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  5. Health studies- Dementia.
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Exit Survey
 
 
What is your gender?
 
Female.
 
Male.
 
Prefer not to say.
 
Other.
 
 
 
What is your age?
 
18 - 24.
 
25 - 34.
 
35 - 44.
 
45 - 54.
 
55 - 64.
 
65 - 74.
 
75+.
 
 
 
Which of the following categories best describe your employment status?
 
Employed(full time).
 
Employed(part time).
 
Not employed.
 
Self employed.
 
Retired.
 
Unable to work.
 
Student.
 
 
 
Do you know anybody that is affected by dementia?
 
Yes.
 
No.
 
Unsure.
 
 
 
Have you ever cared for anybody with dementia?
 
Yes.
 
No.
 
Unsure.
 
 
 
Do you think dementia is a normal part of aging?
 
Strongly agree.
 
Agree.
 
Neither.
 
Disagree.
 
Strong disagree.
 
Unsure.
 
 
 
Do you think it is easy to recognize dementia symptoms?
 
Strongly agree.
 
Agree.
 
Disagree.
 
Strong disagree.
 
Unsure.
 
 
 
Do you think dementia is genetic?
 
Yes.
 
No.
 
Unsure.
 
 
 
Tick which of the following you think affects the brain leading to dementia?
 
Smoking.
 
Unhealthy drinking and eating.
 
Being socially active.
 
Drinking alcohol.
 
Being over weight.
 
Having children.
 
 
Tick which of the following are signs of dementia.
Yes. No.
Change of mood.
Memory loss.
Physically moving slower.
Hallucinations.
Falling over.
Overeating.
Going out less.