Palmore Facts on Aging and Mental Health Quiz (FAMHQ)

Abstract

The Palmore Facts on Aging and Mental Health Quiz (FAMHQ) is a well-established psychometric instrument developed by Erdman B. Palmore and colleagues. Its primary function is to assess knowledge and challenge ageism by measuring individuals’ understanding of the physical, psychological, and social realities of the aging process. The scale is an extension of the original Facts on Aging Quiz (FAQ) and includes specific items related to mental health prevalence, cognitive function, and institutional care among the elderly. The instrument is widely used in educational settings to identify misconceptions and evaluate the effectiveness of educational interventions designed to improve knowledge about ageism and gerontology.

Keywords

Palmore Quiz, Facts on Aging, Gerontology, Ageism, Cognitive Impairment, Mental Health, Elderly Stereotypes, Knowledge Assessment, Educational Intervention

Authors

Erdman B. Palmore, D.K. Harris, P.S. Changas

Purpose

The fundamental purpose of the FAMHQ is two-fold: first, to provide a standardized measure of knowledge concerning the gerontology field, covering areas such as physical health, socioeconomic status, and mental well-being of persons aged 65 and older. The quiz aims to provide empirical data on the level of public and professional understanding regarding the elderly population.

Second, and perhaps more critically, it serves as an effective educational tool used to identify and correct misconceptions and negative biases associated with ageism. By presenting factual statements (or common misconceptions) that respondents must evaluate, the FAMHQ facilitates direct learning and promotes a more nuanced and accurate understanding of the aging process.

Construct

The scale primarily measures the construct of factual knowledge concerning the aging process, which is often inversely correlated with the degree of stereotyping displayed toward older adults. The quiz items cover diverse domains including biological changes (e.g., sensory decline, physical strength), psychological characteristics (e.g., happiness, adaptability, mental illness prevalence), and social/economic realities (e.g., poverty rates, employment, institutionalization).

The scoring key explicitly categorizes incorrect answers as reflecting either a “Positive bias,” a “Negative bias,” or “Neutral” misinformation. This feature is crucial for researchers and educators, as it allows them to gauge the specific direction and intensity of the participant’s stereotypes and prejudices. The mental health items specifically address prevalent myths surrounding dementia, depression, and institutional care.

Validity

The validity of the Palmore Quizzes has been extensively studied across various cultural and demographic groups since its inception in 1977. Studies, including those conducted in Canada (Matthews et al., 1984) and New Zealand (Pennington et al., 2001), have confirmed the content validity, ensuring the items accurately reflect established facts in gerontology and cover a comprehensive range of topics pertinent to the elderly experience.

Furthermore, the instrument demonstrates strong construct validity, particularly in educational contexts, as knowledge scores typically increase significantly following educational interventions, indicating the scale’s sensitivity to genuine changes in understanding about aging. The multiple-choice format (FAQ1 and FAMHQ) developed by Harris, Changas, and Palmore was specifically designed to improve the psychometric properties and reduce ambiguity compared to the original True/False format.

Reliability

While the source materials do not provide specific numerical reliability coefficients (such as Cronbach’s Alpha) for all versions presented, the widespread adoption and continuous validation of the scale across several decades and countries suggest robust psychometric stability.

The existence of multiple equivalent forms (the initial True/False FAQ1 and FAQ2, and the later Multiple-Choice FAMHQ) allows for rigorous assessment of alternative-form reliability and test-retest reliability, especially when the instrument is used as a pre- and post-test measure in educational studies. Research comparing the different versions has generally supported their reliability as equivalent measures of aging knowledge.

Factor Analysis

Specific published factor analysis results detailing the precise underlying structure of the combined FAMHQ items were not explicitly detailed in the provided source material. However, conceptually, the items naturally cluster around several domains—including physical health/functioning, socioeconomic status, and mental health/cognitive functioning—suggesting a multi-dimensional structure inherent to comprehensive knowledge of gerontology. Future research may seek to formally validate these assumed factors.

Instrument

Test Type: Knowledge/Attitude Assessment Quiz; Educational Intervention Tool

Format: True/False (Original FAQ versions) and Multiple-Choice (FAQ1 and FAMHQ versions).

