================================================================================
BM165I MEM PX BEF/DUR/AFT TACHYCARDIA
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163IBEF
165. If [TACHYCARDIA] endorsed: To the best of your recollection, did the memory
problems start before, during or after the [TACHYCARDIA]
.................................................................................
3 1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
249 Blank. Inap
==========================================================================================
BM165J MEM PX BEF/DUR/AFT PACEMAKER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JABEF
165. If [PACEMAKER] endorsed: To the best of your recollection, did the memory
problems start before, during or after the [PACEMAKER]
.................................................................................
6 1. BEFORE
2. DURING
3. AFTER
2 6. NA
7. REFUSED
8. DON'T KNOW
244 Blank. Inap
==========================================================================================
BM165K MEM PX BEF/DUR/AFT ARTERIOSCLEROSIS/HARDENING OF THE ARTERIES/CAD
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JBBEF
165. If ARTERIOSCLEROSIS/HARDENING OF THE ARTERIES/CAD] endorsed: To the best of
your recollection, did the memory problems start before, during or after the
[ARTERIOSCLEROSIS/HARDENING OF THE ARTERIES/CAD]
.................................................................................
1. BEFORE
2. DURING
1 3. AFTER
6. NA
7. REFUSED
1 8. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM165L MEM PX BEF/DUR/AFT AORTIC ANEURYSM
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JCBEF
165. If [AORTIC ANEURYSM] endorsed: To the best of your recollection, did the
memory problems start before, during or after the [AORTIC ANEURYSM]
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM165M MEM PX BEF/DUR/AFT VALVE REPLACEMENT/OTHER VALVE ISSUES
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JDBEF
165. If [VALVE REPLACEMENT/OTHER VALVE ISSUES] endorsed: To the best of your
recollection, did the memory problems start before, during or after the [VALVE
REPLACEMENT/OTHER VALVE ISSUES]
.................................................................................
1 1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM165N MEM PX BEF/DUR/AFT CARDIAC ABLATION
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JEBEF
165. If [CARDIAC ABLATION] endorsed: To the best of your recollection, did the
memory problems start before, during or after the [CARDIAC ABLATION]
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM165O MEM PX BEF/DUR/AFT CARDIAC MYOPATHY/CARDIOMEGALY
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JFBEF
165. If CARDIAC MYOPATHY/CARDIOMEGALY] endorsed: To the best of your
recollection, did the memory problems start before, during or after the [CARDIAC
MYOPATHY/CARDIOMEGALY]
.................................................................................
1. BEFORE
2. DURING
3. AFTER
1 6. NA
7. REFUSED
8. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM165P MEM PX BEF/DUR/AFT 2ND CABG
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JGBEF
165. If [2nd CABG] endorsed: To the best of your recollection, did the memory
problems start before, during or after the [2nd CABG]
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM165Q MEM PX BEF/DUR/AFT HEART MURMUR
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JHBEF
165. If [HEART MURMUR] endorsed: To the best of your recollection, did the
memory problems start before, during or after the [HEART MURMUR]
.................................................................................
2 1. BEFORE
2. DURING
1 3. AFTER
1 6. NA
7. REFUSED
8. DON'T KNOW
248 Blank. Inap
==========================================================================================
BM165R MEM PX BEF/DUR/AFT DEFIBRILLATOR
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JIBEF
165. If [DEFIBRILLATOR] endorsed: To the best of your recollection, did the
memory problems start before, during or after the [DEFIBRILLATOR]
.................................................................................
2 1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM165S MEM PX BEF/DUR/AFT CARDIAC ARREST
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JJBEF
165. If [CARDIAC ARREST] endorsed: To the best of your recollection, did the
memory problems start before, during or after the [CARDIAC ARREST]
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM165T MEM PX BEF/DUR/AFT 2ND ANGIOPLASTY
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JKBEF
165. If [2ND ANGIOPLASTY] endorsed: To the best of your recollection, did the
memory problems start before, during or after the [2ND ANGIOPLASTY]
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM165U MEM PX BEF/DUR/AFT CARDIAC CATHETERIZATION
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JLBEF
165. If [CARDIAC CATHETERIZATION] endorsed: To the best of your recollection,
did the memory problems start before, during or after the [CARDIAC
CATHETERIZATION]
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM165V MEM PX BEF/DUR/AFT 2ND CARDIAC CATHETERIZATION
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JMBEF
165. If [2ND CARDIAC CATHETERIZATION] endorsed: To the best of your
recollection, did the memory problems start before, during or after the [2ND
CARDIAC CATHETERIZATION]
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM165W MEM PX BEF/DUR/AFT OTHER 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163JBEF
165. If [OTHER SPECIFIED] endorsed: To the best of your recollection, did the
memory problems start before, during or after the [OTHER SPECIFIED]
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM165X MEM PX BEF/DUR/AFT OTHER 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163KBEF
165. If [2ND OTHER SPECIFIED] endorsed: To the best of your recollection, did
the memory problems start before, during or after the [2ND OTHER SPECIFIED]
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM165Y MEM PX BEF/DUR/AFT OTHER 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH163LBEF
165. If [3RD OTHER SPECIFIED] endorsed: To the best of your recollection, did
the memory problems start before, during or after the [3RD OTHER SPECIFIED]
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM172 EVER HAD CAROTID ENDARTERECTOMY
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH172
172. Has (NAME) ever had a carotid endarterectomy or surgery on the arteries in
her/his neck?
.................................................................................
1 1. YES
246 2. NO
7. REFUSED
8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM173 AGE AT FIRST CAROTID ENDARTERECTOMY
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH173
173. If yes, how old was (NAME) when (s/he) first had carotid endarterectomy?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
1 80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM174 EVER BEEN TOLD BY DOCTOR HAD DIABETES
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH174
174. Has (s/he) ever been told by a doctor that (s/he) has diabetes?
.................................................................................
64 1. YES
181 2. NO
7. REFUSED
2 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM175 AGE WHEN FIRST LEARNED HAD DIABETES
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH175
175. How old was (NAME) when (s/he) first learned (s/he) had diabetes?
.................................................................................
1-19. AGE
20-29. AGE
1 30-39. AGE
3 40-49. AGE
6 50-59. AGE
21 60-69. AGE
17 70-79. AGE
7 80-89. AGE
1 90-99. AGE
100-109. AGE
8 998. DON'T KNOW
188 Blank. Inap
==========================================================================================
BM176 DID DR PRESCRIBE TREATMENT FOR DIABETES
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH176
176. Did a doctor prescribe a treatment for the diabetes?
.................................................................................
5 1. YES, DIET
38 2. YES, PILLS
18 3. YES, INSULIN
3 4. NO
7. REFUSED
8. DON'T KNOW
188 Blank. Inap
==========================================================================================
BM177 DOES SUBJECT STILL HAVE DIABETES NOW
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH177
177. Does (s/he) still have diabetes now?
.................................................................................
63 1. YES
2. NO
7. REFUSED
1 8. DON'T KNOW
188 Blank. Inap
==========================================================================================
BM178 MEM PXS START BEF/DUR/AFT TOLD DIABETES
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH178
178. To the best of your recollection, did the memory problems start before,
during or after (s/he) was told (s/he) had diabetes?
.................................................................................
15 1. BEFORE
2. DURING
37 3. AFTER
9 6. NA
7. REFUSED
3 8. DON'T KNOW
188 Blank. Inap
==========================================================================================
BM180 EVER TOLD BY DOCTOR HAD THYROID DISEASE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH180
180. Has a doctor ever told (NAME) that (s/he) has thyroid disease?
.................................................................................
34 1. YES
211 2. NO
7. REFUSED
2 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM181 AGE WHEN DOCTOR TOLD HAD THYROID DISEASE
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH181
181. How old was (NAME) when the doctor first told (her/him) they (s/he) had
thyroid disease?
