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Protocol - Family History of Dementia and Longevity

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Description:

An interviewer-administered questionnaire that assesses medical diagnoses of an individual's mother and father as they relate to dementia and Alzheimer's Disease.

Protocol:

Questions about Mother

1. Has a doctor ever told your mother that she has Alzheimer's Disease?

(Medical doctors include specialists such as Neurologists, Dermatologists, Psychiatrists, Ophthalmologists, Osteopaths, Cardiologists, as well as family doctors, internists and physicians' assistants. Also include diagnoses made by Nurses and Nurse Practitioners.)

[ ] 1 YES, GO TO Question 3

[ ] 5 NO

[ ] 7 [IF VOLUNTEERED] NOT ALZHEIMER'S DISEASE, GO TO Question 3

[ ] 8 DK

[ ] 9 RF

2. Has a doctor ever told your mother that she has dementia, senility or any other serious memory impairment?

[ ] 1 YES

[ ] 5 NO

[ ] 8 DK

[ ] 9 RF

3. About how old was she when she (died/passed away)?

[INTERVIEWER: PROBE IF NECESSARY]

AGE ________ (go to question 3b)

[ ] DK (go to question 4)

[ ] RF

3b. In what month and year did she (die/pass away)?

MONTH __________

[ ] DK

[ ] RF

YEAR __________

[ ] DK

[ ] RF

Questions about Father

4. Has a doctor ever told your father that he has Alzheimer's Disease?

(Medical doctors include specialists such as Neurologists, Dermatologists, Psychiatrists, Ophthalmologists, Osteopaths, Cardiologists, as well as family doctors, internists and physicians' assistants. Also include diagnoses made by Nurses and Nurse Practitioners.)

[ ] 1 YES, GO TO Question 6

[ ] 5 NO

[ ] 7 [IF VOLUNTEERED] NOT ALZHEIMER'S DISEASE, GO TO Question 6

[ ] 8 DK

[ ] 9 RF

5. Has a doctor ever told your father that he has dementia, senility or any other serious memory impairment?

[ ] 1 YES

[ ] 5 NO

[ ] 8 DK

[ ] 9 RF

6. About how old was he when he (died/passed away)?

[INTERVIEWER: PROBE IF NECESSARY]

AGE _____

[ ] DK

[ ] RF

6b. In what month and year did he (die/pass away)?

MONTH________

[ ] DK

[ ] RF

YEAR______

[ ] DK

[ ] RF

Protocol Name from Source:

Family History of Dementia and Longevity 2016, Section F

Availability:

Publicly available

Personnel and Training Required

The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a "don't know" response is provided.

Equipment Needs
The PhenX Working Group acknowledges that these questions can be administered in a computerized or noncomputerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire.
Requirements
Requirement CategoryRequired
Mode of Administration

Interviewer-administered questionnaire

Life Stage:

Participants:

Adults over 50 years of age in the United States

Specific Instructions:
Selection Rationale

The Health and Retirement Study is longitudinal survey of a representative sample of Americans over 50 years of age. The study has more than 3,000 publications to date. These questions capture the important data about longevity and dementia status of the parents of an individual.

Language

Standards
StandardNameIDSource
Process and Review

The Expert Review Panel has yet to review this measure.

Source

National Institute on Aging Health and Retirement Study. Family History of Dementia and Longevity 2016, Section F: Questions F233, F234, F006, F007, F008, F235, F236, F016, F017, F018.

General References
Protocol ID:

250801

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
Research Domain Information
Measure Name:

Family History of Dementia and Longevity

Release Date:

N/A

Definition

Questionnaire obtaining history of diagnosis of dementia and Alzheimer's Disease in an individual's mother and father.

Purpose

Both dementia and longevity exhibit some degree of heritability, so information on maternal and paternal history is important to an individual.

Keywords

Alzheimer's Disease, Dementia, Memory Impairment, Senility, Health and Retirement Study, National Institute on Aging, NIA, gerontology, aging