Alzheimer's Disease Symptom Screener

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Symptom Screener

The symptom screener can help you find out if the problems you're noticing could be symptoms of Alzheimer's. Answer the eight questions below about changes in your loved one and share them with the doctor.

Remember, "Yes, a change" indicates that there has been a change in the last several years caused by cognitive (thinking and memory) problems.

Print this page and talk to your doctor or health care provider, especially if you've answered
"Yes, a change" to two or more questions.

Important: This screening tool cannot be used to tell if your loved one has a medical problem, only whether he or she should be tested.

Adapted from Galvin JE, et al. The AD8, a brief informant interview to detect dementia. Neurology 2005:65:559-564.

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ARICEPT^® (donepezil HCl tablets) is indicated for the treatment of mild, moderate, and severe dementia of the Alzheimer's type.

Important Safety Information

ARICEPT is well tolerated but may not be for everyone. People at risk for stomach ulcers or who take certain other medicines should tell their doctors because serious stomach problems, such as bleeding, may get worse. Some people who take ARICEPT may experience fainting. Some people may have nausea, vomiting, diarrhea, bruising, or not sleep well. Some people may have muscle cramps or loss of appetite or may feel tired. In studies these were usually mild and temporary. For full prescribing information, please visit Prescribing Information.

This Web site contains information relating to various medical conditions and their treatment. Such information is provided for educational purposes only and is not meant to be a substitute for the advice of a physician or other health care professional. You should not use this information for diagnosing a health problem or disease. In order for you to make intelligent health care decisions, you should always consult with a physician or other health care provider for your, or your loved one's, personal medical needs.

All quotes included in this Web site represent the individual experience of some doctors, some patients, and their caregivers. Individual responses to ARICEPT treatment may vary. Actual identities have been changed to protect individual privacy.

(i) The Licensed Material is being used for illustrative purposes only; and (ii) any person depicted in the Licensed Material, if any, is a model.

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1	Problems with judgment (problems making decisions, bad financial decisions, problems with thinking, etc.)
	Yes, a change	No, no change	Don't know
2	Less interest in hobbies/activities
	Yes, a change	No, no change	Don't know
3	Repeats the same things over and over (questions, stories, or statements)
	Yes, a change	No, no change	Don't know
4	Trouble learning how to use a tool, appliance, or gadget (e.g., VCR, computer, microwave, remote control)
	Yes, a change	No, no change	Don't know
5	Forgets correct month or year
	Yes, a change	No, no change	Don't know
6	Trouble handling complicated financial affairs (balancing checkbook, income taxes, paying bills, etc.)
	Yes, a change	No, no change	Don't know
7	Trouble remembering appointments
	Yes, a change	No, no change	Don't know
8	Daily problems with thinking or memory
	Yes, a change	No, no change	Don't know