The Dementia Prevention Clionsky ChecklistTM
BEFORE YOU START
While you can complete the checklist with some ‘don’t know’ answers, you may want to have the following information before starting:
1. Blood Pressure
2. Height and weight (BMI)
3. Homocysteine level (a blood test)
4. Methylmalonic acid level (a blood test)
5. Vitamin D level (a blood test)
6. Total Cholesterol, HDL and LDL (a blood test)
How to take the Checklist
By clicking on the Start button, you will be presented with 25 questions. Click on the option that best describes you or your behavior. Each response will characterize your response as being either On Target, Near Target, or Off Target. Some responses require a numerical answer, such as a laboratory value. Your ‘numbers’ will determine the Target category. Other responses are descriptive, asking you to best characterize your thinking, behavior or lifestyle when answering. Your personal honesty will give you the most accurate conclusion. Some items allow for only On Target or Off Target responses. They have no middle ground. Other items offer more leeway and will offer an option that results in a Near Target rating. Can’t make up your mind or don’t have the information you need to answer the question? That’s why there is a Don’t Know response. Sometimes you need to gather information and return to the Checklist later.
The End Result
After completing each item, you will produce your individual Dementia Prevention Profile.
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Part 1: Two numerical scores a) Your personal Dementia Prevention Index™, showing how close you are to 100% of the target b) A modified McCance Brain Care Score, a 21-point published scale validated to reflect dementia risk. The closer you are to 21 points, the lower your risk. |
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Part 2: A colorized model A dementia risk model so you can see how all of the pieces fit together and how well you are doing. On Target areas are green, Near Target scores are amber, and Off Target Scores are red. If you don’t know the answer, that area will be gray. |
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Part 3: A four-column table Each column lists your risk factors by Target Category to make it easy to construct your approach to making changes. |
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Part 4: A detailed plan We show each of your answers and how close you are to being on-target. Most importantly, it provides Next Steps for you to consider. This creates your personal Dementia Prevention Plan. |
Cautionary Advice
This checklist and all of its information is presented as a guide; it is not intended as medical advice. It does not replace personalized advice from your own health care professional, someone who knows you and can factor in all of your possibly complex health information. In addition, your age, gender, race, and other health conditions will impact some target ranges. Treat the Dementia Prevention Checklist like a GPS: It may tell you where to turn but it is not driving the car. Even though it says to turn right, you might be driving in a tunnel, not on the street above.
Payment
The checkist is available as a free tool for everyone to review. In order to to view your personalized results a one-time payment of $15.00 is required each time you complete the checklist. Payments will be be processed via the online processing platform STRIPE.
Now it is time to take the next step in decreasing your dementia risk.
NEXT STEPPart 1: The Introduction
Part 2: The How To
Part 3: The Plan
DOWNLOAD & PRINT PDF
If you prefer to complete the Clionsky Checklist by hand. Please download and print the PDF version provided here. Please note, the printed version only allows the ability to see if you are on, off or near target. Only the interactive online version provides a detailed analysis with personalized custom model.
DOWNLOAD