Adult Changes in Thought Study

ACT Form 72 Summary

Data Description

ACT Form 72 collects self-reported vision, hearing, and olfaction information on ACT participants. A high-level overview of the content areas is shown below.

Vision

  • Does participant wear eyeglasses or contacts, use glasses/ contacts for reading and close work, use glasses/ contacts for seeing distant objects?
  • Can participant see well enough to recognize a friend across the street, see well enough to read ordinary newsprint?
  • About how old was participant when they started to have to use glasses, change prescription, etc., in their middle years, for reading and close work?

Hearing

  • Has participant ever worn a hearing aid, have difficulty hearing, causing embarrassment when meeting new people, causing participant to feel frustrated when talking to family members, difficulty when someone speaks in a whisper, feel handicapped by a hearing problem, hearing difficulty when visiting with friends/relatives or neighbors?
  • Difficulty causes participant to attend religious services less often than they would like, causing arguments with family members, difficulty when listening to TV or radio or difficulty limiting or hampering person or social life, difficulty when in a restaurant with relatives or friends, if a person talks to you in a normal voice, can you usually understand them without watching their mouth (with a hearing aid if you use one)?
     

Olfaction

  • Have you had congestion of your nose in the past 3 weeks?
  • Has your sense of smell deteriorated over the period of your adult life?
  • Over what time-period has your sense of smell gotten worse?
  • What was your age when you first noticed these problems?
  • Do you know why you could not smell things as well as before?
  • Do you suffer from taste problems?
  • At what age did you first notice these problems?
     

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. 

Data Structure 

This Form 72 dataset contains one row per visit at which the study form was collected. 

 

Historical Data Collection Forms

For Baseline and Biennial Visits (PDFs)