Many forms or checking list for detecting MCI/dementia are available today. The series of forms I created, however, differ from traditional forms and can be used in various daily situations. The series contains eight different forms according to the situations such as at shops, at banks, at pharmacies, at dentists/hospitals, at barbers/hairdressers, at social circles, at delivery services, and in neighborhoods. These forms will help relevant members in each field to detect the early-onset of MCI or dementia of customers, friends, and neighbors. The evaluation items of each form were prepared with the advice of members in the field.

   When a member involved in each field notices abnormal forgetfulness of someone the results of the form can be communicated to the person, a family member, or the regional comprehensive support center. These forms may be useful in particular for persons who live alone and lack self awareness of their forgetfulness. The below is an example of the “barbers/ hairdressers” form.