Self-Evaluation Test | Memory Disorders

This self-evaluation test is an easy stress-free way to give yourself a personal evaluation concerning the following Memory Disorders: Memory Loss, Mild Cognitive Impairment, Dementia, Alzheimer’s Disease. The results of you or your loved one’s self-evaluation can help assess if what you are experiencing is normal, with a healthy nourished brain, or if F&Q could have a life-changing impact for you or your loved ones.

You can start the test at anytime by moving the slider below to show how strongly you feel about each statement. Then simply click on “submit” at the end of the test to determine your results.

QuestionAnswers
1. I often have trouble remembering the password on my computer or PIN number at the ATM machine.
2. I forget simple words and substitute unusual words for familiar ones.
3. I go to read the newspaper or a magazine article and then find it difficult to remember what I just read.
4. I can frequently forget where I am and how I got there.
5. I sometimes encounter difficulties remembering or performing everyday tasks such as taking medication or driving.
6. I sometimes find it difficult to remember the name of an acquaintance after just being introduced.
7. I have misplaced valuable possessions by hiding or putting things in strange places and then I forget where they are.
8. I frequently forget the day, month, time or location.
9. I sometimes make repeated statements about something I just discussed.
10. I may sometimes neglect personal safety, hygiene, or nutrition.
11. I feel like my mental abilities are declining.
12. I have felt that my personality has changed a bit.
13. I have had family and friends complain about my memory or forgetting important things.
14. I sometimes feel apathy and lack of engagement in life around me.
15. I am sometimes confused and forget names and words; might make up words, or quit talking to avoid mistakes.
16. I have forgot my own history before and recent personal events or current events.
17. I am sometimes less able to plan, organize, or think logically.
18. I have increasing difficulty with routine tasks such as planning dinner, grocery shopping, paying bills.
19. I have increasingly felt unable to make decisions; defers to others’ choices.
20. I sometimes feel I have poor judgment and at times decline in problem-solving skills.
21. I sometimes have trouble concentrating and learning new things; avoids change.
22. I sometimes have increasing difficulty comprehending reading material.
23. I can sometimes be easily angered when frustrated, tired, rushed, or surprised.
24. I have had increasing difficulty in sorting out names and faces of family and friends, but can still distinguish.
25. I still know my own name, but can no longer remember my own address or phone.
26. I have lost track of my own possessions and may have taken others’ belongings.
27. I can no longer think logically or clearly and can’t organize my own speaking or follow others’ logic.
28. I can no longer follow written or oral instructions or a sequence of steps.
29. I feel disconnected from reality and sometimes don’t recognize self in the mirror.
30. I am having problems with speaking, understanding, reading, and writing.

Calculate your total score:

Disclaimer 1: I understand that if my score is 50 points or more, F&Q may be right for me.

Disclaimer 2: I understand that this self-evaluation is not intended to diagnose, treat, cure, or prevent any disease. It is provided as an aid for self understanding and exploring your life experiences.