ACT Form 71 Summary

Data Description

ACT Form 71 collects administrative information on ACT participants for the study. A high-level overview of the content areas is shown below.

Administrative Information

• Present address / living situation; own home, nursing home, etc.
• Date of birth
• Gender
• Physician / clinic name
• Exam start / stop time
• Place of examination; clinic, home, etc.
• Alert conditions; does interviewer feel participant is alert, or have any impairment?
• Forms completed at this visit

Important Note: Form contents have changed over the years so all the above items may not be collected over the full duration of the ACT study. 

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Data Structure 

This Form 71 dataset contains one row per visit at which the study form was collected. 

 

Historical Data Collection Forms

For Baseline and Biennial Visits (PDFs)