Q1: self-questionnaire | Q2: questionnaire administered by the doctor |
---|---|
 | During the six last months: |
1. In the last six months, have any of your close relations suggested that you have a possible memory problem? | 1. Have any of your close relations told you that you have memory problems? |
2. Do you sometimes suffer from a lapse of memory during daily life? | 2. Have you noticed any change in your memory? |
3. Do you find it difficult to calculate? | 3. Do you think that your memory now works less well than memory of other people of age? |
4. Do you have difficulties finding your words? | 4. Do you find it difficult to orientate yourself, or did you ever not recognize a place where your close relations have told you that you have been? |
5. Do you have problems remembering new information? | 5. Have you ever fogotten everything about an event (even if your close relations told you about it or you saw pictures about it)? |
6. Do you find it difficult to focus? | Â |