AASC™

Agitation in Alzheimer’s 
Screener for Caregivers

The information on this website and from the questionnaire are not a substitute for professional/clinical judgment. The content is designed to provide educational information and not intended to define a standard of care or exclusive course of treatment. The AASC™ is a screening tool and is not a diagnostic tool.

The form below is view-only. To obtain a copy, please click the ‘Download AASC™ Questionnaire’ button below.

A person with Alzheimer's dementia may become easily upset, frustrated, or angry. These feelings may be associated with agitation, a common symptom of Alzheimer's. 

The following questions ask about behaviors associated with agitation that you may have observed in the individual for whom you provide care. 

Your answers to these questions can help you talk with your person’s healthcare professional. Please select one response for each question.

Patient Name:

Date:

QUESTION 1

Are you noticing any of the following that represent a change from the individual’s usual or past behavior?

  • Repeating motions or behaviors (e.g., rocking, raising fist, pointing finger)

    • Yes
    • No

  • Pacing or restlessness (cannot be still)

    • Yes
    • No

  • Cursing/using profanity or lashing out verbally

    • Yes
    • No

  • Raising voice or yelling or screaming

    • Yes
    • No

  • Resisting assistance or care

    • Yes
    • No

  • Throwing or hitting or breaking things

    • Yes
    • No

  • Trying to hurt self or others (e.g., grabbing. kicking, hitting, biting)

    • Yes
    • No

QUESTION 2

Do any of these behaviors negatively affect the individual’s relationships, activities, or willingness to receive care?

  •  
    • Yes
    • No

Disclaimer: This screener was developed by Otsuka Global Medical Affairs along with a panel of multidisciplinary experts and was funded by Otsuka Pharmaceutical Development & Commercialization, Inc. The AASC™ is a screening tool and is not a diagnostic tool.

Download AASC™ Questionnaire

Agitation criteria based on the International Psychogeriatric Association (IPA) definition (Sano et al., 2023).   

References: 1. Clevenger C, et al. One Minute to Recognition: The Agitation in Alzheimer’s Screener for Caregivers (AASC™). The Gerontological Society of America Annual Scientific Meeting; November 8-12, 2023; Tampa, FL. 2. Sano M, Cummings J, Auer S, et al. Int Psychogeriatr. 2023;1-13.