Dementia

This survey is designed to provide a quick assessment of whether you might have signs and symptoms related to dementia. However, no test is 100% accurate. No matter what your score is, you should seek help if you have any concerns about yourself or your loved ones.

 

This questionnaire is the AD8 Screening Interview, and has been developed to detect dementia.

 

Have you noticed any of the following:

1. Problems with judgment (e.g., problems making decisions, bad financial decisions, problems with thinking)
(1.0) (0.0)
2. Less interest in hobbies/activities
(1.0) (0.0)
3. Repeats the same things over and over (questions, stories, or statements)
(1.0) (0.0)
4. Trouble learning how to use a tool, appliance, or gadget (e.g., VCR, computer, microwave, remote control)
(1.0) (0.0)
5. Forgets correct month or year
(1.0) (0.0)
6. Trouble handling complicated financial affairs (e.g., balancing checkbook, income taxes, paying bills)
(1.0) (0.0)
7. Trouble remembering appointments
(1.0) (0.0)
8. Daily problems with thinking and/or memory
(1.0) (0.0)