Language Available: English (validated internationally in English-speaking contexts).

Population Group: General public, students (especially those in health and social sciences), professionals, and caregivers.

Age Group: Administered to adults of all ages, though the content pertains to individuals aged 65 or older.

Population Details: Widely used among students in gerontology, nursing, counseling programs, and other fields where interaction with older adults is common. The scale is used to measure baseline knowledge prior to training.

Test Methodology: Self-report quiz, typically administered in group settings. Scoring is based on the number of correct answers, often accompanied by an analysis of the direction of bias (positive or negative) reflected in incorrect responses.

Keywords

Palmore, Education, Stereotypes, Mental Health, Dementia, Cognitive Function, Institutionalization, Public Opinion, Geriatrics, Social Acceptance

Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: Not provided in source material.

Correspondence Address: Not provided in source material.

Permissions & Fee and Test Year

The initial version of the Facts on Aging Quiz (FAQ) was published in 1977 (Palmore, 1977). The multiple-choice format, including the Mental Health component (FAMHQ), was updated around 1998 (Palmore, 1998). Given its history and publication in academic journals, the instrument is widely accessible and frequently utilized in research and educational settings without proprietary usage fees.

The original PDF can be downloaded here: http://opensiuc.lib.siu.edu/cgi/viewcontent.cgi?article=1461&context=dissertations. The instrument can also be found online at: https://www.researchgate.net/publication/229325813.

Reference’s

• Dotson‚ Damien Gent. (2012). “The Effects of an Educational Intervention on the Aging Knowlege of Graduate Counseling Students”. Southern Illinois University Carbondale . Doctoral Dissertations. Paper 461.
• Harris‚ D.K.‚ Changas‚ P.S.‚ & Palmore‚ E.B. (1996). Palmore’s first facts on aging quiz in a multiple-choice format. Educational Gerontology‚ 22‚ 575-589.
• Matthews‚ A. M.‚ Tindale‚ J. A.‚ & Norris‚ J. E. (1984). The Facts on Aging Quiz: A Canadian validation and cross-cultural comparison. Canadian Journal on Aging‚ 3‚ 165-174.
• Palmore‚ E. D. (1977). Facts on aging: A short quiz. Gerontologist‚ 17‚ 315-320.
• Palmore‚ E. D. (1988). The Facts on Aging Quiz. New York‚ NY: Springer.
• Palmore‚ E. D. (1990). Ageism‚ negative and positive. New York‚ NY: Springer.
• Palmore‚ E. D. (2005). Three decades of research on ageism. Generations: Journal of the American Society on Aging‚ 29‚ 87-90.
• Pennington‚ H. R.‚ Pachana‚ N. A.‚ & Coyle‚ S. L. (2001). Use of the facts on aging quiz in New Zealand: Validation of questions‚ performance of a student sample‚ and effects of a don’t know option. Educational Gerontology‚ 27(5)‚ 409-41.
• Seufert‚ Robert L .‚ Carrozza‚ Mark. (2002). A test of Palmore’s Facts on Aging Quizzes as alternate measures. Journal of Aging Studies; 16: 279–294.
• Wisdom‚ Nicholas M. (2010). social acceptance of age discrimination. Oklahoma State University. Doctoral dissertation.

Items of the Palmore Facts on Aging and Mental Health Quiz (FAMHQ)

FAQ1

Circle “T” for true or “F” for false.

