Alzheimer’s Disease Psychosis

LEARN ABOUT ELIGIBILITY

To see if you may qualify for this research study, please complete this Pre-Qualifying Questionnaire.

By clicking to begin the pre-screening process, you allow us to proceed with the pre-screening questions and to begin recording your answers. By clicking you also agree to the terms of the Privacy Policy.

If pre-qualified, please enter YOUR (the Care Partner) name and contact information. Your name and contact information will not be associated with the questionnaire answers unless you provide this information after you complete the pre-qualifying questionnaire.

Is the person you care for 55 to 95 years of age?

Yes No

How did you hear about this research study?

Please enter the home or work zip code of the person you care for. This zip code will be used to locate a study center near you. Please provide the zip code that would be most convenient.

Enter 5-digit zip code

Does the person you care for have dementia symptoms due to Alzheimer’s disease?

Yes No Unsure

Has the person you care for experienced delusions or hallucinations for at least the past 2 months?

Yes No Unsure

Completion Status

Who should complete the pre-qualifying questionnaire for this study?

If you feel you can answer “Yes” to any of the following questions, please take the pre-qualification questionnaire to see if our study may be right for your loved one:

1. Has the person you care for become suspicious or fearful?
2. Is the person you care for seeing, hearing, or sensing things that are false, unreal, or strange?
3. Is the person you care for feeling, thinking, or believing things that are false, unreal, or strange?

Is there an obligation to continue if I complete the pre-qualifying questionnaire?

No. You may take the pre-qualifying questionnaire just to see if the person you care for might pre-qualify. Participation in a research study is completely voluntary at every step in the process.

If pre-qualified, you will have the opportunity to submit your (the Care Partner’s) contact information to be contacted by the study staff. Submitting your information to a study center does not mean the person you care for must participate, and participation can be stopped at any time with no penalty to you or the person you care for.