.................................................................................
1-19. AGE
20-29. AGE
1 30-39. AGE
1 40-49. AGE
6 50-59. AGE
3 60-69. AGE
11 70-79. AGE
4 80-89. AGE
90-99. AGE
100-109. AGE
8 998. DON'T KNOW
218 Blank. Inap
==========================================================================================
BM182 MEM PXS START BEF/DUR/AFT TOLD THYROID
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH182
182. To the best of your recollection, did the memory problems start before,
during or after (s/he) was told (s/he) had thyroid disease?
.................................................................................
2 1. BEFORE
2. DURING
21 3. AFTER
9 6. NOT APPLICABLE
7. REFUSED
2 8. DON'T KNOW
218 Blank. Inap
==========================================================================================
BM183 EVER HAD CHRONIC RESPIRATORY PROBLEMS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH183
183. Has (NAME) ever had chronic respiratory problems?
.................................................................................
56 1. YES
189 2. NO
7. REFUSED
2 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM184A EVER HAD ASTHMA
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH184A
184. What type of problems: ASTHMA
.................................................................................
8 1. YES
47 2. NO
7. REFUSED
1 8. DON'T KNOW
196 Blank. Inap
==========================================================================================
BM184B EVER HAD CHRONIC BRONCHITIS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH184B
184. What type of problems: CHRONIC BRONCHITIS
.................................................................................
3 1. YES
52 2. NO
7. REFUSED
1 8. DON'T KNOW
196 Blank. Inap
==========================================================================================
BM184C EVER HAD COPD
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH184C
184. What type of problems: COPD
.................................................................................
9 1. YES
46 2. NO
7. REFUSED
1 8. DON'T KNOW
196 Blank. Inap
==========================================================================================
BM184D EVER HAD EMPHYSEMA
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH184D
184. What type of problems: EMPHYSEMA
.................................................................................
10 1. YES
45 2. NO
7. REFUSED
1 8. DON'T KNOW
196 Blank. Inap
==========================================================================================
BM184E EVER HAD COUGH (NON-SPECIFIC)
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH184E
184. What type of problems: COUGH (no specific diagnosis)
.................................................................................
3 1. YES
52 2. NO
7. REFUSED
1 8. DON'T KNOW
196 Blank. Inap
==========================================================================================
BM184F EVER HAD WHEEZING (NON-SPECIFIC)
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH184F
184. What type of problems: WHEEZING (no specific diagnosis)
.................................................................................
3 1. YES
52 2. NO
7. REFUSED
1 8. DON'T KNOW
196 Blank. Inap
==========================================================================================
BM184G EVER HAD DYSPNEA (NON-SPECIFIC)
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH184G
184. What type of problems: DYSPNEA (no specific diagnosis)
.................................................................................
18 1. YES
37 2. NO
7. REFUSED
1 8. DON'T KNOW
196 Blank. Inap
==========================================================================================
BM184H EVER HAD ALLERGIES/SINUS PROBLEMS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH184HA
184. What type of problems: ALLERGIES/SINUS PROBLEMS
.................................................................................
1. YES
56 2. NO
7. REFUSED
8. DON'T KNOW
196 Blank. Inap
==========================================================================================
BM184I EVER HAD PNEUMONIA
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH184HB
184. What type of problems: PNEUMONIA
.................................................................................
1 1. YES
55 2. NO
7. REFUSED
8. DON'T KNOW
196 Blank. Inap
==========================================================================================
BM184J EVER HAD TB
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH184HC
184. What type of problems: TB
.................................................................................
1. YES
56 2. NO
7. REFUSED
8. DON'T KNOW
196 Blank. Inap
==========================================================================================
BM184K EVER HAD LUNG REMOVED, LUNG TUMOR/CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH184HD
184. What type of problems: LUNG REMOVED, LUNG CAPACITY DECREASED, OR LUNG
TUMOR/CANCER
.................................................................................
2 1. YES
54 2. NO
7. REFUSED
8. DON'T KNOW
196 Blank. Inap
==========================================================================================
BM184L EVER HAD ASBESTOS EXPOSURE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH184HE
184. What type of problems: ASBESTOS EXPOSURE
.................................................................................
1. YES
56 2. NO
7. REFUSED
8. DON'T KNOW
196 Blank. Inap
==========================================================================================
BM184M EVER HAD OTHER RESPIRATORY PROBLEM
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH184H
184. What type of problems: OTHER (Specify)
.................................................................................
3 1. YES
52 2. NO
7. REFUSED
1 8. DON'T KNOW
196 Blank. Inap
==========================================================================================
BM185 USING OXYGEN FOR RESPIRATORY PROBLEM
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH185
185. Is (s/he) on oxygen for her/his respiratory problems?
.................................................................................
15 1. YES
42 2. NO
7. REFUSED
8. DON'T KNOW
195 Blank. Inap
==========================================================================================
BM185HR DURATION OF OXYGEN FOR RESPIRATORY PX
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH185HRS
185. If yes, O2, number of hours on oxygen
.................................................................................
1 1-5. Number
6-10. Number
10 11-95. Number
2 998. DON'T KNOW
239 Blank. Inap
==========================================================================================
BM185PM DURATION OF OXYGEN (AM/PM)
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH185PM
185. If yes, O2, on oxygen... IF MH185HRS = 998, MH185PM IS LEFT BLANK
.................................................................................
12 1. HOURS/DAY
3 2. NIGHT ONLY
237 Blank. Inap
==========================================================================================
BM186 AGE WHEN STARTED OXYGEN TREATMENT
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH186
186. How old was (s/he) when (s/he) started taking this treatment?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
1 60-69. AGE
7 70-79. AGE
5 80-89. AGE
1 90-99. AGE
100-109. AGE
1 998. DON'T KNOW
237 Blank. Inap
==========================================================================================
BM187 EVER TOLD BY DOCTOR HAD SLEEP APNEA
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH187
187. Has a doctor ever told (NAME) that (s/he) has sleep apnea?
.................................................................................
2 1. YES
238 2. NO
7. REFUSED
7 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM188 AGE WHEN DIAGNOSED WITH SLEEP APNEA
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH188
188. How old was (s/he) when (s/he) was diagnosed with sleep apnea?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
2 70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM189 DIFFICULTY STAYING AWAKE DURING DAYTIME
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH189
189. Does (s/he) have a lot of difficulty staying awake during the daytime?
.................................................................................
44 1. YES
198 2. NO
7. REFUSED
3 8. DON'T KNOW
1 9. NA OR ERROR
6 Blank. Inap
==========================================================================================
BM190 EVER BEEN DIAGNOSED WITH ANY CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH190
190. Has (s/he) ever been diagnosed with any type of cancer?
.................................................................................
21 1. YES
226 2. NO
7. REFUSED
8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM191A EVER DIAGNOSED WITH PROSTATE CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191A
191. What type of cancer: PROSTATE
.................................................................................
11 1. YES
10 2. NO
7. REFUSED
8. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM191B EVER DIAGNOSED WITH LUNG CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191B
191. What type of cancer: LUNG
.................................................................................
1 1. YES
20 2. NO
7. REFUSED
8. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM191C EVER DIAGNOSED WITH BREAST CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191C
191. What type of cancer: BREAST
.................................................................................
1. YES
21 2. NO
7. REFUSED
8. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM191D EVER DIAGNOSED WITH COLON CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191D
191. What type of cancer: COLON
.................................................................................
3 1. YES
18 2. NO
7. REFUSED
8. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM191E EVER DIAGNOSED WITH OVARIAN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191E
191. What type of cancer: OVARIAN
.................................................................................
1. YES
21 2. NO
7. REFUSED
8. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM191F EVER DIAGNOSED WITH BLADDER CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191F
191. What type of cancer: BLADDER
.................................................................................
