Understanding whether you or a loved one has dementia can be tricky, especially at an early point. Diagnosing it typically involves a series of interviews with medical professionals, tests, and brain scans. However, a brief check-in can help get a rough idea of you or your loved one’s state of mind. That is why we set up this short test for early dementia symptoms. It consists of 15 yes or no questions in a few different categories and takes about 5 minutes to complete.

Please count the number of questions you answer “Yes” to, and we will discuss your score at the end. Let’s begin.

Memory and Confusion

1. Have you noticed any recent memory loss that affects daily activities?
(Yes/No)
2. Does the person forget recent events or appointments?
(Yes/No)
3. Does the person misplace objects more frequently than before?
(Yes/No)
4. Does the person seem confused about the place, date, or time?
(Yes/No)
5. Has the person gotten lost in a previously familiar setting?
(Yes/No)

Language and Communication

6. Does the person struggle to find the right words during conversations? (Yes/No)
7. Have you noticed any changes in the person’s ability to follow or join a conversation?
(Yes/No)
8. Does the person call objects by the wrong name?
(Yes/No)

Mood and Behavior Changes

9. Have you noticed any rapid mood swings without a clear reason?
(Yes/No)
10. Does the person show less interest in hobbies or activities they previously enjoyed?
(Yes/No)
11. Have you observed a decline in the person’s ability to make decisions? (Yes/No)
12. Does the person show poor judgment in safety or money matters?
(Yes/No)

Daily Activities

13. Does the person need help with basic tasks like dressing, eating, or personal hygiene?
(Yes/No)
14. Is the person experiencing decreased motivation to initiate or complete daily tasks?
(Yes/No)
15. Have you noticed changes in the person’s ability to drive, cook, or use appliances safely?
(Yes/No)

Scoring:

0-5 “Yes” Answers:
May indicate mild or early signs of cognitive decline. Continue to monitor these signs and consider consulting a healthcare provider.

6-10 “Yes” Answers:
There are moderate signs of cognitive decline present. It is advisable to seek a medical evaluation.

11-15 “Yes” Answers:
There are strong indications of dementia. It is important to consult with a healthcare professional urgently.

Next Steps:

1. Schedule an appointment with a healthcare provider for a thorough assessment.

2. Keep Records: Note specific instances or changes in behavior that are concerning.

3. Explore Support Resources: Alzheimer’s associations, support groups, or educational materials can provide additional guidance.

This questionnaire is a starting point to help identify potential signs of dementia. It is not designed to provide a diagnosis. Please follow up with a healthcare provider for an accurate diagnosis and appropriate care planning if you are concerned.