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1) Age
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Less than 12
12
13
14
15
16
17
18
Greater than 18
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2) Gender
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Male
Female
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3) Country of Current Residence (List of Country Codes)
If you select this, make sure that the radio button is select and the text field is given a value.
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4) State (if US)
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5) Type of surroundings:
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a major city
a city
suburban
a town
rural
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6) Number of living grandparents
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0
1
2
3
4
5
6
more than 6
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7) Number of living great grandparents
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0
1
2
3
4
5
6
more than 6
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8) Number of grandparents residing with Respondent
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0
1
2
3
4
5
6
more than 6
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9) If living with grandparents, either or both parents live with the respondent
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All of the time
Some of the time
None of the time
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10) Number of great grandparents living with respondent
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0
1
2
3
4
5
6
more than 6
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11) Family structure
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Nuclear
Extended
Joint
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12) Type of school
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College or University
Secondary School or High School
Middle or Junior High School
Primary or Elementary School
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13) Number of students at school
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less than 100
100-500
500-1000
1000-2000
over 20000
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14) Education on the Biology of Aging
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Received at least 1 hour of instruction in this area
Received less than 1 hour or no instruction in this area
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15) Education on Psychological and social aspects of aging
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Received at least 1 hour of instruction in this area
Received less than 1 hour or no instruction in this area
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16) Education on Creativity and Aging
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Received at least 1 hour of instruction in this area
Received less than 1 hour or no instruction in this area
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17) Education on the Contribution of the Elderly
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Received at least 1 hour of instruction in this area
Received less than 1 hour or no instruction in this area
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18) Education on the Social, Political, or Legal Responsibility to the Elderly
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Received at least 1 hour of instruction in this area
Received less than 1 hour or no instruction in this area
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19) Education on Intergenerational Learning
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Received at least 1 hour of instruction in this area
Received less than 1 hour or no instruction in this area
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20) Education on Cultural Views about aging
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Received at least 1 hour of instruction in this area
Received less than 1 hour or no instruction in this area
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21) Education on none of the above
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Received at least 1 hour of instruction in this area
Received less than 1 hour or no instruction in this area
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22) Contact with elderly related to Respondent
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Daily
At least once a week
Once a month
Several times a month
A few times a year
Rarely
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23) Contact with elderly not related to Respondent
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Daily
At least once a week
Once a month
Several times a month
A few times a year
Rarely
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24) Response: I think that people become old when they reach the age of:
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45
55
65
75
85
95
over 95
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25) Response: most of the elderly I know are proud of their age
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Strongly Disagree
Disagree
Agree
Strongly Agree
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26) Response: Most of the elderly I know like to spend time with people my age
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Strongly Disagree
Disagree
Agree
Strongly Agree
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27) Most of the elderly I know are wise
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Yes
Not Selected
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28) Most of the elderly I know are honest
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Yes
Not Selected
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29) Most of the elderly I know are kind
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Yes
Not Selected
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30) Most of the elderly I know are helpful
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Yes
Not Selected
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31) Most of the elderly I know are fun to be with
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Yes
Not Selected
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32) Most of the elderly I know are friendly
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Yes
Not Selected
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33) Most of the elderly I know have a good sense of humor
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Yes
Not Selected
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34) How many of the elderly you know are set in their ways
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All
Most
Some
Few
None
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35) How many of the elderly you know keep in touch with what is happening in the world?
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All
Most
Some
Few
None
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36) How many of the elderly you know are physically active:
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All
Most
Some
Few
None
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37) How many of the elderly you know are careful with money:
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All
Most
Some
Few
None
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38) How many of the elderly you know enjoy life?
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All
Most
Some
Few
None
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39) How many of the elderly you know are forgetful?
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All
Most
Some
Few
None
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40) How many of the elderly you know have had their personalities change as their bodies age?
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All
Most
Some
Few
None
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41) How many of the elderly you know often help others?
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All
Most
Some
Few
None
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42) How many of the elderly you know have important things to say?
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All
Most
Some
Few
None
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43) In the year 2030, people in my country will live longer than people today
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Strongly Disagree
Disagree
Agree
Strongly Agree
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44) In the year 2030, people in my country will live happier lives than people today
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Strongly Disagree
Disagree
Agree
Strongly Agree
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45) By the year 2030, scientists will have discovered ways to extend the life span
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Yes
No
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46) By the year 2030, scientists will have discovered a cure for cancer
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Yes
No
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47) By the year 2030, scientists will have discovered a cure for Alzheimer's disease
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Yes
No
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48) By the year 2030, scientists will have discovered treatments for many disorders of late life
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Yes
No
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49) By the year 2030, scientists will have discovered what regulates cell aging and death
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Yes
No
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50) By the year 2030, scientists will have discovered none of the above
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Yes
No
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51) When I am old, the importance of religion as compared to today will be
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more
less
the same
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52) When I am old, the importance of family as compared to today will be
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more
less
the same
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53) When I am old, the importance of friends as compared to today will be
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more
less
the same
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54) When I am old, the importance of money as compared to today will be
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more
less
the same
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55) When I am old, the amount of time I will spend with family as compared to today will be
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more
less
the same
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56) When I am old, the number of friends I will have as compared to today will be
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more
less
the same
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