The AD8 (Ascertain Dementia 8-item Questionnaire) is a brief screening interview developed by James E. Galvin and colleagues at Washington University in St. Louis to differentiate normal aging from mild dementia. Published in 2005, it consists of 8 items assessing intra-individual change across memory, orientation, judgment, and function (Galvin et al., Neurology, 2005). The score ranges from 0 to 8, with a cutoff of 2 or more indicating possible cognitive impairment. The AD8 demonstrates strong psychometric properties with sensitivity exceeding 84%, specificity above 80%, and an area under the curve of 0.908. Zentake's digital version allows clinicians to administer and auto-score the AD8 in a HIPAA-compliant environment.
The AD8 uses a simple summative scoring method. The respondent — either an informant (spouse, adult child, caregiver) or the patient — answers each of the 8 items with "Yes, a change," "No, no change," or "N/A, don't know." Only "Yes, a change" responses are counted. The total score is the number of items marked "Yes, a change," yielding a range of 0 to 8 (Galvin et al., Neurology, 2006).
Some studies suggest a cutoff of 4 may reduce false positives in certain populations, though the standard clinical cutoff remains 2. The AD8 is a screening tool and is insufficient to diagnose a dementing disorder on its own. Zentake automatically calculates the AD8 score upon form submission, flagging results that meet or exceed the clinical threshold for follow-up.
Step 1: Select the respondent. The AD8 can be completed by an informant who knows the patient well (preferred) or by the patient directly. Zentake supports both administration modes, allowing you to send the form to a caregiver's email or administer it in-office on a tablet.
Step 2: Present the 8 items. Each item asks whether the patient has experienced a change in a specific cognitive or functional domain compared to their previous level. Zentake displays items in a clear, accessible format optimized for older adults and caregivers.
Step 3: Record responses. The respondent selects "Yes, a change," "No, no change," or "N/A" for each item. Zentake's digital form enforces complete responses and prevents submission errors.
Step 4: Review the auto-calculated score. Zentake instantly sums the "Yes" responses and displays the total score alongside the clinical interpretation. Scores of 2 or higher are flagged automatically.
Step 5: Document and follow up. Zentake sends the completed AD8 score and responses directly to your EMR. For patients scoring 2 or higher, the system can trigger a follow-up workflow recommending comprehensive cognitive evaluation.
Scoring: Paper AD8 forms require manual counting of "Yes" responses. Zentake auto-scores instantly and flags results above the clinical threshold.
Completion: Paper administration takes approximately 3 minutes. Zentake's digital version takes 2–3 minutes with guided prompts that reduce respondent confusion.
Delivery: Paper forms must be handed to the informant or patient in person. Zentake can send the AD8 via email, text, or patient portal before the appointment.
Data Storage: Paper forms are filed in physical charts and difficult to retrieve for longitudinal review. Zentake stores all submissions securely in encrypted, HIPAA-compliant cloud storage.
Longitudinal Tracking: Comparing paper AD8 scores over time requires manual chart review. Zentake displays score trends in a dashboard, making it easy to detect cognitive decline across visits.
Security: Paper forms risk loss, damage, or unauthorized access. Zentake uses end-to-end encryption and role-based access controls.
Integration: Paper scores must be manually transcribed into the EMR. Zentake integrates directly with systems like Elation, automatically sending scores and flagged results.
Cost: Paper forms require printing and storage. Zentake eliminates these costs with unlimited digital submissions.
What does the AD8 measure?
The AD8 measures intra-individual change across eight cognitive and functional domains including memory, orientation, judgment, problem-solving, community affairs, home activities and hobbies, and personal care. It is designed to detect early signs of dementia by comparing current function to previous levels of ability. Zentake's digital version captures these changes systematically for clinical documentation.
How do you score the AD8?
Count the number of items answered "Yes, a change." The total score ranges from 0 to 8. A score of 0–1 indicates normal cognition, while a score of 2 or higher suggests possible cognitive impairment warranting further evaluation. Zentake auto-calculates this score and highlights results above the cutoff.
How long does the AD8 take to complete?
The AD8 takes approximately 3 minutes to complete, making it one of the fastest validated dementia screening tools available. It can be administered in person, over the phone, or digitally through Zentake before the patient's appointment.
Is the AD8 free to use?
The AD8 is a copyrighted instrument of Washington University, St. Louis, Missouri. Washington University grants permission to use and reproduce the AD8 without modification solely for clinical care and non-commercial research. Zentake provides a licensed digital version ready for immediate clinical deployment with a free trial.
What age group is the AD8 designed for?
The AD8 was developed and validated primarily in older adult populations, typically aged 65 and older, though it can be used in younger adults when early-onset dementia is suspected. It has been validated across diverse populations and in multiple languages. Zentake's digital form can be used for any adult patient undergoing cognitive screening.
Who should administer the AD8?
The AD8 can be administered by any healthcare professional, including physicians, nurse practitioners, physician assistants, nurses, and social workers. It was originally designed as an informant-completed questionnaire but has also been validated for self-administration by the patient. No specialized training is required. Zentake's interface guides both clinicians and respondents through the process.
Can the AD8 be completed by the patient instead of an informant?
Yes. While the AD8 was originally validated as an informant-based interview, subsequent studies have confirmed its validity when completed directly by the patient. However, informant-based administration is generally preferred when a reliable informant is available, as it may provide more accurate assessment of functional change. Zentake supports both administration modes.
What types of dementia does the AD8 detect?
The AD8 is sensitive to early cognitive changes associated with multiple dementing illnesses, including Alzheimer's disease, vascular dementia, Lewy body dementia, and frontotemporal dementia. It assesses broad functional change rather than testing a single cognitive domain, making it effective across etiologies.
1. Galvin JE, Roe CM, Powlishta KK, et al. The AD8: a brief informant interview to detect dementia. Neurology. 2005;65(4):559-564.
2. Galvin JE, Roe CM, Coats MA, Morris JC. Patient's rating of cognitive ability: using the AD8, a brief informant interview, as a self-rating tool to detect dementia. Archives of Neurology. 2007;64(5):725-730.
3. Galvin JE, Roe CM, Xiong C, Morris JC. Validity and reliability of the AD8 informant interview in dementia. Neurology. 2006;67(11):1942-1948.
Last updated: March 2026
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