1 1. YES
20 2. NO
7. REFUSED
8. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM191G EVER DIAGNOSED WITH LYMPH CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191G
191. What type of cancer: LYMPH
.................................................................................
1. YES
21 2. NO
7. REFUSED
8. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM191H EVER DIAGNOSED WITH UTERINE CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191H
191. What type of cancer: UTERUS
.................................................................................
1. YES
21 2. NO
7. REFUSED
8. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM191J EVER DIAGNOSED WITH SKIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191I
191. What type of cancer: SKIN
.................................................................................
4 1. YES
17 2. NO
7. REFUSED
8. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM191K EVER DIAGNOSED WITH BRAIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191J
191. What type of cancer: BRAIN
.................................................................................
1. YES
21 2. NO
7. REFUSED
8. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM191L EVER DIAGNOSED WITH OTHER TYPE OF CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191K
191. What type of cancer: OTHER (specify)
.................................................................................
2 1. YES
19 2. NO
7. REFUSED
8. DON'T KNOW
231 Blank. Inap
==========================================================================================
BM192A AGE WHEN TOLD HAD PROSTATE CANCER
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH191AAGE
192. How old was (s/he) when (s/he) was told had [PROSTATE] cancer?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
1 60-69. AGE
3 70-79. AGE
7 80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
241 Blank. Inap
==========================================================================================
BM192B AGE WHEN TOLD HAD LUNG CANCER
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH191BAGE
192. How old was (s/he) when (s/he) was told had [LUNG] cancer?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
1 70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM192C AGE WHEN TOLD HAD BREAST CANCER
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH191CAGE
192. How old was (s/he) when (s/he) was told had [BREAST] cancer?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM192D AGE WHEN TOLD HAD COLON CANCER
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH191DAGE
192. How old was (s/he) when (s/he) was told had [COLON] cancer?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
1 70-79. AGE
1 80-89. AGE
1 90-99. AGE
100-109. AGE
998. DON'T KNOW
249 Blank. Inap
==========================================================================================
BM192E AGE WHEN TOLD HAD OVARIAN CANCER
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH191EAGE
192. How old was (s/he) when (s/he) was told had [OVARIAN] cancer?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM192F AGE WHEN TOLD HAD BLADDER CANCER
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH191FAGE
192. How old was (s/he) when (s/he) was told had [BLADDER] cancer?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
1 80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM192G AGE WHEN TOLD HAD LYMPH CANCER
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH191GAGE
192. How old was (s/he) when (s/he) was told had [LYMPH] cancer?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM192H AGE WHEN TOLD HAD UTERINE CANCER
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH191HAGE
192. How old was (s/he) when (s/he) was told had [UTERUS] cancer?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM192J AGE WHEN TOLD HAD SKIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH191IAGE
192. How old was (s/he) when (s/he) was told had [SKIN] cancer?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
2 70-79. AGE
1 80-89. AGE
1 90-99. AGE
100-109. AGE
998. DON'T KNOW
248 Blank. Inap
==========================================================================================
BM192K AGE WHEN TOLD HAD BRAIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH191JAGE
192. How old was (s/he) when (s/he) was told had [BRAIN] cancer?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM192L AGE WHEN TOLD HAD OTHER TYPE OF CANCER 1
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH191KAGE
192. How old was (s/he) when (s/he) was told had [OTHER] cancer?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
1 70-79. AGE
1 80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM192M AGE WHEN TOLD HAD OTHER TYPE OF CANCER 2
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH191LAGE
192. How old was (s/he) when (s/he) was told had [2ND OTHER] cancer?
.................................................................................
1-19. Age
20-29. Age
30-39. Age
40-49. Age
50-59. Age
60-69. Age
70-79. Age
80-89. Age
90-99. Age
100-109. Age
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193A1 FIRST TREATMENT FOR PROSTATE CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ATX
193. What type of treatment did (s/he) have for [PROSTATE] cancer?
.................................................................................
2 1. RADIATION
2. CHEMOTHERAPY
2 3. SURGERY
4 4. OTHER MEDICATION
2 5. NONE
1 6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
241 Blank. Inap
==========================================================================================
BM193A2 SECOND TREATMENT FOR PROSTATE CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ATX2
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193A3 THIRD TREATMENT FOR PROSTATE CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ATX3
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193A4 FOURTH TREATMENT FOR PROSTATE CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ATX4
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193A5 FIFTH TREATMENT FOR PROSTATE CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ATX5
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193A6 SIXTH TREATMENT FOR PROSTATE CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ATX6
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193B1 FIRST TREATMENT FOR LUNG CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191BTX
193. What type of treatment did (s/he) have for [LUNG] cancer?
.................................................................................
1 1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM193B2 SECOND TREATMENT FOR LUNG CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191BTX2
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193B3 THIRD TREATMENT FOR LUNG CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191BTX3
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193B4 FOURTH TREATMENT FOR LUNG CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191BTX4
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193B5 FIFTH TREATMENT FOR LUNG CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191BTX5
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193B6 SIXTH TREATMENT FOR LUNG CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191BTX6
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193C1 FIRST TREATMENT FOR BREAST CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191CTX
193. What type of treatment did (s/he) have for [BREAST] cancer?
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193C2 SECOND TREATMENT FOR BREAST CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191CTX2
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193C3 THIRD TREATMENT FOR BREAST CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191CTX3
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193C4 FOURTH TREATMENT FOR BREAST CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191CTX4
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193C5 FIFTH TREATMENT FOR BREAST CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191CTX5
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193C6 SIXTH TREATMENT FOR BREAST CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191CTX6
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193D1 FIRST TREATMENT FOR COLON CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191DTX
193. What type of treatment did (s/he) have for [COLON] cancer?
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3 3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
249 Blank. Inap
==========================================================================================
BM193D2 SECOND TREATMENT FOR COLON CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191DTX2
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193D3 THIRD TREATMENT FOR COLON CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191DTX3
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193D4 FOURTH TREATMENT FOR COLON CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191DTX4
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193D5 FIFTH TREATMENT FOR COLON CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191DTX5
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193D6 SIXTH TREATMENT FOR COLON CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191DTX6
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193E1 FIRST TREATMENT FOR OVARIAN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ETX
193. What type of treatment did (s/he) have for [OVARIAN] cancer?
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193E2 SECOND TREATMENT FOR OVARIAN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ETX2
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193E3 THIRD TREATMENT FOR OVARIAN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ETX3
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193E4 FOURTH TREATMENT FOR OVARIAN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ETX4
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193E5 FIFTH TREATMENT FOR OVARIAN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ETX5
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193E6 SIXTH TREATMENT FOR OVARIAN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ETX6
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193F1 FIRST TREATMENT FOR BLADDER CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191FTX
193. What type of treatment did (s/he) have for [BLADDER] cancer?
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
1 4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM193F2 SECOND TREATMENT FOR BLADDER CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191FTX2
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193F3 THIRD TREATMENT FOR BLADDER CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191FTX3
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193F4 FOURTH TREATMENT FOR BLADDER CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191FTX4
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193F5 FIFTH TREATMENT FOR BLADDER CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191FTX5
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193F6 SIXTH TREATMENT FOR BLADDER CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191FTX6
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193G1 FIRST TREATMENT FOR LYMPH CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191GTX
193. What type of treatment did (s/he) have for [LYMPH] cancer?
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193G2 SECOND TREATMENT FOR LYMPH CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191GTX2
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193G3 THIRD TREATMENT FOR LYMPH CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191GTX3
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193G4 FOURTH TREATMENT FOR LYMPH CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191GTX4
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193G5 FIFTH TREATMENT FOR LYMPH CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191GTX5
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193G6 SIXTH TREATMENT FOR LYMPH CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191GTX6
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193H1 FIRST TREATMENT FOR UTERINE CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191HTX