1. The majority (more than half) of old people (age 65 or older) are senile (i.e.‚ defective memory‚ disoriented‚ or demented‚ etc.).
2. All five senses tend to decline in old age.
3. The majority (more than half) of old people (age 65 or older) have no capacity for sexual relations.
4. Lung capacity tends to decline in old age.
5. The majority of old people (age 65 or older) say they feel miserable most of the time.
6. Physical strength tends to decline in old age.
7. At least 10% of the aged (age 65 or older) are living in long-stay institutions (i.e.‚ nursing homes‚ mental hospitals‚ homes for the aged‚ etc.).
8. Aged drivers (age 65 or older) have fewer accidents per driver than drivers under the age 65.
9. The majority of older workers cannot work as effectively as younger workers.
10. About 80% of the aged (age 65 or older) say they are healthy enough to carry out their normal activities.
11. The majority of old people are unable to adapt to change.
12. Old people usually take longer than young people to learn something new.
13. It is almost impossible for the majority of old people to learn new things.
14. The reaction time of the majority of old people tends to be slower than the reaction time of younger people.
15. In general‚ the majority of old people tend to be pretty much alike.
16. The majority of old people (age 65 or older) say they are seldom bored.
17. The majority of old people (age 65 or older) say they are lonely.
18. Older workers have fewer accidents than younger workers.
19. Over 15% of the U.S. population are now 65 or over.
20. The majority of medical practitioners give low priority to the aged.
21. The majority of older people (age 65 or older) have incomes below the poverty level ($5‚447 for an older person or $6‚872 for an older couple).
22. The majority of old people (age 65 or older) are working or would like to have some kind of work to do (including housework or volunteer work).
23. Older people tend to become more religious as they age.
24. The majority of older people (age 65 or older) say they are seldom angry.
25. The health and socioeconomic status of older people (compared to younger people) in the year 2000 will probably be about the same as now.

FAQ2

1. A person’s height tends to decline in old age.
2. More older persons (age 65 or older) have chronic illnesses that limit their activity than younger persons.
3. Older persons (age 65 or older) have more acute (short-term) illnesses than persons under 65.
4. Older persons (age 65 or older) have more injuries than persons under 65.
5. Older workers have less absenteeism than younger workers.
6. The life expectancy of Blacks at age 65 is about the same as White life expectancy at age 65.
7. The life expectancy of men at age 65 is about the same as the life expectancy of women at age 65.
8. Medicare pays over half of the medical expenses for the aged.
9. Social Security Income automatically increases with inflation.
10. Supplemental Security Income guarantees a minimum income for the needy aged.
11. The aged (age 65 or older) do not get their proportionate share of the nations income.
12. The aged (age 65 or older) have higher rates of criminal victimization than persons under 65.
13. The aged (age 65 or older) are more fearful of crime than persons under 65.
14. The aged (age 65 or older) are the most law abiding of all adult groups according to official statistics.
15. There are two widows for each widower among the aged (age 65 or older).
16. A bigger percentage of the aged (age 65 or older) vote than any other age group.
17. There are proportionately more older persons (age 65 or older) in public office than in the total population.
18. The proportion of Blacks among the aged (age 65 or older) is growing.
19. Participation in voluntary organizations (such as churches and clubs) tends to decline among healthy aged 65 or over.
20. The majority of aged (age 65 or older) live alone.
21. The aged (age 65 or older) have about the same percentage of people below the official poverty level as the rest of the population (below age 65).
22. The rate of poverty among aged Blacks (age 65 or older) is about 3 times as high as among Whites 65 or over.
23. Older persons who reduce their activities tend to be happier than those who remain active.
24. When the last child leaves home‚ the majority of parents have serious problems adjusting to their ‘‘empty nest.’’
25. The proportion widowed is decreasing among the aged (age 65 or older).

Palmore Facts on Aging and Mental Health Quiz‚ multiple-choice format (Palmore‚ 1998)

