Memory Screening

The following questionnaire is aimed to help senior citizens to identify whether their forgetfulness is due to ageing or Dementia.

If you choose to fill out the questionnaire, all questions are compulsory.

Once completed, please press the submit button found at the bottom of this page. After submitting, the memory screening score along with the analysis of the score will show on the page.


Memory Screening Questionnaire:

No Yes

No Yes

No Yes

No Yes

No Yes

No Yes

No Yes

No Yes

No Yes

No Yes

No Yes

No Yes

No Yes

No Yes


What Your Results Mean:

  • If the score is less than 4 the symptoms may have occurred by chance and the individual is not at risk for developing Dementia immediately. However, the individual may need to be screened in 6 months.
  • If the score is between 4-7, the individual has a moderate risk of developing dementia. Hence, it is recommended to get a consultation to be screened for presence or to rule out dementia.
  • If the score is above 7 it will be very wise to consult a medical professional for further testing to confirm or rule out Dementia.
DISCLAIMER:

This questionnaire is designed only to increase awareness about Dementia and help patients and their family members to get timely professional assistance, if there is a need. It is not a substitute for a professional / neuro – psychiatric evaluation. This is neither an attempt for a medical screening nor a substitute to the professional assessment procedures to diagnose dementia. The signs and symptoms listed herein are not claimed to be fully comprehensive. There may be more varied, serious and individualistic symptoms than these, experienced by different patients. Nightingales Medical Trust is not responsible for any wrong assessment and subsequent consequences. In case of any doubt, you can either consult your doctor or contact us for better advice.

Contact us:
9:00 am - 9:00 pm. All 7 days of the week.
Phone numbers: 9035025443 / 9243737232