193. What type of treatment did (s/he) have for [UTERUS] cancer?
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193H2 SECOND TREATMENT FOR UTERINE CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191HTX2
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193H3 THIRD TREATMENT FOR UTERINE CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191HTX3
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193H4 FOURTH TREATMENT FOR UTERINE CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191HTX4
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193H5 FIFTH TREATMENT FOR UTERINE CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191HTX5
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193H6 SIXTH TREATMENT FOR UTERINE CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191HTX6
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193J1 FIRST TREATMENT FOR SKIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ITX
193. What type of treatment did (s/he) have for [SKIN] cancer?
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
4 3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
248 Blank. Inap
==========================================================================================
BM193J2 SECOND TREATMENT FOR SKIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ITX2
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193J3 THIRD TREATMENT FOR SKIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ITX3
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193J4 FOURTH TREATMENT FOR SKIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ITX4
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193J5 FIFTH TREATMENT FOR SKIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ITX5
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193J6 SIXTH TREATMENT FOR SKIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191ITX6
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193K1 FIRST TREATMENT FOR BRAIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191JTX
193. What type of treatment did (s/he) have for [BRAIN] cancer?
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193K2 SECOND TREATMENT FOR BRAIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191JTX2
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193K3 THIRD TREATMENT FOR BRAIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191JTX3
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193K4 FOURTH TREATMENT FOR BRAIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191JTX4
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193K5 FIFTH TREATMENT FOR BRAIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191JTX5
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193K6 SIXTH TREATMENT FOR BRAIN CANCER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191JTX6
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193L1 FIRST TREATMENT FOR OTHER CANCER 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191KTX
193. What type of treatment did (s/he) have for [OTHER] cancer?
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
1 3. SURGERY
1 4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM193L2 SECOND TREATMENT FOR OTHER CANCER 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191KTX2
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193L3 THIRD TREATMENT FOR OTHER CANCER 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191KTX3
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193L4 FOURTH TREATMENT FOR OTHER CANCER 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191KTX4
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193L5 FIFTH TREATMENT FOR OTHER CANCER 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191KTX5
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193L6 SIXTH TREATMENT FOR OTHER CANCER 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191KTX6
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193M1 FIRST TREATMENT FOR OTHER CANCER 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191LTX
193. What type of treatment did (s/he) have for [2ND OTHER] cancer?
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193M2 SECOND TREATMENT FOR OTHER CANCER 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191LTX2
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193M3 THIRD TREATMENT FOR OTHER CANCER 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191LTX3
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193M4 FOURTH TREATMENT FOR OTHER CANCER 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191LTX4
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193M5 FIFTH TREATMENT FOR OTHER CANCER 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191LTX5
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM193M6 SIXTH TREATMENT FOR OTHER CANCER 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH191LTX6
.................................................................................
1. RADIATION
2. CHEMOTHERAPY
3. SURGERY
4. OTHER MEDICATION
5. NONE
6. OTHER (specify)
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM196 EVER HAD HYSTERECTOMY
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH196
196. Has (NAME) ever had a hysterectomy? REFS MH196-MH203 ARE SKIPPED IF SUBJECT
IS MALE
.................................................................................
3 1. YES
118 2. NO
7. REFUSED
8. DON'T KNOW
131 Blank. Inap
==========================================================================================
BM197 AGE AT TIME OF HYSTERECTOMY
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH197
197. When did she have a hysterectomy (age)? REFS MH196-MH203 ARE SKIPPED IF
SUBJECT IS MALE
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
1 40-49. AGE
1 50-59. AGE
60-69. AGE
1 70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
249 Blank. Inap
==========================================================================================
BM198 MENOPAUSAL SYMPTOMS BOTHERSOME
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH198
198. During the menopausal change, women may experience many symptoms, such as
hot flashes, night sweats, sleep problems, trouble concentrating, and being
irritable or ill-tempered. Do you recall whether these symptoms were very
bothersome to her or only slightly or somewhat bothersome? REFS MH196-MH203 ARE
SKIPPED IF SUBJECT IS MALE
.................................................................................
1. SLIGHTLY/SOMEWHAT BOTHERSOME
2. VERY BOTHERSOME
7. REFUSED
8. DON'T KNOW
9. NA OR ERROR
252 Blank. Inap
==========================================================================================
BM199 AGE SUBJECT WENT THROUGH MENOPAUSE
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH199
199. About what age did (NAME) go through menopause or the change of life? REFS
MH196-MH203 ARE SKIPPED IF SUBJECT IS MALE
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM200 EVER USED ESTROGEN SUPPLEMENTS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH200
200. Has she ever used estrogen supplements (medication)? REFS MH196-MH203 ARE
SKIPPED IF SUBJECT IS MALE
.................................................................................
16 1. YES
100 2. NO
7. REFUSED
5 8. DON'T KNOW
9. NA OR ERROR
131 Blank. Inap
==========================================================================================
BM201 AGE WHEN STARTED ESTROGEN SUPPLEMENTS
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH201
201. How old was she when she started taking estrogen supplements (medication)?
REFS MH196-MH203 ARE SKIPPED IF SUBJECT IS MALE
.................................................................................
1-19. AGE
20-29. AGE
1 30-39. AGE
2 40-49. AGE
4 50-59. AGE
2 60-69. AGE
2 70-79. AGE
1 80-89. AGE
90-99. AGE
100-109. AGE
4 998. DON'T KNOW
236 Blank. Inap
==========================================================================================
BM202 CURRENTLY TAKING ESTROGEN SUPPLEMENTS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH202
202. Is she still taking it? REFS MH196-MH203 ARE SKIPPED IF SUBJECT IS MALE
.................................................................................
12 1. YES
4 2. NO
7. REFUSED
8. DON'T KNOW
236 Blank. Inap
==========================================================================================
BM203 AGE STOPPED TAKING ESTROGEN SUPPLEMENTS
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH203
203. IF no, how old was she when she stopped taking the estrogen supplements
(medication)? REFS MH196-MH203 ARE SKIPPED IF SUBJECT IS MALE
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
2 70-79. AGE
2 80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
248 Blank. Inap
==========================================================================================
BM204 DOCTOR EVER TOLD TESTED POS FOR SYPHILIS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH204
204. To your knowledge, has a doctor ever told (NAME) that (s/he) tested
positive for syphilis?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM205 EVER DRUNK ALCOHOL
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH205
205. Has (NAME) ever drunk alcohol?
.................................................................................
78 1. YES
169 2. NO
7. REFUSED
8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM206 EVER HAD PX DRINKING MORE THAN SHOULD
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH206
206. Has (NAME) ever had a problem drinking more alcohol than (s/he) should?
.................................................................................
6 1. YES
70 2. NO
7. REFUSED
2 8. DON'T KNOW
174 Blank. Inap
==========================================================================================
BM207 AGE STARTED HAVING PROBLEM WITH DRINKING
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH207
207. How old was (s/he) when (s/he) started having a problem drinking more
alcohol than (s/he) should?
.................................................................................
1-19. AGE
1 20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
1 70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
4 998. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM208 STILL DRINKING MORE ALCOHOL THAN SHOULD
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH208
208. Is (s/he) still drinking more alcohol than (s/he) should?
.................................................................................
4 1. YES
2 2. NO
7. REFUSED
8. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM209 AGE STOPPED DRINKING MORE THAN SHOULD
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH209
209. If not, how old was (s/he) when (s/he) stopped drinking more alcohol than
(s/he) should?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
1 70-79. AGE
1 80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM210NUM TYPICAL NUMBER OF DRINKS
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH210NUM
210. During the time when (s/he) was drinking more alcohol than (s/he) should,
how much did (s/he) typically drink?
.................................................................................
