Early Memory & Cognitive Health Screening
A free, validated screening questionnaire to help you or a loved one check everyday memory changes—and generate a 2-page report ready for your doctor.
Over half of adults noticing memory decline have never mentioned it to a healthcare provider.
Average wait time between first noticing cognitive changes and receiving a medical evaluation.
Early mild cognitive changes are frequently missed in rushed 15-minute routine checkups.
Page 1 gives you a plain-English summary. Page 2 provides clinical scores for your physician.
How CogniGlass Works in 3 Simple Steps
Designed for effortless reading, zero medical jargon for you, and complete clinical precision for your doctor.
Choose Who It Is For
Select "For Myself" (which includes 18 everyday questions plus 3 short word-memory, date, and sequence activities) or "For a Loved One" (an observational questionnaire for a spouse, parent, or relative).
Check Everyday Routines & Health Factors
Move one card at a time at your own pace. Along with everyday memory and routine questions, we check for common sleep aids, allergy pills, and health conditions (like sleep quality, thyroid, or hearing) that can cause reversible "brain fog."
Print or Save Your 2-Page Report
Receive your results immediately with no sign-up or email required. Keep Page 1 for yourself and hand Page 2 directly to your primary care doctor/specialist at the start of your next appointment.
Ready to begin? Choose a mode to jump right in:
Validated Alzheimer's & Dementia Screening Instruments Used
To eliminate redundant questions while giving physicians comprehensive data for Alzheimer's and Mild Cognitive Impairment (MCI) risk assessment, our 18-item questionnaire and 3 brief activities compute scores across 6 established clinical tools:
1. Washington Univ. AD8 (0–8)
An 8-item change screen developed at Washington University in St. Louis that detects early intra-individual change in memory, orientation, judgment, and daily hobbies (clinical cutoff ≥ 2).
2. ADCS CFI (0.0–14.0)
The 14-item Cognitive Function Instrument developed by the Alzheimer's Disease Cooperative Study to capture subtle, early subjective cognitive drift before formal testing turns abnormal (cutoff ≥ 4.0).
3. Pfeffer FAQ (0–30, Prorated)
The 10-item Functional Activities Questionnaire measuring independence in complex daily tasks (finances, forms, shopping, meal prep, travel), including proration for tasks never performed historically (cutoff ≥ 9).
4. Buschke MIS Cued Recall (0–8)
Uses 4-word controlled learning and delayed category-cued recall from a 160-word bank to help physicians distinguish general retrieval slowing (which improves with hints) from true encoding deficits.
5. Temporal Orientation (0–4)
Standardized 4-item time orientation assessment (Year, Month, Date of Month with ±1 day tolerance, and Day of the Week) modeled on the MMSE and 6-CIT subtests.
6. Digital Trail-Making A & B
Measures Part A motor tapping speed (1–5) and Part B alternating executive switching (1-A-2-B-3-C-4-D-5-E), subtracting baseline motor speed so physical arthritis or tremor is not mistaken for cognitive slowing.
Privacy, Ethics & Non-Diagnostic Notice
100% Private & Anonymous: CogniGlass never asks for your name, email address, phone number, street address, or birth date. Your 2-page report is generated directly in your browser. If you optionally leave the research box checked on the setup screen, only de-identified numeric scores are contributed to our public-health research cohort.
Communication Aid, Not a Diagnosis: CogniGlass is designed to organize observations and performance metrics for a primary care physician, geriatrician, or neurologist. It does not replace a formal medical evaluation.
Medical & Legal Disclaimer: CogniGlass, its creator, and everyone associated with this project are not licensed healthcare providers and assume no medical, clinical, or legal responsibility or liability for any health decisions, interpretations, diagnoses, treatments, or outcomes resulting from the use of this website or its generated reports. This questionnaire is strictly an informational and self-advocacy tool to assist in conversations with your physician, and does not establish a doctor-patient relationship. Always consult a qualified healthcare professional regarding any cognitive or medical concerns, and seek immediate emergency care (call 911) if you or a loved one experience sudden or acute neurological changes.