CSHA - Risk Factor Questionnaire

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Information on risk factors was collected in two ways. As the memory problems of dementia prevent patients from providing accurate information, questionnaires were administered to a person who knew the subject well (typically, the spouse or other family member). This was done for people with dementia at CSHA-1, and also for a random sample of controls who were clinically examined and confirmed to be cognitively normal.

In addition, at the CSHA-1 baseline, 6,628 participants who were found to be cognitively normal completed a risk factor questionnaire themselves. This was used in the cohort risk factor study which was undertaken using incident cases identified at the CSHA-2 follow-up study.

Content of the CSHA Risk Factor Questionnaires:

Theme	Data Collected
Demographics	Date & place of birth Marital status, education, ethnic origin
Residential History	Countries and towns lived in; dates Water sources used
Occupational History	Jobs held: title, industry, dates
Hobbies	Gardening, painting, automotive Home or furniture repairs Contact sports, camping, boating
Occupational or Hobby Exposures	Dyes, paints, fuels, oils, solvents, glues Pesticide, herbicide or fertilizer use Radiation Excessive noise
Family Structure	Age of parents at subject’s birth Siblings, children, twin?
Health History	Chronic conditions Mental problems Head injuries Operations and anesthetics Vaccinations Medication use
Family history	Selected chronic conditions
Other	Use of antacids, analgesics, anti-perspirants
Lifestyle	Use of alcohol, tobacco, selected nutritional items Physical activity level