1. Severe mental illness among persons over 65 afflicts
   • a) The majority –
   • b) About half –
   • c) About 15% to 25% *
   • d) Very few +
   • e) Don’t know
2. Cognitive impairment (impairment of memory‚ disorientation‚ or confusion)
   • a) Is an inevitable part of the aging process –
   • b) Increases in old age *
   • c) Declines with age +
   • d) Does not change with age +
   • e) Don’t know
3. If older mental patients make up false stories‚ it is best to
   • a) Point out to them they are lying –
   • b) Punish them for lying –
   • c) Reward them for their imagination +
   • d) Ignore or distract them *
   • e) Don’t know
4. The prevalence of anxiety disorders and schizophrenia in old age tends to
   • a. Decrease *
   • b. Stay about the same –
   • c. Increase somewhat –
   • d. Increase markedly –
   • e. Don’t Know
5. Suicide rates among women tend to
   • a. Stay about the same *
   • b. Decrease somewhat in old age +
   • c. Decrease markedly +
   • d. Don’t Know
6. Suicide rates among men tend to
   • a. Increase markedly *
   • b. Increase somewhat –
   • c. Stay about the same +
   • d. Decrease +
   • e. Don’t know
7. When all major types of mental impairment are added together‚ the elderly have
   • a. Higher rates than younger persons –
   • b. About the same rates as younger persons –
   • c. Lower rates than younger persons *
   • d. Higher rates for ages 65 to 74 than for those over 75 0
   • e. Don’t know
8. The primary mental illness of the elderly is
   • a. Anxiety disorders +
   • b. Mood disorders +
   • c. Schizophrenia 0
   • d. Cognitive impairment *
   • e. Don’t know
9. Alzheimer’s disease is
   • a. The most common type of cognitive impairment *
   • b. An acute illness +
   • c. A benign memory disorder +
   • d. A form of affective disorder +
   • e. Don’t know
10. Alzheimer’s disease usually
    • a. Can be cured with psychotherapy +
    • b. Can be cured with pharmacology +
    • c. Goes into remission among the very old +
    • d. Cannot be cured *
    • e. Don’t know
11. Most patients with Alzheimer’s disease
    • a. Act pretty much the same way –
    • b. Have confusion and impaired memory *
    • c. Wander during the day or night –
    • d. Repeat the same question or action over and over –
    • e. Don’t know
12. Organic brain impairment
    • a) Is easy to distinguish from functional mental illness +
    • b) Is difficult to distinguish from functional mental illness *
    • c) Tends to be similar to functional mental illness +
    • d) Can be reversed with proper therapy +
    • e) Don’t know
13. When talking to an older patient‚ it is best
    • a) To avoid looking directly at the patient –
    • b) To glance at the patient occasionally –
    • c) To ignore the patient’s reaction –
    • d) To look directly at the patient *
    • e) Don’t know
14. Talking to demented older patients
    • a. Tends to increase their confusion –
    • b. Is usually pleasurable for the patient *
    • c. Should be confined to trivial matters –
    • d. Should be avoided as much as possible –
    • e. Don’t know
15. When demented patients talk about their past‚ it usually
    • a. Is enjoyed by the patient *
    • b. Depresses the patient –
    • c. Increases the patient’s confusion –
    • d. Has no effect –
    • e. Don’t know
16. The prevalence of sever cognitive impairment
    • a. Is unrelated to age +
    • b. Decreases with age +
    • c. Increases with age after age 45 *
    • d. Increases with age only after 75 +
    • e. Don’t know
17. The primary causes of paranoid disorders in old age are
    • a. Isolation and hearing loss *
    • b. Persecution and abuse 0
    • c. Near death experiences 0
    • d. None of the above 0
    • e. Don’t know
18. Poor nutrition may produce
    • a. Depression 0
    • b. Confusion 0
    • c. Apathy 0
    • d. All of the above *
    • e. Don’t know
19. Mental illness in elders is more prevalent among
    • a. The poor *
    • b. The rich 0
    • c. The middle-class 0
    • d. None of the above 0
    • e. Don’t know
20. The prevalence of mental illness among the elderly in long-term care institutions is
    • a. About 10% +
    • b. About 25 % +
    • c. About 50 % +
    • d. More than 75% *
    • e. Don’t know
21. Elders tend to have
    • a. Less sleep problems +
    • b. More sleep problems *
    • c. Deeper sleep +
    • d. The same sleep patterns as younger persons +
    • e. Don’t know
22. Major depression is
    • a. Less prevalent among elders *
    • b. More prevalent among elders –
    • c. Unrelated to age –
    • d. A sign of senility –
    • e. Don’t know
23. Widowhood is
    • a. Less stressful among elders *
    • b. More stressful among elders –
    • c. Similar levels of stress at all ages –
    • d. Least stressful among young adults –
    • e. Don’t know
24. Elders use mental health facilities
    • a. More often than younger people –
    • b. Less often than younger people *
    • c. At about the same rate as younger people –
    • d. Primarily when they have no family to care for them –
    • e. Don’t know
25. Psychotherapy with older patients is
    • a. Usually ineffective –
    • b. Often effective *
    • c. Effective with Alzheimer’s patients 0
    • d. A waste of the therapist’s time –
    • e. Don’t know