Note:
Now we want you to remember what your friend or relative was like 5 years ago
and to compare it with what he/she is like now. Below
are situations where this person has to use his/her memory or intelligence and
we want you to indicate whether this has improved, stayed the same or got worse
in that situation over the past 5 years. Note the importance of comparing his/her
present performance with 5 years ago. So if 5 years ago this person always forgot
where he/she had left things, and he/she still does, then this would be considered "Hasn't
changed much". Please indicate the changes you have observed by circling the
appropriate answer.
Compared with 5 years ago how is this person at:
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Age:
Sex: /
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Much
improved |
A bit
improved |
Not
much
change |
A bit
worse |
Much
worse |
Not
sure |
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1. Remembering things about family and friends e.g. occupations, birthdays, addresses |
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2. Remembering things that have happened recently |
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3. Recalling conversations a few days later |
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4. Remembering his/her address and telephone number |
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5. Remembering what day and month it is |
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6. Remembering where things are usually kept |
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7. Remembering where to find things which have been put in a different place from usual |
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8. Knowing how to work familiar machines around the house |
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9. Learning to use a new gadget or machine around the house |
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10. Learning new things in general |
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11. Following a story in a book or on TV |
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12. Making decisions on everyday matters |
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13. Handling money for shopping |
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14. Handling financial matters e.g. the pension, dealing with the bank |
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15. Handling other everyday arithmetic problems e.g. knowing how much food to buy, knowing how long between visits from family or friends |
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16. Using his/her intelligence to understand what's going on and to reason things through |
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Reference
1. Fuh, J.L., Teng, E.L., Lin, K.N., Larson, E.B., Wang, S.J., Liu, C.Y., Chou, P., Kuo, B.I.T., & Liu, H.C. (1995). The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a screening tool for dementia for a predominantly illiterate Chinese population. Neurology, 45, 92-96.
2. Jorm, A.F. (2004). The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): a review. International Psychogeriatrics, 16:3, 1-19.
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