Brain Station Follow Up Quiz - Brain Health Hub

Step 1 of 15 - Demographics

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I agree to the terms and conditions(Required)

I agree to the terms and conditions

Please indicate how much you agree or disagree with the following statements:

There is nothing anyone can do to reduce their risk of dementia.(Required)

Strongly disagree

Somewhat disagree

Neither agree nor disagree

Somewhat agree

Strongly agree

I am able to make differences that will change the risk of developing dementia(Required)

Strongly disagree

Somewhat disagree

Neither agree nor disagree

Somewhat agree

Strongly agree

Changing my lifestyle and health habits can help me reduce my chance of developing dementia(Required)

Strongly disagree

Somewhat disagree

Neither agree nor disagree

Somewhat agree

Strongly agree

Has your doctor told you that you have any of the following medical conditions?

A heart or blood vessel condition (including heart attack, angina (chest pain), heart failure, stroke or TIA’s [transient ischemic attack])

Chronic kidney disease

Diabetes

High blood pressure

High cholesterol

None of these

Do you have trouble with your hearing?(Required)

Never

Rarely

Sometimes

Often

Do you smoke?(Required)

Yes

What is your height? (to the nearest cm)(Required)

What is your weight? (to the nearest kg)(Required)

Your Body Mass Index (BMI) is 0

Do you regularly get at least 2.5 hours moderate exercise a week? This is approximately 30 mins a day.(Required)

Always

Most weeks

Some weeks

Rarely

How many units of alcohol do you drink in an average week? (one unit = half a pint of beer or a single measure of spirits or a small glass of wine)

Pints of beer or cider(Required)

Please enter a number greater than or equal to 0.

Medium glasses of wine(Required)

Please enter a number greater than or equal to 0.

Single measure of spirits(Required)

Please enter a number greater than or equal to 0.

Premixed drinks/cans (e.g. G&T, alcopop, spritzer)(Required)

Please enter a number greater than or equal to 0.

0 = Total units of alcohol in a typical week

The Mediterranean diet includes foods like fish, vegetables, legumes, olive oil, pasta and occasionally a glass of red wine. Does this sound similar to the way you eat?(Required)

Yes

A little

How has your mood been in the past four weeks?(Required)

Mostly happy only the occasional bad day

More good days than bad

More bad days than good days

Feel low most of the time

Do you generally engage in mentally stimulating activities, like learning new things, making music, or practicing hobbies?(Required)

All of the time

Often

Some of the time

Rarely

Never

Do you generally consider yourself as someone who is socially engaged, such as being involved in social activities?(Required)

Yes, all the time

Sometimes

A little

Not much

How good would you rate the quality of your sleep on average?

Best sleep, feeling refreshed

Slept pretty well

An okay night’s sleep

Slept a little, but not well

Tossed and turned all night

Are you open to a phone interview?

Phone Interview(Required)

Yes

Can you explain why

Other reason(Required)

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Name

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