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Patient Identifier

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Question 1

Has significant neurological or medical disease other than AD that may affect cognition, for example hydrocephalus, min B12 deficiency, or clinically significant hypo or hyperthyroidism.

True False

Question 2

Current, clinically significant major psychiatric disorder (eg, major depressive disorder) according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), or symptoms (eg, hallucinations) that could affect the subject’s ability to complete the study.