1-5. Number
2 6-10. Number
3 11-95. Number
998. DON'T KNOW
999. NOT ASKED/NOT ASSESSED
247 Blank. Inap
==========================================================================================
BM210DUR TIME PERIOD FOR TYPICAL NUMBER OF DRINKS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH210DUR
210. During the time when (s/he) was drinking more alcohol than (s/he) should,
how much did (s/he) typically drink?
.................................................................................
4 1. DAY
1 2. WEEK
3. MONTH
7. REFUSED
1 8. DON'T KNOW
9. NA OR ERROR
246 Blank. Inap
==========================================================================================
BM211 EVER RECEIVED TREATMENT FOR DRINKING PX
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH211
211. Has (s/he) ever received treatment for drinking more alcohol than (s/he)
should?
.................................................................................
1 1. YES
5 2. NO
7. REFUSED
8. DON'T KNOW
9. NA OR ERROR
246 Blank. Inap
==========================================================================================
BM212 EVER CHARGED WITH DUI/DWI
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH212
212. Has (s/he) ever been charged with driving while under the influence of
alcohol?
.................................................................................
1 1. YES
5 2. NO
7. REFUSED
8. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM213 EVER MISS WORK BECAUSE OF DRINKING
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH213
213. When (s/he) was drinking more than (s/he) should, did (her/his) drinking
cause (her/him) to miss work?
.................................................................................
1. YES
2. NO
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM214 EVER HAVE FAMILY PX BECAUSE OF DRINKING
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH214
214. When (s/he) was drinking more than (s/he) should, did her/his drinking
cause her/him to have problems with family members or friends?
.................................................................................
5 1. YES
1 2. NO
7. REFUSED
8. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM216 MEM PX START BEF/DUR/AFT DRINKING PX
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH216
216. To the best of your recollection, did the memory problems start before,
during or after (her/his) drinking more alcohol than (s/he) should?
.................................................................................
1 1. BEFORE
1 2. DURING
3 3. AFTER
6. NA
7. REFUSED
1 8. DON'T KNOW
246 Blank. Inap
==========================================================================================
BM218 MEM PX CHANGE WHEN STOPPED DRINKING
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH218
218. Did her/his memory improve, stay the same or get worse after (s/he) stopped
using more alcohol than (s/he) should?
.................................................................................
1 1. IMPROVE
2. STAY SAME
3. GET WORSE
6. NA
7. REFUSED
1 8. DON'T KNOW
250 Blank. Inap
==========================================================================================
BM220 EVER SMOKED CIGARETTES OR CIGARS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH220
220. Has (s/he) ever smoked cigarettes or cigars?
.................................................................................
24 1. YES
222 2. NO
7. REFUSED
1 8. DON'T KNOW
5 Blank. Inap
==========================================================================================
BM221 AGE STARTED SMOKING CIGARETTES/CIGARS
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH221
221. How old was (s/he) when (s/he) started smoking cigarettes or cigars?
.................................................................................
12 1-19. AGE
4 20-29. AGE
1 30-39. AGE
40-49. AGE
1 50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
6 998. DON'T KNOW
228 Blank. Inap
==========================================================================================
BM222 SUBJECT STILL SMOKING CIGARETTES/CIGARS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH222
222. Is (s/he) still smoking cigarettes or cigars?
.................................................................................
19 1. YES
5 2. NO
7. REFUSED
8. DON'T KNOW
228 Blank. Inap
==========================================================================================
BM223 AGE STOPPED SMOKING CIGARETTES/CIGARS
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH223
223. If not, when did (s/he) stop smoking cigarettes or cigars?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
1 40-49. AGE
1 50-59. AGE
60-69. AGE
1 70-79. AGE
2 80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
247 Blank. Inap
==========================================================================================
BM224 EVER HAD 2 WEEK PERIOD OF DEPRESSION
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH224
Now I am going to ask you a few questions about (NAME'S) mood: 224. In (her/his)
lifetime, has (NAME) ever had a period of two weeks or more when, nearly ever
day, (s/he) felt sad, blue or depressed?
.................................................................................
35 1. YES
208 2. NO
7. REFUSED
4 8. DON'T KNOW
9. NA OR ERROR
5 Blank. Inap
==========================================================================================
BM226 EVER HAD 2 WEEK PERIOD OF LOST INTEREST
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH226
226. In (her/his) lifetime, has (NAME) ever had a period of two weeks or more
when, nearly every day (s/he) lost all interest and pleasure in things that
(s/he) usually cared about or enjoyed?
.................................................................................
31 1. YES
215 2. NO
7. REFUSED
1 8. DON'T KNOW
9. NA OR ERROR
5 Blank. Inap
==========================================================================================
BM228 EVER HAD 2 WEEK PERIOD FELT IRRITABLE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH228
228. In (her/his) lifetime, has (NAME) ever had a period of two weeks or more
when, nearly ever day, (s/he) felt unusually cross or irritable?
.................................................................................
23 1. YES
223 2. NO
7. REFUSED
1 8. DON'T KNOW
9. NA OR ERROR
5 Blank. Inap
==========================================================================================
BM229 CURRENTLY EXPERIENCING THIS EPISODE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH229
229. At present, is (NAME) still experiencing this episode of sadness, loss of
interest or irritability?
.................................................................................
21 1. YES
22 2. NO
7. REFUSED
8. DON'T KNOW
209 Blank. Inap
==========================================================================================
BM230 LIFETIME, NUMBER OF EPISODES
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH230
230. In (her/his) life, how many episodes of two weeks or more of sadness, loss
of interest or irritability has (NAME) had?
.................................................................................
28 1-5. Number
6-10. Number
11-100. Number
15 998. DON'T KNOW
209 Blank. Inap
==========================================================================================
BM232 AGE OF FIRST EPISODE
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH232
232. How old was (NAME) when (s/he) had (her/his) first episode of two weeks or
more of sadness, loss of interest or irritability?
.................................................................................
1-19. AGE
1 20-29. AGE
30-39. AGE
1 40-49. AGE
50-59. AGE
1 60-69. AGE
18 70-79. AGE
12 80-89. AGE
3 90-99. AGE
1 100-109. AGE
5 998. DON'T KNOW
210 Blank. Inap
==========================================================================================
BM233A APPETITE PROBLEMS WITH EPISODE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH233A
233. You said (NAME) has had [MH230] period(s) of sadness, loss of interest and
pleasure, or irritability. With (this episode/these previous episodes), did
(s/he) typically experience problems with: APPETITE
.................................................................................
23 1. YES
18 2. NO
7. REFUSED
2 8. DON'T KNOW
9. NA OR ERROR
209 Blank. Inap
==========================================================================================
BM233B SLEEP PROBLEMS WITH EPISODE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH233B
233. You said (NAME) has had [MH230] period(s) of sadness, loss of interest and
pleasure, or irritability. With (this episode/these previous episodes), did
(s/he) typically experience problems with: SLEEP
.................................................................................
26 1. YES
13 2. NO
7. REFUSED
4 8. DON'T KNOW
9. NA OR ERROR
209 Blank. Inap
==========================================================================================
BM233C FEELING SLOWED/RESTLESS WITH EPISODE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH233C
233. You said (NAME) has had [MH230] period(s) of sadness, loss of interest and
pleasure, or irritability. With (this episode/these previous episodes), did
(s/he) typically experience problems with: FEELING SLOWED DOWN, RESTLESS OR
FIDGETY
.................................................................................
27 1. YES
12 2. NO
7. REFUSED
4 8. DON'T KNOW
9. NA OR ERROR
209 Blank. Inap
==========================================================================================
BM233D ENERGY PROBLEMS WITH EPISODE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH233D
233. You said (NAME) has had [MH230] period(s) of sadness, loss of interest and
pleasure, or irritability. With (this episode/these previous episodes), did
(s/he) typically experience problems with: HER/HIS ENERGY LEVEL
.................................................................................
