First Signs

Dementia doesn't wait. Nor should you.

Three-Stage Cognitive Screening Pathway

Before You Begin

This tool walks you through a validated three-stage cognitive screening pathway. It is designed to be completed by the patient (Stage 1) and by a caregiver or family member guiding the patient through Stages 2 and 3.

The full pathway takes approximately 15–20 minutes. Not every patient will need all three stages. The tool will guide you based on results.

Important: This tool does not diagnose dementia. It identifies individuals who may benefit from further clinical evaluation. All results should be reviewed by a healthcare provider.

Patient Education Level

This is needed to interpret scores accurately. The patient's highest level of education completed:

Stage 1 of 3

Subjective Cognitive Decline

SCD-Q MyCog — Self-Report Questionnaire

Pre-Screening Questions

Ask the patient (or have them read) the following three questions. These are not scored but help frame the assessment.

a) Do you perceive memory or cognitive difficulties?

b) Would you ask a doctor about these difficulties?

c) In the last two years, has your cognition or memory declined?

Stage 1 Results

SCD-Q MyCog Results

Stage 2 of 3

Cognitive Assessment

SLUMS Examination + Clock Drawing Test

Caregiver Instructions

You will now guide the patient through a series of cognitive tasks. Read each instruction aloud, exactly as written. Do not help the patient with answers, but you may repeat instructions once if asked.

You will need: a pen or pencil, blank paper, and a watch or timer (a phone timer works).

Make sure no clock is visible to the patient during this section.

Clock Drawing Test — Shulman Scoring

The patient drew a clock during the SLUMS tasks above. Now score that same clock drawing using the Shulman scale below. Look at the clock the patient drew and select the description that best matches it.

Stage 2 Results

SLUMS + CDT Results

Stage 3 of 3

Confirmatory Screen

Short IQCODE + Mini-Cog™

Caregiver Instructions

Stage 3 has two parts. Part A is a questionnaire for you, the caregiver, about changes you have observed in the patient over the last 10 years. Part B is a brief test for the patient involving word recall and clock drawing.

Total time: approximately 8–12 minutes. You will need: blank paper and a pen or pencil for Part B.

Make sure no clock is visible to the patient during Part B of this test.
Stage 3 Results

IQCODE + Mini-Cog™ Results

Complete

Screening Summary