Let us compare with one year ago!

A “quick reference” list for forgetfulness

If you are experiencing something like forgetfulness, try using this “quick reference” list.
Compare your current daily life with the situation one year ago.

Diagnosis cannot be made based on this result alone. This list is just a “quick reference.”

Enter applicable numbers in the list (2/1/0). The score will be calculated automatically.

  • 2 ... Unchanged
  • 1 ... Somewhat worsened
  • 0 ... Markedly worsened
Being aware of the date and month
Remembering the regularly used routes as before
Remembering the address and phone number
Remembering where things are kept
Being able to find things that are not in the usual places
Being able to use electrical appliances, such as washing machines and TV remote controllers
Being able to dress oneself to suit the situation
Being able to pay money when shopping
Lack of willpower despite not feeling sick
Understanding the contents of books and TV programs
Writing letters
Remembering conversations that took place a few days earlier
Experiencing difficulty in remembering the contents of the conversation that took place a few days earlier
Occasionally forgetting things to say in a conversation
Occasionally experiencing difficulty in finding the appropriate words to use in a conversation
Being able to recognize familiar faces
Remembering the names of familiar people
Knowing where people you are familiar with live and work
Becoming forgetful about recent events

Supervised by Akira Homma, Otafuku Monowasure Clinic
(Created based on an article by a French psychiatrist, Richie, et al. in 1996)

Total score
0

If the total score is 24 points or lower, it is recommended that you first consult your primary care doctor or your nearest consultation service center (family pharmacy, Local Elderly Care Management Center, etc.).

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