Brain Health Self Assessment


Printer-Friendly Version of This Page

emeritus senior living brain health

Brain Health Self Assessment

The purpose of the brain health personal survey is to provide feedback on your current brain health lifestyle and to provide some direction for improvement. Assess yourself periodically to monitor your behaviors and to celebrate your success!

Lifestyle/Behavior (check True or False to each of the following "I" statement)

Primary Benefit - Mental*

True

False
...am currently taking a class or learning a new task, skill, art form.
...play challenging board games.
...am learning a new language or musical instrument.
...garden or knit.
...have reduced TV and/or video game exposure.

Primary Benefit - Nutritional*

True

False

...drink 64 ounces of water a day.
...eat at least 5 servings of colorful fruits and vegetables every day.
...include fish, walnuts, almonds or flax seed in my diet at least 3 times a week.
...eat the appropriate number of calories for my body age, height, and bone structure.
...drink daily glass of grape juice or red wine, if medically permissible.

Primary Benefit - Physical*

True

False
...do not smoke.
...stretch or strengthen exercise 3-5 times a week.
...walk (with the goal of reaching) 10,000 steps (2.5 to 3 miles) a day.
...dance.
...do not use illegal drugs.

*One brain health behavior can provide several benefits. For the sake of this self-assessment, behaviors are categorized into "primary" benefits to provide consistency in scoring.

Primary Benefit - Social*

True

False
...eat at least one meal a day with others.
...participate daily in an enjoyable event, activity or experience with others (other than at meal time).
...maintain strong ties/relationships with family and friends.
...am forgiving.

Primary Benefit - Spiritual*

True

False
...pray or meditate daily.
...identify and renew my purposes and values daily.
...participate in yoga, tai chi, stretching or deep breathing exercises.
...get enough sleep during the night to feel rested by morning.
...write in a daily journal or meditation or prayer log.

Calculate Your Brain Health

Mental Domain (# of items checked "True") x 4 =
Nutritional Domain (# of items checked "True") x 4 =
Physical Domain (# of items checked "True") x 4 =
Social Domain (# of items checked "True") x 4 =
Spiritual Domain (# of items checked "True") x 4 =
Total Points

Scoring (Total Points)

85-100 = Great! Keep doing what you are doing and improve in weak areas.

70-84 = Good job! Review areas checked "False" and begin to make lifestyle changes in these domains. Make the changes one at a time.

69 or less = Opportunities to improve your brain health. Review the survey as significant changes is needed. Begin to make changes in one or two domain areas at a time.

*This assessment was modified with permission from Emeritus' partner in brain health programming and education: Dr. Paul Nessbaum, Guide to Brain Health across the Lifespan . You may contact Dr. Nussbaum and learn more about brain health by visiting www.paulnussbaum.com .

print this page

Click Here To Locate a Community Nearest You.


Emeritus' Brain Health program consists of five key areas. Within these areas are many opportunities, activities and challenges for creating a complex and novel environment.

Five Key Areas

Social/Emotional - Simply put, we need other people; and we need strong, healthy relationships. Older adults who isolate and segregate are at risk for dementia.

Physical Activity - Running, walking, stretching, and dancing–use both sides of the brain and body! These activities also increase the supply of vital oxygen to the brain and relate to reduced risk of dementia.

Mental/Intellectual - can be compared to “aerobics for the brain.” Keep your mind challenged, active, and not passive. Activities such as board games, learning a second language, travel, reading, sign language, and speaking promote brain health.

Nutritional - Good nutrition is necessary for overall health. Foods rich in antioxidants (such as brightly colored fruits and vegetables) and Omega 3 fatty acids (such as salmon, walnuts, almonds, and flax seeds) are excellent choices to promote brain health.

Spiritual - opportunities to engage in deep personal reflection. To further develop your sense of purpose, meaning and hope. To relax, and relieve stress. Sleeping regular hours can promote overall health and relate to cognitive efficiency.