Question-and-answer tests can help tell if someone is developing Alzheimer’s disease or a related dementia. When given at home, these tests are best for deciding whether to seek a professional diagnosis. If your loved one seems more forgetful, taking the test can tell you whether or not to make an appointment with the doctor. In the doctor’s office, or other clinical setting, tests help medical professionals study and diagnose these diseases.
Formal tests don’t only say whether someone has dementia, they also help identify the specific type and its severity or stage of dementia. This information can be crucial for treatment, because while there is no cure for dementias including Alzheimer’s, symptoms like forgetfulness can be improved and quality of life can be boosted.
Several online tests can help families come closer to knowing whether a loved one suffers from Alzheimer’s disease or a related dementia. To be clear, these tests are not designed to give a diagnosis of Alzheimer’s. A diagnosis requires several medical experts, as well as expensive technology and potentially unpleasant procedures such as brain scans and spinal fluid extractions. Recent studies, in fact, have shown that dementia is often misclassified when using only the following tests.
A certain degree of forgetfulness is common to most aging individuals. Mild Cognitive Impairment (MCI) is a condition which is more severe than normal memory decline associated with aging, but not so severe as Alzheimer’s. Online tests for dementia/Alzheimer’s should be adequate to help families distinguish between these conditions.
Before discussing the various options available to self-administer an Alzheimer’s test from the Internet, some words of caution are advised.
1. No online test can definitively tell if your loved one has Alzheimer’s. Do not believe any website saying otherwise.
2. There are many free tests, available online, produced by universities, nonprofits and reputable medical institutions. It is strongly recommended that one use the following links to find one of these tests. Do not pay for an Alzheimer’s test advertised online; more than likely, these paid tests are not valid and can possibly be scams.
3. Some online tests are simply advertisements for brain-training products masking as tests. They still may be valid, but users should be aware if the test provider is trying to sell a product or service.
The Clinical Dementia Rating (CDR) test was originally designed to be administered by a trained professional. However, the level of expertise required to administer the test has been modified so that a family member or someone familiar with the individual can answer 6 questions about the person’s mental acuity and receive an immediate result. To be clear, this test questions caregivers not individuals with symptoms.
Taking the modified CDR Test only takes about 3 minutes and requires no personal information. Obviously, this does not provide a definitive diagnosis, but it helps determine if additional steps are necessary. Of the tests described here, this is fastest and easiest for family members to undertake.
SAGE stands for Self-Administered Gerocognitive Examination, and while it is not exactly self-administered, it does not require a doctor. This is the gold standard of Alzheimer’s tests on the Internet, developed by the Department of Neurology at Ohio State University. Again, it will not result in a diagnosis of Alzheimer’s, but is found to be 95-percent effective at identifying persons with memory challenges. The test itself is meant to be downloaded, printed and taken either alone or with the help of a loved one. The results are best interpreted by a medical professional, but the scoring instructions are also available online and they are not especially challenging. In short, a family member can give this test to their loved one and accurately understand the results without a medical professional. The SAGE takes approximately 10-20 minutes to complete, and the scoring process takes only 5-10 minutes.
The Mini-Cog differs slightly from the SAGE Test in that a test administrator is required and plays an active role. However, only about five minutes are required to administer the test and only one minute is needed to score it and interpret results. The test administration role is not challenging, and any healthy adult can serve in that role, no medical training required. Instead of a series of questions, the test requires the subject to listen to three unrelated words, draw a clock, and then repeat the words. The results do not diagnose dementia but permit the administrator to know if further action is necessary. It is important that only the administrator view this document, not the test taker.
Included as a portion of the SAGE and Mini-Cog evaluations above, the clock test can stand alone and be evaluated by a loved one, rather than a medical professional, because it’s so simple. A person suspected of possible dementia is asked to draw an analog clock, the kind with an hour hand and minute hand. Sometimes, the circle is provided. The person being tested is usually asked to draw the numbers and hands so the clock shows a specific time (most commonly 10 minutes after 11).
Scoring can be elaborate—with points for every number correct, the two hands, and the accuracy of the time—but the Alzheimer’s Association recommends simple scoring, saying that a normal clock indicates an absence of dementia and an abnormal clock suggests further testing is necessary.
While the Mini-Mental State Exam was originally meant to be administered by medical professionals, it is also possible for loved one to administer the MMSE at-home and interpret the results. Knowing an approximate MMSE score is valuable to family members even if the score is not entirely accurate. Read more about taking the MMSE at home.
This test is not very practical, but it’s interesting. The person being tested plugs one nostril closed, and an open jar of peanut butter is held about 30 centimeters away. The peanut butter is slowly brought closer, in about 1-centimeter increments, until it can be smelled. Then the test is repeated with the opposite nostril plugged. Because the left half of the frontal lobe is affected by Alzheimer’s, someone with the disease will not be able to smell with their left nostril as well as their right. The peanut butter, therefore, is closer to the left nostril when the person can smell it. Studies have shown the test has merit, but loss of smell is common for people as they age, and one nostril can be more plugged than the other for reasons having nothing to do with dementia (like allergies). It is not advised that people do the peanut butter test at home, although it may be amusing, and it probably won’t be part of a professional diagnosis.
