Memory Questionnaire

This is intended to be used with family or friends of a patient who is being evaluated for memory loss. It’s a brief, eight-item questionnaire (“AD8”) which has been studied and appears to help detect dementia. Informants are asked whether the patient has exhibited any increase in the following deficits or behaviors (not just occurring occasionally):

  • Problems with judgment
  • Reduced interest in hobbies/activities
  • Repeats questions, stories, or statements
  • Trouble learning how to use a tool or appliance
  • Forgetting the correct month or year
  • Difficulty handling financial affairs (bill-paying, taxes)
  • Difficulty remembering appointments
  • Consistent problems with thinking and/or memory

If only one of the above is noted (or none), dementia is very unlikely.  If 3 are felt to occur, there’s a 70% chance of having dementia.

Much information can be obtained from the Alzheimerโ€™s Association:

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