Health Age Questionnaire

Select the most correct option. Enter your age and click Calculate.

Personal

Sex

Select one ---------- female male

Race

Select one ---------- white black Hispanic Asian American Indian other

Longevity

Select one ---------- grandparents lived past 90, parents past 80 grandparents lived past 80, parents past 70 grandparents lived past 70, parents past 60 few relatives lived past 60 few relatives lived past 50

Education

Select one ---------- college graduate or skilled craftsman some college or trade school high school graduate grade school graduate

Sleep

Select one ---------- 7-8 hours 8-9 hours 6-7 hours more than 9 hours less than 6 hours

Coronary Artery Disease (CAD)

Cholesterol / HDL ratio

Select one Unknown ---------- < 3 3-4 4-5 5-6 > 6

Blood pressure (systolic / diastolic)

Select one ---------- < 110 / 60-80 110-130 / 60-80 130-150 / 80-90 150-170/ 90-100 > 170 / > 100

Smoking

Select one ---------- never quit more than 10 years ago quit less than 10 years ago around others who smoke occasional 1 pack cigarettes daily 2 or more packs daily

Heredity

Select one ---------- no family history of CAD 1 close relative over 60 with CAD 2 close relatives over 60 with CAD 1 close relative under 60 with CAD 2 or more close relatives under 60 with CAD

Waist / Hip Ratio

Select one ---------- low risk (< 0.84 male; < 0.72 female) moderate risk (<0.94 male; <0.82 female) high risk (< 1.04 male; <0.92 female) very high risk (>1.04male; >9.2 female)

Stress

Select one ---------- unhurried, happy ambitious but relaxed sometimes competive or time conscious competitive and time conscious (type A) type A with repressed hostility

Physical activity

Select one ---------- 60 min, high intensity, most days 30 min, moderate, most days 20-30 min, moderate, 3-5 days/wk 10-20 min, light, 1-2 days/wk sedentary

Medical

Medical exam and screening tests

Select one ---------- regular medical exam and tests periodic medical exam sometimes get tests no tests or medical exams

Heart

Select one ---------- no history of problems self or family some history rheumatic fever as child, no murmur now rheumatic fever as child, have murmur EKG abnormality or angina

Lung

Select one ---------- no problems some past problem mild asthma or bronchitis emphysema, severe asthma, or bronchitis severe lung problems

Digestive tract

Select one ---------- no problems occasional diarrhea, loss of appetite frequent diarrhea or stomach upset ulcers, colitis, gall bladder, or liver problems severe gastrointestinal disorders

Diabetes

Select one ---------- no problem and no family history no problem but family history controlled hypoglycemia (low blood sugar) hypoglycemia and family history mild diabetes (diet and exercise) diabetes (insulin)

Drugs

Select one ---------- seldom use minimal but regular use of aspirin or other medications heavy use of aspirin or other medications regular use of drugs heavy use of drugs

Medical (women only)

Women's health care

Women only ---------- Regular Pap and breast exam occasional Pap and breast exam never have exam treated disorder untreated cancer

Birth control pill

Women only ---------- never used quit 5 years ago still use, under 30 years of age use pill and smoke use pill, smoke, over 35

Dietary

Breakfast

Select one ---------- daily sometimes none coffee coffee and doughnut

Regular meals

Select one ---------- 3 or more 2 daily not regular starve and stuff

Fruits and vegetables

Select one ---------- 5 or more full servings daily 2-4 servings daily 1 or less servings daily don't eat them

Monounsaturated fats

Select one ---------- daily consumption consumption 2-4 times each week occassional consumption rare consumption

Omega 3 fatty acids

Select one ---------- daily consumption consumption 2-4 times each week occassional consumption rare consumption

Refined oils / fried foods

Select one ---------- no high omega 6 or fried foods occassional high omega 6 and fried foods rarely 2-4 times weekly of high omega 6, occasional fried foods daily high omega 6 and fried foods 2-4 times a week regular hydrogenated fats, deep fried, or shortening

Refined foods

Select one ---------- no refined foods some refined foods several servings: bread, rice, cereals, packaged foods several servings: sugar, soft drinks, sweets, snack foods

Alcohol

Select one ---------- none 1 drink daily 2 drinks daily 3+ drinks, periodically 3-6 drinks daily more than 6 drinks daily

Psychological

Happiness

Select one ---------- generally feel very happy feel satisfied unsure about life often unhappy usually unhappy

Depression

Select one ---------- no family history of depression some family history, I feel OK family history and I am mildly depressed sometimes I feel life isn't worth living thoughts of suicide

Anxiety

Select one ---------- seldom anxious occasionally anxious often anxious always anxious panic attacks

Relaxation

Select one ---------- relax or meditate daily relax often seldom relax usually tense always tense

Love and marriage

Select one ---------- happily married married unmarried separated, divorced, or widowed extramarital relationship

Job satisfaction

Select one ---------- enjoy job, see results, able to advance job OK, no results, nowhere to go dislike job hate job

Social

Select one ---------- have some close friends have some friends have no good friends stuck with people I don't enjoy do not have friends

Safety

Driving

Select one ---------- less than 7,000 miles (11,000 km) / year 7,000-15,000 miles (11,000-24,000 km) / year 15,000-20,000 (24,000-32,000 km) miles / year more than 20,000 miles (32,000 km) / year

Seat belt usage

Select one ---------- always most of the time (75%) on highway only sometimes (25%) never

Risk-taking

Select one ---------- never some with careful preparation occasional often try anything for thrills

Enter your actual age

Calculate Reset

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Typical Life Expectancy*

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Your Life Expectancy

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Your Health Age

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Personal

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Medical

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CAD

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Diet

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Psych

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Safety

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Total

*Typical Life Expectancy is based on population reference data (2005). Your results are an estimate and are not medical advice.