Question | Response options | |
---|---|---|
1a) What is the most probable syndrome for this patient? | Subjective cognitive impairment | |
Mild cognitive impairment | ||
Dementia | ||
1b) the most probable aetiology for this patient? | Completely uncertain | Completely certain |
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% | ||
2a) What is the most probable aetiology for this patient? | Alzheimer | |
Vascular | ||
Frontotemporal | ||
Lewy Bodies | ||
Parkinson | ||
Other neurodegenerative disease, namely _______________ | ||
No neurodegenerative disease, namely ________________ | ||
2b) How certain are you of this? | Completely uncertain | Completely certain |
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% | ||
3a) In your opinion, what will be the most likely course of cognitive and/or daily functioning within 2 years? | Decline | |
Stable | ||
Improvement | ||
3b) How certain are you of this expectation? | Completely uncertain | Completely certain |
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% |