Alzheimer’s Risk Screener

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Please answer each question honestly by choosing the option that best describes your recent experiences. For each question, 0 indicates no difficulty and 3 indicates almost always experiencing the symptom.

1. Do you frequently forget the names of close family or friends?

2. Do you struggle to recall recent conversations?

3. Do you get confused about time, dates, or locations?

4. Do you struggle to follow familiar recipes or instructions?

5. Do you often misplace objects and have difficulty retracing steps?

6. Do you find it difficult to recall words during conversation?

7. Do you have difficulty recognizing familiar faces?

8. Have you experienced sudden changes in mood or personality?

9. Do you have difficulty planning or organizing your daily activities?

10. Do you struggle with tasks like assembling puzzles or recognizing patterns or shapes?

The Long Goodbye