Dementia Support Line
Dementia symptoms checklist
A checklist to help you make a note of symptoms before you talk to your GP.
How to use the dementia symptoms checklist
The checklist will help you discuss your concerns with a GP. It is not a diagnosis tool and having these symptoms does not mean you are developing dementia.
- Watch a video of the symptoms checklist in British Sign Language (BSL)
- Print a copy of the symptoms checklist in Welsh (Cymraeg)
Using the checklist to speak with your GP
Once the online checklist is complete, you will be given the choice of downloading your answers, or getting them emailed to you.
This may help you have a conversation with your GP, healthcare professional or a trusted individual. Talk to them about any concerns you've indicated on the checklist.
Completing the dementia symptoms checklist
The checklist contains 20 questions about possible symptoms or behaviours relating to dementia. You will need to think about:
- the symptoms that each question describes
- how long they have been happening
- how much they are affecting daily life
If you do not wish to answer a question, you can move on to the next one. You can also go back and change the answer to a previous question.
If you are completing this form on behalf of someone else, answer the questions from their perspective.
It is not intended to diagnose dementia or any other health condition. This checklist includes common signs of dementia, but there can be other reasons for any changes you've noticed.
Dr Jill Rasmussen, Clinical Representative for Dementia at the Royal College of General Practitioners, said: