Scoring:
Give yourself 1 point for every true (T) response. Then total your points at the end of each section. Add a 0 to your total score: This is your age print for that biological system.
T/F
2. I have experienced hair loss
T/F
3. My ability to remember faces has decreased
T/F
4. I need to write down even the simplest directions or instructions
T/F
5. My ability to recall numbers has decreased
T/F
6. My memory has decreased
T/F
7. My management skills have decreased
T/F
8. I do not feel like my brain is working well
T/F
9. Alzheimer’s and/or dementia runs in the family
T/F
10. I often forget where it put important things, like keys or prescription medicines
T/F
Number of true responses: __________; add 0 to number= Acetylcholine age code: _______