35 1. YES
8 2. NO
7. REFUSED
8. DON'T KNOW
9. NA OR ERROR
209 Blank. Inap
==========================================================================================
BM233E FEELING WORTHLESS/GUILTY WITH EPISODE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH233E
233. You said (NAME) has had [MH230] period(s) of sadness, loss of interest and
pleasure, or irritability. With (this episode/these previous episodes), did
(s/he) typically experience problems with: FEELINGS OF WORTHLESSNESS OR GUILT
.................................................................................
22 1. YES
18 2. NO
7. REFUSED
3 8. DON'T KNOW
9. NA OR ERROR
209 Blank. Inap
==========================================================================================
BM233F CONCENTRATION PROBLEMS WITH EPISODE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH233F
233. You said (NAME) has had [MH230] period(s) of sadness, loss of interest and
pleasure, or irritability. With (this episode/these previous episodes), did
(s/he) typically experience problems with: CONCENTRATION
.................................................................................
27 1. YES
10 2. NO
7. REFUSED
6 8. DON'T KNOW
9. NA OR ERROR
209 Blank. Inap
==========================================================================================
BM233G THOUGHTS OF DEATH/SUICIDE WITH EPISODE
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH233G
233. You said (NAME) has had [MH230] period(s) of sadness, loss of interest and
pleasure, or irritability. With (this episode/these previous episodes), did
(s/he) typically experience problems with: THOUGHTS ABOUT DEATH OR SUICIDE
.................................................................................
13 1. YES
30 2. NO
7. REFUSED
8. DON'T KNOW
9. NA OR ERROR
209 Blank. Inap
==========================================================================================
BM234A TREATED FOR DEPRESSION WITH COUNSELING
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH234A
234. Did (NAME) ever receive any of the following treatments for depressed mood,
clinical depression, or for any of the above symptoms? COUNSELING
.................................................................................
6 1. YES
37 2. NO
7. REFUSED
8. DON'T KNOW
9. NA OR ERROR
209 Blank. Inap
==========================================================================================
BM234B TREATED FOR DEPRESSION WITH MEDICINES
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH234B
234. Did (NAME) ever receive any of the following treatments for depressed mood,
clinical depression, or for any of the above symptoms? MEDICINES
.................................................................................
19 1. YES
23 2. NO
7. REFUSED
1 8. DON'T KNOW
9. NA OR ERROR
209 Blank. Inap
==========================================================================================
BM234C TREATED FOR DEPRESSION WITH EST/ECT
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH234C
234. Did (NAME) ever receive any of the following treatments for depressed mood,
clinical depression, or for any of the above symptoms? ELECTRIC SHOCK OR EST OR
ELECTRIC CONVULSIVE THERAPY OR ECT
.................................................................................
1. YES
43 2. NO
7. REFUSED
8. DON'T KNOW
9. NA OR ERROR
209 Blank. Inap
==========================================================================================
BM235 EVER HOSPITALIZED FOR DEPRESSION
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH235
235. Has (NAME) ever been hospitalized for depressed mood, clinical depression,
or any of the symptoms we've just discussed?
.................................................................................
1. YES
45 2. NO
7. REFUSED
8. DON'T KNOW
9. NA OR ERROR
207 Blank. Inap
==========================================================================================
BM236 EVER HAD MOOD SWINGS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH236
236.Has (NAME) ever had mood swings in which (s/he) goes from being extremely
depressed to being excessively happy and energetic?
.................................................................................
6 1. YES
238 2. NO
7. REFUSED
2 8. DON'T KNOW
1 9. NA OR ERROR
5 Blank. Inap
==========================================================================================
BM237 EVER TOLD BY DR WAS BIPOLAR OR MANIC
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH237
237. Has a doctor ever told (her/him) that (s/he) has a bipolar disorder or
manic-depressive illness?
.................................................................................
1. YES
245 2. NO
7. REFUSED
2 8. DON'T KNOW
9. NA OR ERROR
5 Blank. Inap
==========================================================================================
BM238 AGE WHEN DOCTOR TOLD BIPOLAR OR MANIC
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH238
238. How old was (s/he) when (s/he) was told (s/he) had bipolar disorder or
manic-depressive illness?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM239 TREATED FOR BIPOLAR OR MANIC DISORDER
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH239
239. Did (s/he) receive treatment for bipolar disorder or manic-depressive
illness?
.................................................................................
1. YES
1 2. NO
7. REFUSED
8. DON'T KNOW
251 Blank. Inap
==========================================================================================
BM240 MEM PXS START BEF/DURING/AFT MOOD SWINGS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH240
240. To the best of your recollection, did the memory problems start before,
during, or after the mood swings?
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM242 EVER TOLD BY DOCTOR HAD SCHIZOPHRENIA
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH242
242. Has a doctor ever told (her/him) that (s/he) had schizophrenia?
.................................................................................
1. YES
246 2. NO
7. REFUSED
1 8. DON'T KNOW
9. NA OR ERROR
5 Blank. Inap
==========================================================================================
BM243 AGE WHEN DOCTOR TOLD HAD SCHIZOPHRENIA
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH243
243. How old was (s/he) when a doctor told (her/him) that (s/he) had
schizophrenia?
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
40-49. AGE
50-59. AGE
60-69. AGE
70-79. AGE
80-89. AGE
90-99. AGE
100-109. AGE
998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM244 RECEIVE TREATMENT FOR SCHIZOPHRENIA
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH244
244. Did (s/he) receive treatment for schizophrenia?
.................................................................................
1. YES
2. NO
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM245 EVER HAD HALLUCINATIONS OR DELUSIONS
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH245
245. Has (s/he) ever had hallucinations or delusions?
.................................................................................
4 1. YES, HALLUCINATIONS ONLY
4 2. YES, DELUSIONS ONLY
4 3. YES, BOTH
232 4. NO
7. REFUSED
3 8. DON'T KNOW
9. NA OR ERROR
5 Blank. Inap
==========================================================================================
BM246 WERE HALLUCINATIONS VISUAL/AUDITORY/BOTH
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH246
246. Were the hallucinations visual, auditory or both?
.................................................................................
2 1. VISUAL ONLY
2 2. AUDITORY
5 3. BOTH
7. REFUSED
8. DON'T KNOW
9. NA OR ERROR
243 Blank. Inap
==========================================================================================
BM247MO MONTH HALLUCINATIONS BEGAN
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH247MO
247. When did this start? (Month)
.................................................................................
5 1-12. MONTH
98. DON'T KNOW
247 Blank. Inap
==========================================================================================
BM247YR YEAR HALLUCINATIONS BEGAN
Section: BM Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: MH247YR
247. When did this start? (Year)
.................................................................................
1930-1949. YEAR
1950-1969. YEAR
1970-1979. YEAR
1980-1989. YEAR
1990-1999. YEAR
5 2000-2003. YEAR
9998. DON'T KNOW
247 Blank. Inap
==========================================================================================
BM247AGE AGE WHEN HALLUCINATIONS BEGAN
Section: BM Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: MH247AGE
247. When did this start? (Age)
.................................................................................
1-19. AGE
20-29. AGE
30-39. AGE
1 40-49. AGE
50-59. AGE
60-69. AGE
1 70-79. AGE
2 80-89. AGE
2 90-99. AGE
100-109. AGE
1 998. DON'T KNOW
245 Blank. Inap
==========================================================================================
BM249MO MONTH OF PSYCHIATRIC EVALUATION
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH249MO
249. Can you tell me the name and address of the doctor (NAME) has seen for the
problem with [psychiatric condition]? MONTH SEEN BY DR OR HOSPITAL
.................................................................................
5 1-12. MONTH
7 98. DON'T KNOW
240 Blank. Inap
==========================================================================================
BM249YR YEAR OF PSYCHIATRIC EVALUATION
Section: BM Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: MH249YR
249. Can you tell me the name and address of the doctor (NAME) has seen for the
problem with [psychiatric condition]? YEAR SEEN BY DR OR HOSPITAL
.................................................................................
