During the past four weeks, how would you rate your sleep quality overall?
During a 24 hour day, how many hours of sleep do you usually get?
About how many days per week do you participate in moderate intensity aerobic activity (brisk walking, dancing, cycling, swimming, etc.) for at least 30 minutes?
About how many days per week do you participate in gentle physical activity (chair exercise, yoga, tai chi, etc.) for at least 30 minutes?
About how many days per week do you participate in muscle strengthening activity (lifting weights, working with resistance bands, doing exercises that use your body weight, Pilates, etc.) for at least 30 minutes?
How many servings of fruits and vegetables do you eat during a typical day? (1 serving = 1 measuring cup)
During the past four weeks, how much did your physical health problems limit your usual social activities (such as going to social events, having meals and visits with friends or family, etc.)?
During the past four weeks, how much energy did you have?
How much physical pain have you had during the past four weeks?
In the past year, how many falls have you experienced?