This form should be best completed by a family member or carer who knows the patient well.

1. About You and the Patient

Please complete this form if you know the patient well and have known them for several years. The questions ask whether the patient’s everyday thinking and memory are now better, worse, or about the same compared with around 10 years ago. Please answer based on your overall impression. If you are unsure about a question, choose the closest answer. This form usually takes about 10–15 minutes.

2. IQCODE: How to answer

For each question, compare the patient now with how they were about 10 years ago. Choose the option that best matches the degree of change.