Page 27 - The Memory Program How to Prevent Memory Loss and Enhance Memory Power
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stand on the spectrum of memory loss, you need to take the following memory tests and see how
well you perform on them.
Simple Tests to Check Your Memory
The questionnaire below is a modified version of a published scale (Gilewski et al., 1990) and is
followed by two tests of memory. You should complete the questionnaire before attempting the
memory tests.
Subjective Memory Questionnaire (Self-Administered)
This test requires five to ten minutes and should be completed by you without any help or
interference from anyone else.
Globally, how would you rate your memory? In the row below, circle a number between 1 and 7 that
best reflects your overall judgment about your memory.
No problem Major problem
1 2 3 4 5 6 7
The next two sets of questions have the same 1–7 scoring scheme for each item: 1=no problem, 2–
3=mild problem, 4–5= moderate problem, 6–7=major problem.
General Frequency of Forgetting
In evaluating your own memory, how often do these present a problem for you? Circle a number
between 1 and 7 for each item separately.
No problem Major problem
Remembering
Names 1 2 3 4 5 6 7
Faces 1 2 3 4 5 6 7
Appointments 1 2 3 4 5 6 7
Where you put things,
like keys 1 2 3 4 5 6 7
To perform household 1 2 3 4 5 6 7
chores
