The seven dimensions of self-assessment

The seven dimensions aren't arbitrary. Each one has decades of population-health research behind it, a clinical society that publishes recommendations, and at least one validated short instrument you can complete in under five minutes. This chapter walks each dimension end-to-end so by the end you know what to measure, who measures it, and what the result means.

A field-skill reminder: self-assessment is not self-diagnosis. The point of running these instruments is to know which dimensions deserve attention now versus later, and which deserve a clinical conversation. Chapter 7 covers the see-a-doctor triggers; this chapter is the measurement.

1. Food adequacy

Authority body: USDA Dietary Guidelines for Americans (current edition: 2020–2025, with 2025–2030 edition in development). The guidelines work in pair with the USDA Dietary Reference Intakes (DRIs) — the per-nutrient targets that define adequacy at the population level.

• Short screen: USDA MyPlate three-day food log (eat normally for three days, log everything, compare against the MyPlate plate model — vegetables half, grains and protein each a quarter, dairy on the side)
• What you're checking: did each day include all five food groups; were vegetables at least half of two meals; was added sugar under 10% of calories; was sodium under 2,300 mg
• Where to verify: dietaryguidelines.gov for the current chapter on your life stage; fdc.nal.usda.gov for any specific food's nutrient breakdown

2. Movement

Authority body: American College of Sports Medicine (ACSM). The current guideline is Physical Activity Guidelines for Americans (2nd edition, 2018), endorsed by HHS and aligned with WHO.

• Short screen: this week, did you get (a) at least 150 minutes of moderate aerobic activity OR 75 minutes of vigorous, (b) muscle-strengthening on 2 or more days, (c) balance work on 3+ days if you're over 65
• What you're checking: weekly totals, not single-day heroics. The Guidelines explicitly say bouts as short as ten minutes count toward the weekly total
• Where to verify: health.gov/paguidelines for the full guideline; acsm.org for activity-specific evidence reviews

3. Sleep

Authority body: American Academy of Sleep Medicine (AASM). Joint with the Sleep Research Society, they publish duration recommendations by age, plus the clinical guidelines for the major sleep disorders (insomnia, OSA, restless legs).

• Self-report check (chronic insomnia): the ICSD-3 / DSM-5-TR diagnostic threshold is trouble falling asleep OR staying asleep at least 3 nights per week for at least 3 months, with daytime impairment. If that pattern fits, the ACP 2016 clinical practice guideline names CBT-I — not medication — as first-line treatment, and your PCP can refer you.
• Self-report check (OSA risk): loud habitual snoring, witnessed gasping or apneas, or daytime sleepiness despite 7+ hours in bed are the consensus signals that should prompt a PCP conversation about a sleep study. Additional risk factors (BMI > 30, hypertension hard to control, age 50+, larger neck circumference) raise pre-test probability.
• Validated screening tools (Insomnia Severity Index, Epworth Sleepiness Scale, STOP-BANG, etc.) are clinical instruments your PCP or sleep specialist can administer — they are copyrighted and licensed through Mapi Research Trust and the University Health Network, so BakedIn doesn't ship them. Use the self-report check above to decide whether to ask your PCP for the validated workup.
• Where to verify: aasm.org/clinical-resources for the clinical guidelines; sleepeducation.org for patient-facing summaries

4. Mind

Authority body: US Preventive Services Task Force (USPSTF) for screening recommendations; American Psychological Association (APA) for treatment guidelines. The USPSTF recommends routine screening for depression and anxiety in adults — using two specific short instruments below.

• Depression screen: PHQ-2 — two questions on the past 2 weeks. Score 0–6. A score of 3+ has 83% sensitivity for major depressive disorder and warrants the full PHQ-9 or a clinical conversation
• Anxiety screen: GAD-2 — two questions on the past 2 weeks. Score 0–6. A score of 3+ warrants the full GAD-7 or a clinical conversation
• Where to verify: uspreventiveservicestaskforce.org (search 'depression screening' and 'anxiety screening' for the current Grade B recommendations); apa.org/depression-guideline

5. Connection

Authority body: HHS / Surgeon General — Vivek Murthy's 2023 advisory 'Our Epidemic of Loneliness and Isolation' established loneliness as a population-health issue with mortality risk comparable to smoking 15 cigarettes per day. The UCLA Loneliness Scale (short form) is the standard instrument.

• Short screen: UCLA Loneliness Scale, 3-item version (UCLA-3). Three questions about how often you feel left out / isolated / lack companionship. Each rated 1–3. Total score 3–9
• What you're checking: scores of 6+ are associated with clinically meaningful loneliness in research. A 6+ alongside other risk factors (recent loss, life transition, mobility limitation) is worth raising with a clinician
• Where to verify: hhs.gov/surgeongeneral for the loneliness advisory; cdc.gov/social-connectedness for population data

6. Sense and pain

Authority body: American Academy of Family Physicians (AAFP) for the red-flag screening framework; specialty academies (AAO, AAO-HNS, etc.) for vision/hearing. There's no single 'sense' screen — the question is whether you have any new or persistent symptom that meets the red-flag criteria.

• Pain red-flag screen (AAFP): new pain that is (a) severe and persistent, (b) accompanied by fever, weight loss, or neurological deficit, (c) wakes you from sleep, or (d) worsening despite simple measures — any one of those warrants urgent care
• Vision red-flag (AAO): sudden vision change, flashing lights, curtain across vision, severe eye pain — same-day specialist
• Hearing red-flag (AAO-HNS): sudden hearing loss in one ear within 72 hours — same-day specialist (steroid window matters)
• Where to verify: aafp.org for primary-care red-flag resources; aao.org and entnet.org for the specialty screens

7. Function

Authority body: CDC STEADI (Stopping Elderly Accidents, Deaths, and Injuries) for fall-risk screening; American Geriatrics Society (AGS) for ADL/IADL assessment. Function is the dimension that most directly predicts independence and quality of life across the lifespan, especially after 60.

• Fall-risk screen (CDC STEADI three-question version): in the past year, (1) have you fallen, (2) do you feel unsteady when standing or walking, (3) do you worry about falling. Any 'yes' triggers the full assessment
• ADL screen (Katz Index): can you do six basic activities independently — bathing, dressing, toileting, transferring, continence, feeding. Score 6/6 = independent; loss in any item is a red flag worth a clinical visit
• Where to verify: cdc.gov/steadi for the full algorithm; americangeriatrics.org for the Katz Index and IADL extensions

What to do with your numbers

Each instrument has thresholds that map directly to clinical action. Some are 'reassuring — keep doing what you're doing.' Some are 'worth a primary-care conversation at your next annual.' Some are 'see a clinician within X weeks.' A few are 'today, or right now.' Chapter 7 catalogs every threshold across all seven dimensions with the exact source language and the recommended urgency.

Until then: a high score on any screen is information, not a diagnosis. It tells you where to focus your reading in chapters 3 and 4, and where to spend your next clinical visit.