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Are you or your loved ones at risk?

*This test has been developed and validated by healthcare professionals to assess individuals with cognitive impairment 1-4. The Short-IQCODE is not a diagnostic tool and was not designed to be used as such. If you are concerned about any aspect of your memory, it´s best to visit to your doctor. However, this questionnaire could help you to start a conversation with your healthcare professional. You can even print out your results and show them during your appointment.

 

Are you concerned that you and your loved ones’ memory has faded? Do you often have the feeling of forgetting or misplacing things? In the second half of life, forgetfulness can be normal. However, rather than occasional forgetfulness, it can also indicate a more serious medical conditions such as Mild Cognitive Impairment. Once you notice changes it’s critical to seek for professional assistance. This test has been validated for detecting cognitive decline in the elderly*.

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Remember what it was like 10 years ago and compare with today by indicating what has improved, stayed the same or got worse. This test takes you only 5-7 minutes to answer 16 questions and can be self-administered without the assistance of healthcare staff.

OBJECTIVE:

EAT-10 helps to measure swallowing difficulties.
It may be important for you to talk with your physician about treatment options for symptoms.

A. INSTRUCTIONS:

Answer each question by writing the number of points in the boxes.
To what extent do you experience the following problems?

 

 

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SYMPTOMS
SCORE
Remembering things about family and friends e.g. occupations, birthdays, addresses*
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Remembering things that have happened recently*
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Recalling conversations a few days later*
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Remembering his/her address and telephone number*
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Remembering what day and month it is*
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Remembering where things are usually kept*
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Remembering where to find things which have been put in a different place from usual*
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Knowing how to work familiar machines around the house*
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Learning to use a new gadget or machine around the house*
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Learning new things in general*
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Following a story in a book or on TV*
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Making decisions on everyday matters*
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Handling money for shopping*
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Handling financial matters e.g. the pension, dealing with the bank*
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Handling other everyday arithmetic problems e.g. knowing how much food to buy, knowing how long between visits from family or friends*
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Using intelligence to understand what's going on and to reason things through*
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Jorm AF, Jacomb PA. The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): socio-demographic correlates, reliability, validity and some norms. Psychol Med. 1989; 19(4):1015-22.

Jorm AF. A short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): development and cross validation. Psychological Medicine 1994;24: 145–53.

Jorm AF. The Informant Questionnaire on cognitive decline in the elderly (IQCODE): a review. Int Psychogeriatr. 2004 Sep; 16(3):275-93.

Harrison JK, et al. Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the early diagnosis of dementia across a variety of healthcare settings. Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No.: CD011333.