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Table 2 Self-administered question items and additional questions for follow-up

From: Effects of “Thursdays at the Museum” at the Montreal Museum of Fine Arts on the mental and physical health of older community dwellers: the art-health randomized clinical trial protocol

Item

Answer

Have you unwillingly lost weight in the past year?

Yes

No

If yes, was the loss of weight above 3 kg/6 lbs?

Yes

No

How many different types of drugs do you take on a daily basis?

- 0

- 1–4

- 5–9

- ≥ 10

Do you have vision problems?

Yes

No

Do you have hearing problems?

Yes

No

Has someone close to you expressed concern about your memory?

Yes

No

Do you receive home care support?

- Family

- Friend

- Professional

If yes, from whom?

Yes

No

Do you need help with your grooming (brushing teeth, hair, shaving, applying make-up)?

Yes

No

Do you need help with bathing or taking a shower?

Yes

No

Do you need assistance when getting dressed?

Yes

No

Do you use mobility aides for walking or transferring (cane, walker, wheelchair)?

Yes

No

Do you need help with your meals: Shopping for food, meal preparation, assistance in eating

Yes

No

Do you need help when using the telephone?

Yes

No

Do you need assistance when taking public transportation?

Yes

No

Do you need help for managing medications on your own?

Yes

No

Do you need help to pay your bills and manage your finances?

Yes

No

Are you incontinent (urine and/or stool)?

Yes

No

How do you feel today?

- Happy

- Unhappy

- Neither one nor the other

Do you feel energetic?

Yes

No

Do you do regular physical activity (walking, swimming, cycling, etc.) at least 1 h per week in the past month?

Yes

No

Have you fallen in the past year (at least one fall)?

Yes

No

Additional questions asked to the participants before completing the CESAM at M1, M2, and M3

Yes

No

 Since you last filled out this questionnaire, have you visited your doctor?

Yes

No

 If yes, was this visit unplanned?

Yes

No

 Since you last filled out this questionnaire, have you been hospitalized?

Yes

No

 If yes, was this hospitalization unplanned?

Yes

No

 Did you visit the emergency room?

Yes

No