| Domain 1: Physical |
| Pain and discomfort |
| Energy and fatigue |
| Sleep and rest |
| Domain 2: Psychological |
| Positive feelings |
| Cognitions |
| Self-esteem |
| Body image and appearance |
| Negative feelings |
| Domain 3: Level of Independence |
| Mobility |
| Activities of daily living |
| Dependence medication |
| Working capacity |
| Domain 4: Social |
| Personal relationships |
| Social support |
| Sexual activity |
| Domain 5: Environment |
| Safety and security |
| Home environment |
| Financial resources |
| Health and social care |
| Information and skills |
| Recreation/leisure |
| Transport |
| Domain 6: Spirituality, Religiousness, and Personal Beliefs (SRPBs) |
| SRPB |
| General |
|
