If you work with older individuals, you may find some of these cognitive assessment tools to be useful. In general, you can quickly use these tools to determine if someone requires further assessment, but you may find the results sufficient for your purpose. This page has been updated: 35+ free cognitive tests, screeners, and questionnaires!
Free DIRECT download: 18 assessment tools for cognition (cheat sheet). (Email subscribers get free access to all the resources in the Free Subscription Library.)
Outline:
- Copyright and user requirements.
- Who uses these tools?
- Free cognitive assessment tools.
- Related Eat, Speak, & Think posts.
- Comment on other tools you know.
Copyright and user requirements
To the best of my knowledge it is fine to use these tools as long as you don’t modify the tool itself. I’ve made a careful effort to be sure that citations are included with each PDF. But if you have any concerns, try contacting the authors or publisher.
A quick word about user requirements. I don’t know if this is true for you as well, but in the past, I sometimes began using a new tool without reading about it. There are two commonly-used tests in particular that have user requirements that I didn’t know about until recently: the Montreal Cognitive Assessment (MoCA) and the SLUMS.
The MoCA now requires paid training and certification, mandatory as of 9/1/19. And the SLUMS requires free yearly video training.
Who uses these tools?
Most of these tools are meant to be used by trained health professionals. It is our responsibility to learn how to administer the tool and interpret the results. Some tools are designed to be taken by anyone, and I’ll point those out.
As always, if you have any concerns about your health or the health of a loved one, you should seek guidance from your doctor or seek an evaluation by a speech-language pathologist (SLP). Remember that these tools do not diagnose dementia or any other cognitive impairment.
Free cognitive assessment tools
BCAT Self-Assessment Tools
BCAT® Self-Assessment Tools Three self-quizzes anyone can take if they are concerned about cognition (thinking), driving, or using power wheelchairs. The score they receive indicates whether they should seek further help.
BCRS, FAST, and GDS
The Brief Cognitive Rating Scale (BCRS) and the Functional Assessment Staging (FAST) are designed to be used with the Global Deterioration Scale (GDS) to determine the stage of dementia that a person is in.
Barry Reisberg and colleagues designed these scales for use with people with primary degenerative dementia. You can use them to assist with ensuring that a person is living as independently as they are able, while planning for future needs.
Brief Evaluation of Executive Function
The Brief Evaluation of Executive Function consists of:
- Controlled Oral Word Association Test.
- Royall’s CLOX Clock Drawing task.
- The Trail Making Test Part B, Oral Version.
The Hartford Institute for Geriatric Nursing, New York University Rory Meyers College of Nursing explains these tasks and the rationales for each in the PDF. See their website for other tools in their Try This: ®Series.
Dementia Severity Rating Scale
The Dementia Severity Rating Scale was developed by Clark & Webank (1996) and updated by Webank et al (2009). You can administer this multiple-choice questionnaire to determine whether a person has a mild, moderate, or severe impairment. In addition, it can be used to predict rate of decline over time.
Functional Activities Questionnaire
The Functional Activities Questionnaire asks someone familiar with the individual to rate that person’s ability to handle 10 common activities. The resulting score indicates whether the person should seek further help. Pfeffer and colleagues developed the questionnaire in 1982. The Hartford Institute for Geriatric Nursing, New York University Rory Meyers College of Nursing published the PDF.
IQCODE
Anthony Jorm and colleagues published the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) in 1991. Anyone familiar with the individual can fill the questionnaire out.
The form asks you to compare the individual’s abilities today with how they were 10 years ago. You indicate how much the person has improved or worsened in 16 different areas, and the resulting score determines whether the person should seek further help.
Lawton-Brody IADL
You can use the Lawton-Brody Instrumental Activities of Daily Living Scale (IADL) with older adults in the community or in a hospital setting. The purpose is to establish a baseline of ability to perform daily activities and to document any decline over time.
You rate the patient or client in eight different activities: ability to use the phone, shopping, food preparation, housekeeping, laundry, transportation, medication management, and handling finances.
