The AD8 Dementia Screening Interview (AD8) is a brief eight-item screening tool that detects early cognitive change associated with dementia. An informant who knows the patient well, or the patient directly, reports whether specific everyday abilities have declined from previous levels. Clinicians use the total score to decide whether a fuller cognitive evaluation is warranted.
Why healthcare providers use the AD8
- Fast to administer. It takes about three minutes and requires no advanced training or special equipment.
- Informant or self-report. It is validated both as an informant interview and as a direct patient questionnaire, giving flexibility when a caregiver is present or not.
- Detects change over time. It focuses on intra-individual decline rather than a fixed norm, so it can catch early shifts that brief performance tests may miss.
- Strong screening accuracy. Published studies report sensitivity above 84 percent and specificity above 80 percent against the Clinical Dementia Rating.
- Fits routine visits. It is recommended for Medicare Annual Wellness Visits and is easy to repeat at annual reviews.
Which settings use the AD8?
- Primary care. Used during wellness visits to flag patients who may need a fuller cognitive workup.
- Geriatric clinics. Supports assessment of older adults who report memory, judgment, or daily-function concerns.
- Memory and neurology clinics. Serves as an initial screen before more detailed diagnostic testing.
- Community and telehealth screening. Can be completed in person or by phone, which supports remote outreach programs.
What does the AD8 measure?
The AD8 asks whether a person's everyday cognitive abilities have changed compared with their previous function. Because the instrument is licensed by Washington University, the questions are not reproduced here; the tool covers the following domains.
- Memory. Everyday recall and consistency in remembering recent information.
- Orientation. Awareness of dates and the ability to keep track of time.
- Judgment and problem-solving. Handling of decisions, finances, and everyday problems.
- Function and daily activities. Independence with hobbies, tasks, and routine responsibilities.
Scoring the AD8
- Number of items. Eight questions about change in cognitive function.
- Per-item scale. Each item is marked as a change (1 point) or no change (0 points); a "don't know" response is not scored.
- Total score range. 0 to 8, equal to the number of items marked as a change.
- Score direction. Higher scores indicate more reported change and a greater likelihood of cognitive impairment.
The AD8 is a screen, not a diagnosis. A positive result guides clinical decision-making and prompts follow-up with more detailed cognitive testing and clinical evaluation. Scores can be influenced by informant familiarity and by conditions such as delirium or depression, so results are interpreted alongside history and examination. The original validation cutoff of 2 or greater is the widely recognized threshold, though later studies have explored higher cutoffs for specific dementia criteria.
| Score | Interpretation | Suggested next step |
|---|---|---|
| 0 to 1 | Normal cognition | Routine monitoring |
| 2 to 8 | Possible cognitive impairment | Consider further assessment |
Best practices for administration
- Choose the right respondent. When possible, use an informant who knows the patient well; the patient can self-report if no informant is available.
- Anchor to change. Ask respondents to judge change compared with previous ability, not lifelong function.
- Pair with a performance test. Combine the AD8 with a brief cognitive test such as the Mini-Cog or MoCA for stronger screening.
- Repeat at intervals. Rescreen annually for adults 75 and older to track change over time.
- Keep administration consistent. Deliver it in person or by phone using the same wording each time.
How Zentake helps with the AD8
- Automatic scoring. Totals calculate on submit, with no hand-tallying.
- Longitudinal tracking. Re-send on a schedule and view change over time.
- Before the visit. Primary care practices can have patients complete it from home on any device so the clinician starts informed.
- HIPAA compliant. Data is encrypted, with a signed BAA on every plan.
References
The AD8 was developed and validated by Galvin and colleagues at Washington University School of Medicine (Neurology, 2005), which established the eight-item structure and the cutoff of 2 or greater for likely cognitive impairment. Licensing and scoring guidance are maintained by the Knight Alzheimer Disease Research Center at Washington University in St. Louis.
Additional psychometric and administration detail is summarized by the Hartford Institute for Geriatric Nursing Try This series, and a 2025 PLOS One re-evaluation reviewed AD8 cutoffs against DSM-5 dementia criteria.
Last updated: August 2026