The Montreal Cognitive Assessment is also 30 questions, like the MMSE above, and takes about 10 minutes. The MoCA includes the Clock Drawing Test and also has questions and small tasks to assess someone’s understanding of time and place, as well as their short-term memory and ability to concentrate. MoCA is similar to the MMSE but about 30 years newer. Studies have shown MoCA is more reliable for identifying dementia, and better at identifying early-stage dementia or mild cognitive impairment. The MoCA is also better at indicating dementia in people with Parkinson’s disease. The test is meant to be administered and scored only by a doctor, and is harder to find online than the MMSE.
The Mini-Mental State Exam is the most common tool for assessing the severity of a person’s Alzheimer’s. The test has 30 questions and takes about 10 minutes to finish. Questions cover orientation (knowing the time and place), short-term memory, attention and ability to solve problems, language (identifying common objects by name), and comprehension and motors skills. The test-taker is asked to answer questions and also draw slightly complicated shapes. The MMSE is more than 40 years old and is widely used by doctors and clinicians studying dementia, but it is not as reliable as other tests on this page for determining whether someone has dementia. Studies have shown that it is better at ruling out dementia than telling someone that they have it. It is also not reliable for identifying mild cognitive impairment, or someone in the very early stages of Alzheimer’s or another dementia.
While originally designed to be administered by medical professionals, family members can now administer the MMSE using their phone or laptop and receive accurate scoring results. Start here.
The St. Louis University Mental Status Examination consists of 11 questions and is graded with a maximum of 30 points. It was developed as an alternative to the more common MMSE. The test is brief, usually taking around eight minutes, but slightly harder than the MMSE and better at identifying mild cognitive impairment or dementia in very early stages. Like other tests above, the SLUMS includes the Clock Drawing Test. It also has math, memory, and orientation questions. The last part is a very short story, which the subject listens to before answering simple questions like “What was the character’s name?” The test is available online, but is intended to be administered and scored by a health professional, so you should probably not try it at home.
|Types of Online, At-Home and Clinical Dementia & Alzheimer’s Tests (Updated May 2020)|
|Test||Take at home or in doctor’s office?||Time required||Number of questions||Accuracy||Important fact|
|Modified CDR||At home||3 minutes||6||Studies called the CDR a reliable test, especially useful for assessing change over time.||Questions are basic enough to be answered by a friend or loved one familiar with the test subject.|
|The Self-Administered Gerocognitive Exam (SAGE)
|At home||10-20 minutes||12||95% effective at identifying dementia, according to studies.||Probably the best test a person can take at home to identify possible dementia.|
|Mini-Cog||At home||5 minutes||2||About 75% effective at identifying dementia, according to studies.||Extremely basic and easy-to-administer, with a memory element on top of the CDT.|
|The Clock Drawing Test||At home||3-5 minutes||1||The dementia community, including the Alzheimer’s Association, widely agrees the CDT is a useful step toward diagnosis.||The simplest of any of these tests. The visual impact of a poorly drawn clock can be powerful for loved ones.|
|The Mini-Mental State Exam (MMSE)||Doctor’s office or home||10 minutes||30||The MMSE is widely used, but studies show it is better for ruling out dementia than telling someone whether they have it. Also used as an input in a dementia life expectancy calculator.||Not sensitive to mild cognitive impairment. The test can be found online and taken at home, but this is not advised.|
|The Montreal Cognitive Assessment (MoCA)||Doctor’s office||10-15 minutes||30||The MoCA is a newer test than the MMSE and is found better at identifying dementia (about 94 percent accurate).||More sensitive to mild cognitive impairment than the MMSE.|
|The St. Louis University Mental Status Examination (SLUMS)||Doctor’s office||7-10 minutes||11||SLUMS has shown sensitivity to mild cognitive impairment, like the MoCA, but has not been studied as much as other tests on this list to determine reliability.||Shorter than other tests taken in doctors’ offices. Not as widespread but probably reliable.|
Aside from online tests, it is worth mentioning both blood tests and genetic tests. Currently, a definitive blood test does not exist for the US market. However, there have been some positive developments on this front and now blood tests in the US market are expected within 3 – 5 years.
Genetic testing does exist but does not provide a definitive answer as to whether someone has Alzheimer’s or dementia. Instead, genetic tests are helpful in telling individuals if they have a propensity to develop dementia based on their genetic makeup. A medical evaluation from a doctor (or more likely several doctors) is currently the only way for an individual to receive an Alzheimer’s or dementia diagnosis. Read more about blood tests, genetic tests and the process of receiving a medical diagnosis.