';

PERSONAL REQUIRED: 1+
OPTION 1
Personal diagnosis of Parkinson’s, Alzheimer’s and/or Dementia
OPTION 2
Patient has/had up to a 3rd degree blood relative with
Parkinson’s, Alzheimer’s, or Dementia and they are exhibiting signs/symptoms themselves
Symptoms:
Delusional disordersUnspecified disturbances of smell and taste
Major depressive disorder single episode unspecifiedHallucinations unspecified
Unspecified mood [affective] disorderNervousness
Anxiety disorder unspecifiedRestlessness and agitation
InsomniaUnhappiness
Sleep disorder unspecifiedDemoralization and apathy
Impaired contrast sensitivityIrritability and anger
Dysphagia unspecifiedViolent behavior
Tremor unspecifiedSlowness and poor responsiveness
Unsteadiness on feetAphasia
Repeated fallsAnorexia
Dizziness and giddinessAbnormal weight loss
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