1930-1949. YEAR
1950-1969. YEAR
1970-1979. YEAR
1980-1989. YEAR
1990-1999. YEAR
8 2000-2003. YEAR
4 9998. DON'T KNOW
240 Blank. Inap
==========================================================================================
BM250MO MONTH OF PSYCHIATRIC HOSPITALIZATION
Section: BM Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: MH250MO
249. Can you tell me the name and address of the doctor (NAME) has seen for the
problem with [psychiatric condition]? MONTH SEEN BY DR OR HOSPITAL
.................................................................................
1-12. MONTH
98. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM250YR YEAR OF PSYCHIATRIC HOSPITALIZATION
Section: BM Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: MH250YR
249. Can you tell me the name and address of the doctor (NAME) has seen for the
problem with [psychiatric condition]? YEAR SEEN BY DR OR HOSPITAL
.................................................................................
1930-1949. YEAR
1950-1969. YEAR
1970-1979. YEAR
1980-1989. YEAR
1990-1999. YEAR
2000-2003. YEAR
9998. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM251AT TYPE OF ICD9 CODE - PROBLEM 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251A_ICDTYPE
.................................................................................
19 1. Supplementary classification of factors influencing health
status and contact with health services (V01-V83.89)
6 2. Procedure codes (00.0-99.99)
87 3. Medical conditions (001-799.9) and supplemental conditions
--injury and poisoning (800-999.9)
140 Blank. Inap
==========================================================================================
BM251A ICD9 CODE - PROBLEM 1
Section: BM Level: Respondent Type: Character Width: 6 Decimals: 0
Ref: MH251A_ICD
251. Does (NAME) have any other important medical problems we have not talked
about? (ICD-9 codes were assigned to all medical conditions reported on MH251)
Note: See Data Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes,
for frequencies and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251AS ICD9 SUBCODE - PROBLEM 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251A_ICD_SUB
MEDICAL CONDITION SUBCODE.
Note: The subcodes were added to capture characteristics, such as treatment or
sequalae of the medical condition, that might be useful in interpreting the
data. If the ICD-9 codes are the same but the subcodes are different, then the
conditions are considered to be different. Subcodes are required if medical
condition code is: 436.0, 435.9, 294.8, 412, 427.9, 496, 250.00. See Data
Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes, for frequencies
and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251BT TYPE OF ICD9 CODE - PROBLEM 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251B_ICDTYPE
.................................................................................
4 1. Supplementary classification of factors influencing health
status and contact with health services (V01-V83.89)
5 2. Procedure codes (00.0-99.99)
46 3. Medical conditions (001-799.9) and supplemental conditions
--injury and poisoning (800-999.9)
197 Blank. Inap
==========================================================================================
BM251B ICD9 CODE - PROBLEM 2
Section: BM Level: Respondent Type: Character Width: 6 Decimals: 0
Ref: MH251B_ICD
251. Does (NAME) have any other important medical problems we have not talked
about?.
Note: See Data Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes,
for frequencies and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251BS ICD9 SUBCODE - PROBLEM 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251B_ICD_SUB
MEDICAL CONDITION SUBCODE.
Note: The subcodes were added to capture characteristics, such as treatment or
sequalea of the medical condition, that might be useful in interpreting the
data. If the ICD-9 codes are the same but the subcodes are different, then the
conditions are considered to be different. Subcodes are required if medical
condition code is: 436.0, 435.9, 294.8, 412, 427.9, 496, 250.00. See Data
Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes, for frequencies
and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251CT TYPE OF ICD9 CODE - PROBLEM 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251C_ICDTYPE
.................................................................................
1 1. Supplementary classification of factors influencing health
status and contact with health services (V01-V83.89)
2. Procedure codes (00.0-99.99)
17 3. Medical conditions (001-799.9) and supplemental conditions
--injury and poisoning (800-999.9)
234 Blank. Inap
==========================================================================================
BM251C ICD9 CODE - PROBLEM 3
Section: BM Level: Respondent Type: Character Width: 6 Decimals: 0
Ref: MH251C_ICD
251. Does (NAME) have any other important medical problems we have not talked
about?
Note: See Data Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes,
for frequencies and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251CS ICD9 SUBCODE - PROBLEM 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251C_ICD_SUB
MEDICAL CONDITION SUBCODE.
Note: The subcodes were added to capture characteristics, such as treatment or
sequalea of the medical condition, that might be useful in interpreting the
data. If the ICD-9 codes are the same but the subcodes are different, then the
conditions are considered to be different. Subcodes are required if medical
condition code is: 436.0, 435.9, 294.8, 412, 427.9, 496, 250.00. See Data
Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes, for frequencies
and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251DT TYPE OF ICD9 CODE - PROBLEM 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251D_ICDTYPE
.................................................................................
1. Supplementary classification of factors influencing health
status and contact with health services (V01-V83.89)
2. Procedure codes (00.0-99.99)
3 3. Medical conditions (001-799.9) and supplemental conditions
--injury and poisoning (800-999.9)
249 Blank. Inap
==========================================================================================
BM251D ICD9 CODE - PROBLEM 4
Section: BM Level: Respondent Type: Character Width: 6 Decimals: 0
Ref: MH251D_ICD
251. Does (NAME) have any other important medical problems we have not talked
about?
Note: See Data Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes,
for frequencies and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251DS ICD9 SUBCODE - PROBLEM 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251D_ICD_SUB
MEDICAL CONDITION SUBCODE.
Note: The subcodes were added to capture characteristics, such as treatment or
sequalea of the medical condition, that might be useful in interpreting the
data. If the ICD-9 codes are the same but the subcodes are different, then the
conditions are considered to be different. Subcodes are required if medical
condition code is: 436.0, 435.9, 294.8, 412, 427.9, 496, 250.00. See Data
Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes, for frequencies
and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251ET TYPE OF ICD9 CODE - PROBLEM 5
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251E_ICDTYPE
.................................................................................
1. Supplementary classification of factors influencing health
status and contact with health services (V01-V83.89)
2. Procedure codes (00.0-99.99)
3. Medical conditions (001-799.9) and supplemental conditions
--injury and poisoning (800-999.9)
252 Blank. Inap
==========================================================================================
BM251E ICD9 CODE - PROBLEM 5
Section: BM Level: Respondent Type: Character Width: 6 Decimals: 0
Ref: MH251E_ICD
251. Does (NAME) have any other important medical problems we have not talked
about?
Note: See Data Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes,
for frequencies and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251ES ICD9 SUBCODE - PROBLEM 5
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251E_ICD_SUB
MEDICAL CONDITION SUBCODE.
Note: The subcodes were added to capture characteristics, such as treatment or
sequalea of the medical condition, that might be useful in interpreting the
data. If the ICD-9 codes are the same but the subcodes are different, then the
conditions are considered to be different. Subcodes are required if medical
condition code is: 436.0, 435.9, 294.8, 412, 427.9, 496, 250.00. See Data
Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes, for frequencies
and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251FT TYPE OF ICD9 CODE - PROBLEM 6
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251F_ICDTYPE
.................................................................................
1. Supplementary classification of factors influencing health
status and contact with health services (V01-V83.89)
2. Procedure codes (00.0-99.99)
3. Medical conditions (001-799.9) and supplemental conditions
--injury and poisoning (800-999.9)
252 Blank. Inap
==========================================================================================
BM251F ICD9 CODE - PROBLEM 6
Section: BM Level: Respondent Type: Character Width: 6 Decimals: 0
Ref: MH251F_ICD
251. Does (NAME) have any other important medical problems we have not talked
about?
Note: See Data Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes,
for frequencies and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251FS ICD9 SUBCODE - PROBLEM 6
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251F_ICD_SUB
MEDICAL CONDITION SUBCODE.
