Cognitive Condition Self-Assessment

Answer the 10 brief questions below, then receive your score and the option to email a formal referral summary to yourself and your physician.

Cognitive Condition Self-Description

For each statement, indicate whether it has applied to you in the past several years.

0 of 10 answered

Your Assessment Result

AD8 Dementia Screening Interview — self-report version

#	Item	Response

Contact Information & Next Steps

Please provide your details so we can send your formal self-assessment referral letter to you and help@cognitivewell.org.

Name

Email *

Age *

Gender

Where do you live (City, state)? *

Please describe your current and previous medical conditions, including but not limited to cancer, uncontrolled heart disease, or are you currently in another research study? (If yes, please list briefly. If no, please put N/A) *

Cell Phone #

Congratulations! You just completed the AD8-based cognitive condition self-assessment.

This tool is designed for the early detection of mild cognitive impairment (MCI) and dementia. A positive screen (score ≥2) indicates the need for further comprehensive evaluation, such as full neuropsychological testing and clinical assessment. The accuracy of the assessment depends on a reliable informant (the self-report version is less ideal in advanced stages). It is free for clinical use, with permissions granted for non-commercial purposes.

Important: This self-assessment is a screening tool only and does not constitute a medical diagnosis. Please share your results with a qualified healthcare provider for clinical evaluation. If you are experiencing urgent concerns, contact your physician or emergency services.

Complete the required fields above (email, age, location, and medical history) to enable email delivery.