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Answer the questions below to help find out if
the memory problems of the person you care for could be symptoms of
Alzheimer's disease. You must answer all 11 questions. |
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Yes |
No |
Don't Know |
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1) ...often repeat themselves or
ask the same questions over and over?
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2) ...more forgetful, that is,
having trouble with short-term memory?
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3)
...need reminders to do things like chores,
shopping, or taking medicine? |
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4)
...forget appointments, family occasions,
or holidays?
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5) ...seem sad, down in the dumps,
or cry more often than in the past?
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6)...started
having trouble doing calculations, managing finances, or balancing the
checkbook?
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7) ...lost interest in
his/her activities such as hobbies, reading, attending church, or
other social activities?
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8) ...started needing help
eating, dressing, bathing, or using the bathroom?
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9) ...become irritable,
agitated, suspicious, or started seeing, hearing, or believing
things that are not real?
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10) Are there concerns about
his/her driving, for example getting lost or driving unsafely, or
has the person had to stop driving? If he/she has never driven,
answer "No".
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11) ...have trouble
finding the words he/she wants to say, finishing sentences, or
naming people or things?
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If you answered yes to 5 or more of these
questions, there could be a problem. In that event it is
recommended that you consult a physician or nurse practitioner.
To read more about what is normal forgetfulness versus symptoms
consistent with significant mental decline,
click here.
Adapted
from Mundt JC, Freed DM,
Griest JH. Lay person-based screening for early detection of
Alzheimer's disease: development and validation of an instrument. J
Gerontol Psychol Sci Sco. 2000, 55B: 163-170
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