HLQ Data: CMMI_HA_013

Participant Information

CMMI ID:
CMMI_HA_013

Study ID:
MMS000095

Questionnaire Date:
2025-10-03 18:40

Upload:
Manual Import

Age:
77

Sex:
Male

Lives Alone:
No

General Health:
Very Good

Takes Supplements:
No

Demographics & Household7
Sex
1
Age Calc
77
Child Hh
0
Other Hh
0
Live Alone
0
Partner Hh
1
Multi Child Hh
0
Pets1
Pets Hh
0
General Health & Supplements6
Amemia
1
Gluten
9
Behav Chg
0
Gen Health
4
Food Allergies
2
Reg Supplement
0
Bowel Habits & Digestion17
Bowel 1
0
Bowel 2
1
Bowel 3
1
Bowel 4
1
Bowel 6
0
Bowel 7
0
Bowel 8
0
Bowel 9
2
Stool 1
1
Stool 2
0
Stool 3
1
Stool 4
0
Stool 5
1
Stool 6
0
Bloating
0
Laxatives
0
Constipation Symp 6 Mo
0
IBS Symptoms3
Pain Abs 3 Mos
0
Pain Abs 6 Mos
0
Pain Abs Menstru
3
Health-Related Medications3
Med Acid Reflux
0
Med Antibiotics
0
Med Constipation
0
Current Medications12
Med 1
ATORVASTATIN
Med 2
BISOPROLOL
Med 3
AMLODIPINE
Med 4
CLOPIDOGREL
Med 5
PREGABALIN
Med Num
5
Med Type 1
CHOLESTEROL
Med Type 2
H.B.P.
Med Type 3
CALCIUM BLOCKER
Med Type 4
BLOOD THINNER
Med Type 5
NERVE PAIN SUPPRESSANT
Med Current
1
Disease History - Cardiovascular11
Hf Ever
0
Mi Ever
0
Chd Ever
1
Hbp Ever
0
Vhd Ever
0
Angina Ever
0
Atrial Ever
0
Cardio Ever
1
Thrombo Ever
0
High Chol Ever
0
Arrhythmia Ever
1
Disease History - Diabetes4
Diab Ever
0
Diab Gest
0
Diab Type1
0
Diab Type2
0
Disease History - Respiratory7
Cb Ever
0
Ild Ever
0
Copd Ever
0
Resp Ever
0
Asthma Ever
0
Emphysema Ever
0
Cystic Fib Ever
0
Disease History - Digestive & GI10
Lc Ever
0
Uc Ever
0
Ibs Ever
0
Gerd Ever
0
Crohn Ever
0
Fatty Ever
0
Celiac Ever
0
Gastro Ever
0
Ulcers Ever
0
Gallstones Ever
0
Disease History - Neurological5
Ms Ever
0
Neuro Ever
0
Dement Ever
0
Migraine Ever
0
Alzheimer Ever
0
Disease History - Autoimmune & Inflammatory8
Sle Ever
0
Arthritis Ever
0
Fibromyal Ever
0
Scleroderma Ever
0
Weak Immune Ever
0
Sjogren Syndrome Ever
0
Hashimoto Thyroid Ever
0
Ankylosing Spondylitis Ever
0
Disease History - Bone & Muscle3
Op Ever
0
Rd Ever
0
Bones Ever
0
Disease History - Skin4
Ps Ever
0
Skin Ever
0
Eczema Ever
0
Rosacea Ever
0
Disease History - Kidney & Liver5
Hemo Ever
0
Liver Ever
0
Acute Fail Ever
0
Chronic Fail Ever
0
Kidney Stones Ever
0
Disease History - Other Conditions7
Ch Ever
0
Hm Ever
0
Hiv Ever
0
Infec Ever
0
Other Cond Ever
9
Infec Type Other
0
Sleep Apnea Ever
0
Mental Health - Depression & Anxiety20
Mh Ever
0
Dep Ever
0
Minor Dep Ever
0
Mh 5 Eating Prob
0
Anxiety Dis Ever
0
Mh 5 Too Restless
0
Mh 3 Sleeping Prob
0
Mh 4 Feeling Tired
0
Mh 6 Easily Annoyed
0
Mh 6 Self Conf Prob
0
Mh 7 Feeling Afraid
0
Mh 8 Slow Fast Prob
0
Mh 1 Feeling Nervous
0
Mh 1 Little Interest
0
Mh 4 Trouble Relaxing
0
Mh 7 Concentrate Prob
0
Mh 2 Constant Worrying
0
Mh 2 Feeling Depressed
0
Mh 9 Suicidal Thoughts
0
Mh 3 Excessive Worrying
0
Mental Health - Other Conditions6
Ocd Ever
0
Ptsd Ever
0
Eating Dis Ever
0
Bipolar Dis Ever
0
Schizophrenia Ever
0
Addiction Disorder Ever
0
Sleep - Duration & Quality12
Sleep Hr
6
Awake Time
23:30:00
Sleep Time
23:30:24
Bed Partner
3
Sleep Behav A
0
Sleep Behav B
0
Sleep Behav C
1
Sleep Behav D
0
Sleep Behav E
0
Sleep Quality
4
Enthusiam Prob
0
Fall Asleep Time
5
Sleep - Trouble & Disturbances11
Trouble A
0
Trouble B
0
Trouble C
0
Trouble D
0
Trouble E
0
Trouble F
0
Trouble G
0
Trouble H
0
Trouble I
0
Trouble J
0
Trouble Awake Freq
0
Sleep - Medication & Treatment1
Med
0
Physical Activity7
Mod Freq
7
Mod Time
120
Vig Freq
0
Walk Freq
6
Walk Time
90
Sit Time Wkday
180
Sit Time Wkend
240
Physical Measurements3
Height Ft
5
Height In
5
Weight Lb
150
Smoking & Tobacco2
Ecig 30 Days
0
Cig Cur Freq
0
Drug Use4
Wrk Freq
0
Home Freq
0
Mj Use Cur
0
Illicit Drugs Cur
0
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