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AD8 Dementia Screening Interview

If you're wondering if your loved one may be experiencing the signs or symptoms of Alzheimer's disease, this brief questionnaire may be a good place to start. Read each question thoroughly, click "Yes," "No," or "Don't know," and press "Submit" to get results you can print on the next page. For an accurate assessment of your loved one's symptoms, be sure to answer each question as honestly as you can. Only a health care professional can provide a proper diagnosis of your loved one.


Keep in mind that many factors or conditions can cause the symptoms described in this questionnaire. This questionnaire is not intended to be a diagnosis or indication of Alzheimer's disease. Alzheimer's disease is a serious condition that only a doctor or health care professional can diagnose.

  1. Does your family member have problems with judgment (problems making decisions, bad financial decisions, problems with thinking, etc)?
  2. Does your family member show less interest in hobbies/activities?
  3. Does your family member repeat the same things over and over (questions, stories, or statements)?
  4. Does your family member have trouble learning how to use a tool, appliance, or gadget (eg, DVD, computer, microwave, remote control)?
  5. Does your family member forget the correct month or year?
  6. Does your family member have trouble handling complicated financial affairs (balancing checkbook, income taxes, paying bills, etc)?
  7. Does your family member have trouble remembering appointments?
  8. Does your family member have daily problems with thinking or memory?

© 2006 Washington University. The Washington University is not affiliated with any company publishing or using this document and does not endorse any products using this document.

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