HLQ Data: CMMI_HA_031
Participant Information
CMMI ID:
CMMI_HA_031
Study ID:
MMS000262
Questionnaire Date:
Upload:
Manual Import
Age:
83
Sex:
Female
Lives Alone:
Yes
General Health:
Good
Takes Supplements:
No
Demographics & Household3
Sex
2
2
Age Calc
83
83
Live Alone
1
1
Pets1
Pets Hh
0
0
General Health & Supplements6
Amemia
0
0
Gluten
2
2
Behav Chg
0
0
Gen Health
3
3
Food Allergies
2
2
Reg Supplement
0
0
Bowel Habits & Digestion17
Bowel 1
0
0
Bowel 2
0
0
Bowel 3
0
0
Bowel 4
0
0
Bowel 6
0
0
Bowel 7
0
0
Bowel 8
0
0
Bowel 9
9
9
Stool 1
0
0
Stool 2
0
0
Stool 3
0
0
Stool 4
0
0
Stool 5
0
0
Stool 6
0
0
Bloating
1
1
Laxatives
0
0
Constipation Symp 6 Mo
0
0
IBS Symptoms3
Pain Abs 3 Mos
0
0
Pain Abs 6 Mos
0
0
Pain Abs Menstru
0
0
Health-Related Medications3
Med Acid Reflux
0
0
Med Antibiotics
0
0
Med Constipation
0
0
Current Medications8
Med 1
AMLODIPINE
AMLODIPINE
Med 2
PERINDOPRIL
PERINDOPRIL
Med 3
CRESTOR
CRESTOR
Med Num
3
3
Med Type 1
BLOOD PRESSURE MEDS
BLOOD PRESSURE MEDS
Med Type 2
BLOOD PRESSURE MEDS
BLOOD PRESSURE MEDS
Med Type 3
HIGH CHOLESTEROL
HIGH CHOLESTEROL
Med Current
1
1
Disease History - Cardiovascular11
Hf Ever
0
0
Mi Ever
0
0
Chd Ever
0
0
Hbp Ever
1
1
Vhd Ever
0
0
Angina Ever
0
0
Atrial Ever
0
0
Cardio Ever
1
1
Thrombo Ever
0
0
High Chol Ever
1
1
Arrhythmia Ever
1
1
Disease History - Diabetes4
Diab Ever
0
0
Diab Gest
0
0
Diab Type1
0
0
Diab Type2
0
0
Disease History - Respiratory7
Cb Ever
0
0
Ild Ever
0
0
Copd Ever
0
0
Resp Ever
0
0
Asthma Ever
0
0
Emphysema Ever
0
0
Cystic Fib Ever
0
0
Disease History - Digestive & GI10
Lc Ever
0
0
Uc Ever
0
0
Ibs Ever
0
0
Gerd Ever
0
0
Crohn Ever
0
0
Fatty Ever
0
0
Celiac Ever
0
0
Gastro Ever
0
0
Ulcers Ever
0
0
Gallstones Ever
0
0
Disease History - Neurological5
Ms Ever
0
0
Neuro Ever
0
0
Dement Ever
0
0
Migraine Ever
0
0
Alzheimer Ever
0
0
Disease History - Autoimmune & Inflammatory8
Sle Ever
0
0
Arthritis Ever
0
0
Fibromyal Ever
0
0
Scleroderma Ever
0
0
Weak Immune Ever
0
0
Sjogren Syndrome Ever
0
0
Hashimoto Thyroid Ever
0
0
Ankylosing Spondylitis Ever
0
0
Disease History - Bone & Muscle3
Op Ever
0
0
Rd Ever
0
0
Bones Ever
0
0
Disease History - Skin4
Ps Ever
1
1
Skin Ever
1
1
Eczema Ever
0
0
Rosacea Ever
0
0
Disease History - Kidney & Liver5
Hemo Ever
0
0
Liver Ever
0
0
Acute Fail Ever
0
0
Chronic Fail Ever
0
0
Kidney Stones Ever
0
0
Disease History - Other Conditions7
Ch Ever
0
0
Hm Ever
0
0
Hiv Ever
0
0
Infec Ever
0
0
Other Cond Ever
0
0
Infec Type Other
0
0
Sleep Apnea Ever
0
0
Mental Health - Depression & Anxiety21
Mh Ever
0
0
Dep Ever
0
0
Minor Dep Ever
0
0
Mh 5 Eating Prob
3
3
Anxiety Dis Ever
0
0
Mh 5 Too Restless
0
0
Mh 3 Sleeping Prob
0
0
Mh 4 Feeling Tired
0
0
Mh 6 Easily Annoyed
0
0
Mh 6 Self Conf Prob
0
0
Mh 7 Feeling Afraid
0
0
Mh 8 Slow Fast Prob
0
0
Mh 1 Feeling Nervous
0
0
Mh 1 Little Interest
0
0
Mh 4 Trouble Relaxing
0
0
Mh 7 Concentrate Prob
0
0
Mh 2 Constant Worrying
0
0
Mh 2 Feeling Depressed
0
0
Mh 9 Suicidal Thoughts
0
0
Mh 10 Impact Depressive
0
0
Mh 3 Excessive Worrying
0
0
Mental Health - Other Conditions6
Ocd Ever
0
0
Ptsd Ever
0
0
Eating Dis Ever
0
0
Bipolar Dis Ever
0
0
Schizophrenia Ever
0
0
Addiction Disorder Ever
0
0
Sleep - Duration & Quality7
Sleep Hr
8
8
Awake Time
8:00:00
8:00:00
Sleep Time
23:00:24
23:00:24
Bed Partner
0
0
Sleep Quality
3
3
Enthusiam Prob
1
1
Fall Asleep Time
9999
9999
Sleep - Trouble & Disturbances11
Trouble A
0
0
Trouble B
0
0
Trouble C
0
0
Trouble D
0
0
Trouble E
1
1
Trouble F
0
0
Trouble G
0
0
Trouble H
0
0
Trouble I
0
0
Trouble J
0
0
Trouble Awake Freq
0
0
Sleep - Medication & Treatment1
Med
0
0
Physical Activity6
Mod Freq
0
0
Vig Freq
0
0
Walk Freq
5
5
Walk Time
30
30
Sit Time Wkday
600
600
Sit Time Wkend
600
600
Physical Measurements3
Height Ft
5
5
Height In
7
7
Weight Lb
122
122
Smoking & Tobacco2
Ecig 30 Days
0
0
Cig Cur Freq
3
3
Drug Use4
Wrk Freq
0
0
Home Freq
0
0
Mj Use Cur
0
0
Illicit Drugs Cur
0
0