| QUESTIONNAIRE |
For each question please put a ring
around the number which best applies to you. When you have answered
all the questions, add up your score.
1 = Never or hardly ever (a few times a year or less)
2 = Occasionally (a few times each month)
3 = Quite often (a few times each week)
4 = Very frequently (every day) |
| 1 Forgetting where you have put
something. Losing things around the house |
1 |
2 |
3 |
4 |
2 Failing to recognise places that
you are
told you have often been to before |
1 |
2 |
3 |
4 |
| 3 Having to go back to check whether
you have done something that you meant to do |
1 |
2 |
3 |
4 |
4 Forgetting to take something with
you
when you go out |
1 |
2 |
3 |
4 |
| 5 Forgetting that you were told
something yesterday or a few days ago, and maybe having to be reminded
about it |
1 |
2 |
3 |
4 |
| 6 Failing to recognise, by sight,
close relatives or friends whom you meet frequently |
1 |
2 |
3 |
4 |
| 7 When reading a newspaper or magazine;
being unable to follow the thread of a story; losing track of what
it is about |
1 |
2 |
3 |
4 |
| 8 Forgetting to tell somebody something
important. Perhaps forgetting to pass on a message or remind someone
of something |
1 |
2 |
3 |
4 |
| 9 Forgetting important details about
yourself, for example, your date of birth or where you live |
1 |
2 |
3 |
4 |
| 10 Getting the details of what someone
has told you mixed up and confused |
1 |
2 |
3 |
4 |
| 11 Forgetting where things are normally
kept or looking for them in the wrong place |
1 |
2 |
3 |
4 |
| 12 Getting lost or turning in the
wrong direction on a journey, a walk or in a building where you
have OFTEN been before |
1 |
2 |
3 |
4 |
| 13 Doing some routine thing twice
by mistake. For example, putting two lots of tea in the teapot,
or going to brush your hair when you have just done so |
1 |
2 |
3 |
4 |
| 14 Repeating to someone what you
have just told them or asking them the same question twice |
1 |
2 |
3 |
4 |
| TOTAL SCORE |
|
| We are grateful to Professor Alan
Baddeley for allowing us to use an adapted version of his questionnaire
on memory lapses. |
| WHA
DOES YOUR SCORE MEAN? |
Score <
14–19
20–29
30–39
40–56
|
Comments
Your memory is very good indeed. You have no need to worry
Your memory performance is about average, but you might find
some of the practical advice on memory aids in the next chapter
useful
This score indicates that your memory is below average. This
may simply mean that you lead a very busy life, which puts considerable
demands on your memory. In the next chapter we give some practical
advice on coping with an unreliable memory, which should
help you
This score suggests that your memory is very poor. Frequent
memory lapses are likely to have a serious effect on the way
you cope with daily life. There may be several reasons for this,
but it would be sensible to discuss your memory difficulties
with your GP
|