Note: The subcodes were added to capture characteristics, such as treatment or
sequalea of the medical condition, that might be useful in interpreting the
data. If the ICD-9 codes are the same but the subcodes are different, then the
conditions are considered to be different. Subcodes are required if medical
condition code is: 436.0, 435.9, 294.8, 412, 427.9, 496, 250.00. See Data
Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes, for frequencies
and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251GT TYPE OF ICD9 CODE - PROBLEM 7
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251G_ICDTYPE
.................................................................................
1. Supplementary classification of factors influencing health
status and contact with health services (V01-V83.89)
2. Procedure codes (00.0-99.99)
3. Medical conditions (001-799.9) and supplemental conditions
--injury and poisoning (800-999.9)
252 Blank. Inap
==========================================================================================
BM251G ICD9 CODE - PROBLEM 7
Section: BM Level: Respondent Type: Character Width: 6 Decimals: 0
Ref: MH251G_ICD
251. Does (NAME) have any other important medical problems we have not talked
about?
Note: See Data Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes,
for frequencies and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251GS ICD9 SUBCODE - PROBLEM 7
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251G_ICD_SUB
MEDICAL CONDITION SUBCODE.
Note: The subcodes were added to capture characteristics, such as treatment or
sequalea of the medical condition, that might be useful in interpreting the
data. If the ICD-9 codes are the same but the subcodes are different, then the
conditions are considered to be different. Subcodes are required if medical
condition code is: 436.0, 435.9, 294.8, 412, 427.9, 496, 250.00. See Data
Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes, for frequencies
and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251HT TYPE OF ICD9 CODE - PROBLEM 8
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251H_ICDTYPE
.................................................................................
1. Supplementary classification of factors influencing health
status and contact with health services (V01-V83.89)
2. Procedure codes (00.0-99.99)
3. Medical conditions (001-799.9) and supplemental conditions
--injury and poisoning (800-999.9)
252 Blank. Inap
==========================================================================================
BM251H ICD9 CODE - PROBLEM 8
Section: BM Level: Respondent Type: Character Width: 6 Decimals: 0
Ref: MH251H_ICD
251. Does (NAME) have any other important medical problems we have not talked
about?
Note: See Data Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes,
for frequencies and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251HS ICD9 SUBCODE - PROBLEM 8
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251H_ICD_SUB
MEDICAL CONDITION SUBCODE.
Note: The subcodes were added to capture characteristics, such as treatment or
sequalea of the medical condition, that might be useful in interpreting the
data. If the ICD-9 codes are the same but the subcodes are different, then the
conditions are considered to be different. Subcodes are required if medical
condition code is: 436.0, 435.9, 294.8, 412, 427.9, 496, 250.00. See Data
Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes, for frequencies
and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251JT TYPE OF ICD9 CODE - PROBLEM 9
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251I_ICDTYPE
.................................................................................
1. Supplementary classification of factors influencing health
status and contact with health services (V01-V83.89)
2. Procedure codes (00.0-99.99)
3. Medical conditions (001-799.9) and supplemental conditions
--injury and poisoning (800-999.9)
252 Blank. Inap
==========================================================================================
BM251J ICD9 CODE - PROBLEM 9
Section: BM Level: Respondent Type: Character Width: 6 Decimals: 0
Ref: MH251I_ICD
251. Does (NAME) have any other important medical problems we have not talked
about?
Note: See Data Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes,
for frequencies and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251JS ICD9 SUBCODE - PROBLEM 9
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251I_ICD_SUB
MEDICAL CONDITION SUBCODE.
Note: The subcodes were added to capture characteristics, such as treatment or
sequalea of the medical condition, that might be useful in interpreting the
data. If the ICD-9 codes are the same but the subcodes are different, then the
conditions are considered to be different. Subcodes are required if medical
condition code is: 436.0, 435.9, 294.8, 412, 427.9, 496, 250.00. See Data
Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes, for frequencies
and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251KT TYPE OF ICD9 CODE - PROBLEM 10
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251J_ICDTYPE
.................................................................................
1. Supplementary classification of factors influencing health
status and contact with health services (V01-V83.89)
2. Procedure codes (00.0-99.99)
3. Medical conditions (001-799.9) and supplemental conditions
--injury and poisoning (800-999.9)
252 Blank. Inap
==========================================================================================
BM251K ICD9 CODE - PROBLEM 10
Section: BM Level: Respondent Type: Character Width: 6 Decimals: 0
Ref: MH251J_ICD
251. Does (NAME) have any other important medical problems we have not talked
about?
Note: See Data Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes,
for frequencies and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM251KS ICD9 SUBCODE - PROBLEM 10
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251J_ICD_SUB
MEDICAL CONDITION SUBCODE.
Note: The subcodes were added to capture characteristics, such as treatment or
sequalea of the medical condition, that might be useful in interpreting the
data. If the ICD-9 codes are the same but the subcodes are different, then the
conditions are considered to be different. Subcodes are required if medical
condition code is: 436.0, 435.9, 294.8, 412, 427.9, 496, 250.00. See Data
Description and Usage, Appendix 3, ICD 9 Codes and Sub-codes, for frequencies
and meaning of the codes and subcodes.
.................................................................................
==========================================================================================
BM252A MEM PXS START BEF/DUR/AFT MEDICAL PX 1
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251ABEF
253. To the best of your recollection, did the memory problems start before,
during or after the medical problem?
.................................................................................
61 1. BEFORE
5 2. DURING
16 3. AFTER
28 6. NA
7. REFUSED
2 8. DON'T KNOW
140 Blank. Inap
==========================================================================================
BM252B MEM PXS START BEF/DUR/AFT MEDICAL PX 2
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251BBEF
254. To the best of your recollection, did the memory problems start before,
during or after the medical problem?
.................................................................................
32 1. BEFORE
4 2. DURING
8 3. AFTER
9 6. NA
7. REFUSED
2 8. DON'T KNOW
197 Blank. Inap
==========================================================================================
BM252C MEM PXS START BEF/DUR/AFT MEDICAL PX 3
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251CBEF
255. To the best of your recollection, did the memory problems start before,
during or after the medical problem?
.................................................................................
10 1. BEFORE
2. DURING
2 3. AFTER
5 6. NA
7. REFUSED
1 8. DON'T KNOW
234 Blank. Inap
==========================================================================================
BM252D MEM PXS START BEF/DUR/AFT MEDICAL PX 4
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251DBEF
256. To the best of your recollection, did the memory problems start before,
during or after the medical problem?
.................................................................................
1 1. BEFORE
2. DURING
3. AFTER
2 6. NA
7. REFUSED
8. DON'T KNOW
249 Blank. Inap
==========================================================================================
BM252E MEM PXS START BEF/DUR/AFT MEDICAL PX 5
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251EBEF
To the best of your recollection, did the memory problems start before, during
or after the medical problem?
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM252F MEM PXS START BEF/DUR/AFT MEDICAL PX 6
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251FBEF
To the best of your recollection, did the memory problems start before, during
or after the medical problem?
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM252G MEM PXS START BEF/DUR/AFT MEDICAL PX 7
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251GBEF
To the best of your recollection, did the memory problems start before, during
or after the medical problem?
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM252H MEM PXS START BEF/DUR/AFT MEDICAL PX 8
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251HBEF
To the best of your recollection, did the memory problems start before, during
or after the medical problem?
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM252J MEM PXS START BEF/DUR/AFT MEDICAL PX 9
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251IBEF
To the best of your recollection, did the memory problems start before, during
or after the medical problem?
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
==========================================================================================
BM252K MEM PXS START BEF/DUR/AFT MEDICAL PX 10
Section: BM Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: MH251JBEF
To the best of your recollection, did the memory problems start before, during
or after the medical problem?
.................................................................................
1. BEFORE
2. DURING
3. AFTER
6. NA
7. REFUSED
8. DON'T KNOW
252 Blank. Inap
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