Checklist for Early Signs of Alzheimers and Dementia

Understanding the early signs of Alzheimer’s and dementia can help you recognize changes sooner and feel more prepared to start supportive conversations with family members or healthcare providers. Inspired by guidance from dementia experts, this checklist is designed to support your awareness and understanding of the symptoms of memory disorders. We encourage you to print this resource out and use it to monitor changes over time, and feel more confident during appointments and daily routines.

Your Checklist for Recognizing Memory and Daily Life Changes

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Understanding the early signs of Alzheimer’s and dementia can help you recognize changes sooner and feel more prepared to start supportive conversations with family members or healthcare providers. Inspired by guidance from dementia experts, this checklist is designed to support your awareness and understanding of the symptoms of memory disorders. We encourage you to print this resource out and use it to monitor changes over time, and feel more confident during appointments and daily routines.

RATING SCALE:

SUPPORT AREA

WHAT YOU MAY NOTICE

Rarely

Often Sometimes

Occasionally forgetting recently learned information, repeating questions, or needing reminders for appointments and important dates.

Memory and Daily Routines

Needing extra time or support with familiar activities such as preparing meals, organizing bills, or managing medications.

Completing Everyday Tasks

Feeling unsure about dates, seasons, or locations from time to time.

Awareness of Time or Place

Communication and Conversation

Pausing to find the right word or needing a little extra time to follow conversations.

Misplacing items more often or needing help retracing steps to find them.

Keeping Track of Belongings

Changes in confidence with finances, personal care, or day-to-day decisions.

Decision-Making and Judgment

Participating less in hobbies, gatherings, or activities they once enjoyed regularly.

Social Engagement

Experiencing changes in mood, increased worry, frustration, or reactions that feel different than usual.

Emotional Well-Being

Feeling more comfortable with reassurance or familiar routines throughout the day.

Comfort with Daily Structure

Becoming unsure of surroundings or needing guidance in familiar places.

Navigation and Direction

This document is an informational tool and is not a substitute for any evaluation or review by a licensed medical provider or other qualified professional.

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