| Table 2: Sherbrooke Postal Questionnaire for assessing risk of functional decline* |
| Do you live alone? (No) |
|
Do you take more than 3 different medications per day? (Yes) |
|
Do you regularly use a cane or walker or wheelchair to get around? (Yes) |
|
Do you see well? (No) |
|
Do you hear well? (No) |
|
Do you have memory problems? (Yes) |
|
*The answer in parentheses indicates the presence of risk. The person is at risk of functional decline if he or she indicates more than 1 risk factor or does not return the questionnaire. |
