Phase eight of eight

Medical Questionnaire 8 – Mental Fitness

Mental efforts

In general, do you keep yourself busy? *

Yes

No

Are you easily bored? *

Yes

No

Are you interested in politics/society? *

Yes

No

Do you interact/talk with others on a daily basis? *

Yes

No

Do you regularly do crosswords or other puzzles? *

Yes

No

Are you interested in learning a new language? *

Yes

No

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Forgetfulness

Do you often forget what you planned to do? *

Yes

No

Can you remember what someone said to you the previous day? *

Yes

No

If someone asks you to do something, do you often forget? *

Yes

No

Do you recognize family and friends without difficulty? *

Yes

No

Do you know the date of your anniversary and place of birth? *

Yes

No

Do you find that you often do things repeatedly? *

Yes

No

Can you recall events from previous days or weeks? *

Yes

No

Do you recognize places you have been before? *

Yes

No

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Mental Fitness

Can you adapt well to changes in your daily routine? *

Yes

No

Do you have trouble comprehending basic information? *

Yes

No

Do you learn things quickly (e.g. a new game or activity)? *

Yes

No

Do you recall names and numbers well? *

Yes

No

Are you able to easily follow a story line in books and films? *

Yes

No

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Total Score