Free Alzheimer’s Test

Do I Have Alzheimer's Or Something Else?

Do you have Alzheimer's disease?

Or are your symptoms indicative something else, that may be more serious and require immediate medical attention?

Take this questionnaire to find out.

** If your health condition is concerning, please do not hesitate to seek immediate medical care or consult your medical provider.

1 / 8

My MoCA (Montreal Cognitive Assessment) test score is:

2 / 8

My AQ21 score is _______. This questionnaire is answered not by the patient, but by someone who lives with the patient, or is a caregiver for the patient.

If you have not taken the AQ21 questionnaire, please click here.

Less than or equal to 4

5 - 14

15 or more

Do not have an AQ21 score

3 / 8

My SLUMS score is ______.

This test is administered in a clinical setting by a medical provider.

More than 26

20 - 25

Less than 20

I did not take the SLUMS test

4 / 8

The patient's age:

Below 50

50 - 60

Above 60

5 / 8

Select all the boxes for symptoms that the patient currently experiences (check all that apply):

Symptoms are worsening rapidly. For example, significant loss of memory within 3-6 months.

Bad headaches all the time

Eyelid or face drooping on one side of the face

Feeling weak on one side of the body

Frequent falling

Fainting episodes

None of the Above

6 / 8

Select all the boxes for symptoms that the patient currently experiences (check all that apply):

Loss of sense of smell

Loss of interest in things that used to be interesting

Hallucinations or delusions

Prolonged staring at other peoples' faces

Uncharacteristic personality changes, like lewd or rude behavior, or stealing

Tremors

Movement problems that started recently, like walking with an abnormal gait

None of the Above

7 / 8

Select all the boxes for symptoms that the patient currently experiences (check all that apply):

Easily confused

Problems with decisionmaking

Getting lost in familiar places

Repeat the same questions and statements in the same day, sometimes within the same hour

Problems remembering date, time and even the current year

Emotional outbursts or mood issues, particularly after evening

Problems managing finances, that did not previously exist

None of the Above

8 / 8

Select all the boxes for symptoms that the patient currently experiences (check all that apply):

Frequent problems recalling the names of people, places or things I know

Chronic constipation

Frequent problems expressing myself correctly, which can cause hesitation when I'm asked a question

None of the Above

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