Domain C — Functional abilities — self c

Domain C — Functional abilities — self care subdomain C (1)

<table cellspacing="0" cellpadding="0" style="border:0.75pt solid #000000; border-collapse:collapse"><thead><tr><td style="width:39.05pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.03pt; vertical-align:top"><p class="TableColHead"><span>Question</span></p></td><td style="width:52.75pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableColHead"><span>Answer code</span></p></td><td style="width:52.2pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableColHead"><span>Raw value</span></p></td><td style="width:40.2pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableColHead"><span>Raw score</span></p></td><td style="width:67.65pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p class="TableColHead"><span>Score from age adjustment table</span></p></td><td style="width:67.2pt; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.4pt; vertical-align:top"><p class="TableColHead"><span>Age adjusted score</span></p></td></tr></thead><tbody><tr><td rowspan="4" style="width:39.05pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center; page-break-after:avoid"><span>24</span></p></td><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>a</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>4</span></p></td><td rowspan="4" style="width:40.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td rowspan="4" style="width:67.65pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td rowspan="4" style="width:67.2pt; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td></tr><tr><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>b</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>3</span></p></td></tr><tr><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>c</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>2</span></p></td></tr><tr><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>d</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>1</span></p></td></tr><tr><td rowspan="4" style="width:39.05pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>25</span></p></td><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>a</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>4</span></p></td><td rowspan="4" style="width:40.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td rowspan="4" style="width:67.65pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td rowspan="4" style="width:67.2pt; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td></tr><tr><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>b</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>3</span></p></td></tr><tr><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>c</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>2</span></p></td></tr><tr><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>d</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>1</span></p></td></tr><tr><td rowspan="4" style="width:39.05pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center; page-break-after:avoid"><span>26</span></p></td><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>a</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>4</span></p></td><td rowspan="4" style="width:40.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td rowspan="4" style="width:67.65pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td rowspan="4" style="width:67.2pt; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td></tr><tr><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>b</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>3</span></p></td></tr><tr><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>c</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>2</span></p></td></tr><tr><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>d</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>1</span></p></td></tr><tr><td rowspan="4" style="width:39.05pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>27</span></p></td><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>a</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>4</span></p></td><td rowspan="4" style="width:40.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td rowspan="4" style="width:67.65pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td rowspan="4" style="width:67.2pt; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td></tr><tr><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>b</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>3</span></p></td></tr><tr><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>c</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>2</span></p></td></tr><tr><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>d</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>1</span></p></td></tr><tr><td style="width:39.05pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>28</span></p></td><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>a</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>4</span></p></td><td style="width:40.2pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.65pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.2pt; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td></tr><tr><td style="width:39.05pt; border-right:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span></span></p></td><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>b</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>3</span></p></td><td style="width:40.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.65pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.2pt; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td></tr><tr><td style="width:39.05pt; border-right:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span></span></p></td><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>c</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>2</span></p></td><td style="width:40.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.65pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.2pt; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td></tr><tr><td style="width:39.05pt; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span></span></p></td><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>d</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>1</span></p></td><td style="width:40.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.65pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.2pt; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td></tr><tr><td style="width:39.05pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center; page-break-inside:avoid; page-break-after:avoid"><span>29</span></p></td><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center; page-break-inside:avoid; page-break-after:avoid"><span>a</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="page-break-inside:avoid; page-break-after:avoid"><span>4</span></p></td><td style="width:40.2pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="page-break-inside:avoid; page-break-after:avoid"><span></span></p></td><td style="width:67.65pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="page-break-inside:avoid; page-break-after:avoid"><span></span></p></td><td style="width:67.2pt; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="page-break-inside:avoid; page-break-after:avoid"><span></span></p></td></tr><tr><td style="width:39.05pt; border-right:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center; page-break-inside:avoid; page-break-after:avoid"><span></span></p></td><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center; page-break-inside:avoid; page-break-after:avoid"><span>b</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="page-break-inside:avoid; page-break-after:avoid"><span>3</span></p></td><td style="width:40.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="page-break-inside:avoid; page-break-after:avoid"><span></span></p></td><td style="width:67.65pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="page-break-inside:avoid; page-break-after:avoid"><span></span></p></td><td style="width:67.2pt; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="page-break-inside:avoid; page-break-after:avoid"><span></span></p></td></tr><tr><td style="width:39.05pt; border-right:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span></span></p></td><td style="width:52.75pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>c</span></p></td><td style="width:52.2pt; border:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>2</span></p></td><td style="width:40.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.65pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.2pt; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td></tr><tr><td style="width:39.05pt; border-right:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span></span></p></td><td style="width:52.75pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText" style="text-align:center"><span>d</span></p></td><td style="width:52.2pt; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span>1</span></p></td><td style="width:40.2pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.65pt; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td><td style="width:67.2pt; border-left:0.75pt solid #000000; padding-right:5.03pt; padding-left:5.03pt; vertical-align:top"><p class="TableText"><span></span></p></td></tr></tbody></table>