| | | |  
| | | | Please underline the letter  
| | | | on which you finished.  
| | | |  
| | | | INTERVIEWER:Now take back the booklet and clipboard.  
| | | |  
| | | |  
| | | | Was the respondent able to do the letter cancellation task?  
| | | | 1 Yes  
| | | | 2 No, because has reading problems  
| | | | 95 No, for other reason (please specify)  
| | | |  
| | | | IF INTERVIEWER: As soon as the co = Other [CfLetEn = 95]  
| | | | |  
| | | | | CFLETEO  
| | | | |  
| | | | | INTERVIEWER: Give details of other reason.  
| | | | | String: 80  
| | | | |  
| | | | END FILTER  
| | | |  
| | | | CFMEMS WHAT RESPONDENT DID WITH CLIPBOARD  
| | | |  
| | | | INTERVIEWER: Code what respondent did when you handed them the clipboard  
and pencil.  
| | | | 1 Wrote their initials in top left hand corner  
| | | | 2 Wrote their initials somewhere else  
| | | | 3 Wrote something else in top left hand corner  
| | | | 4 Did something else  
| | | | 5  
| | | |  
| | | END FILTER  
| | |  
| | | CFLISD NUMBER OF WORDS RECALLED AFTER DELAY  
| | | A little while ago, you were read a list of words and you repeated the ones you  
| | | could remember. Please tell me any of the words that you can remember now.  
| | |  
| | |  
| | |  
| | |  
| | | INTERVIEWER:Write the words in the booklet provided.  
| | | Allow as much time as the respondent  
| | | wishes, up to 2 minutes.  
| | | Enter the number of words the respondent correctly recalls.  
| | | Range: 0..10  
| | |  
| | | CFWHO WHETHER ANYONE ELSE WAS PRESENT  
| | |  
| | | INTERVIEWER: Was there anyone other than you and the respondent in the room  
while you were  
| | | conducting the cognitive function tests?