The scale was published in 1969 by MP Lawton and EM Brody. The attached PDF was published by The Hartford Institute for Geriatric Nursing, New York University Rory Meyers College of Nursing.
Mini MoCA Self Screen
BONUS: The Mini Self MoCA will be released soon. People who are concerned about their memory will be able to take this test and share the results with their doctor.
Neuro-QoL
Neuro-QoL is a great resource hosted by Northwestern University with many assessment tools to “quantify the physical, mental, and social effects experienced by adults and children living with neurological conditions.”
The print versions are free, while the computer based tools have a subscription fee.
To find free tools, use their “search & view measures” tool. For instance, if you select “cognition” as the domain and “fixed length short form” as the measure type, you will find 10 entries.
To obtain the form, click on the name and then click on the desired version under “View Measure.” Here you’ll find English and Spanish versions of the Neuro-QoL Short Form v2.0 and the scoring guide in three separate files. Published by the National Institute on Neurological Disorders and Stroke (NINDS).
SAGE
The Self-Administered Gerocognitive Exam (SAGE) is a test that anyone can complete and take to their doctor. Douglas Scharre developed it at Ohio State University Medical Center.
Short Blessed Test
The Short Blessed Test (also known as the Orientation-Memory-Concentration Test) is a sensitive screening tool used to detect cognitive impairment in older people in the community, in nursing homes, and in hospital settings. R. Katzman and colleagues developed it in 1983.
SLUMS
The Saint Louis University Mental Status Examination (SLUMS) is a valid, standardized tool used by a qualified health provider to “screen individuals to look for the presence of cognitive deficits, and to identify changes in cognition over time.” According to the Saint Louis University website, these professionals should complete the free video training on a yearly basis.
Iowa Trail Making Test
The Iowa Trail Making Test (TMT) assesses “visual search, scanning, speed of processing, mental flexibility, and executive functions.”
There are two parts. In the first part, the patient draws a line to connect numbered circles as quickly as they can. In the second task, they connect numbers and letters, starting with 1 and then A and then alternating between numbers and letters in ascending order, as fast as they can.
You can find norms for ages 18 to 89 for different education levels. The TMT has been around for quite a long time. A research article published in 1958 by Ralph Reitan cites three earlier studies and provided preliminary norms.
Related Eat, Speak, & Think posts
- 35+ free cognitive tests, screeners, and questionnaires.
- How to plan cognitive therapy with 6 questions.
- How to assess pragmatic skills in adults with brain injury.
- 3 versions of the Clock Drawing Test for cognition.
- Collaborative goal setting to identify meaningful cognitive goals.
Comment on other tools you know
I hope you’ll find these cognitive assessment tools useful. If you know of any other free resources for assessing cognitive or cognitive-communication skills in particular, please comment below. Please share this post with your SLP friends and colleagues.
Free DIRECT download: 18 assessment tools for cognition (cheat sheet). (Email subscribers get free access to all the resources in the Free Subscription Library.)
Lisa earned her M.A. in Speech-Language Pathology from the University of Maryland, College Park and her M.A. in Linguistics from the University of California, San Diego.
She participated in research studies with the National Institute on Deafness and other Communication Disorders (NIDCD) and the University of Maryland in the areas of aphasia, Parkinson’s Disease, epilepsy, and fluency disorders.
Lisa has been working as a medical speech-language pathologist since 2008. She has a strong passion for evidence-based assessment and therapy, having earned five ASHA Awards for Professional Participation in Continuing Education.
She launched EatSpeakThink.com in June 2018 to help other clinicians be more successful working in home health, as well as to provide strategies and resources to people living with problems eating, speaking, or thinking.
Someone on the Neurogenic Communication Disorders email forum (SIG 2) just mentioned that COMBI (Center for Outcome Measurement in Brain Injury) has a long list of assessment tools. If I counted right, there are 37.
COMBI lists each tool, references, description, and a PDF of at least some of the tools. You can find them here: http://www.tbims.org/combi/list.html
The National Alzheimer’s and Dementia Resource Center has a page with several assessment tools in PDF form as well as a list of validated measures. The page is here: https://nadrc.acl.gov/program-tools
The Alzheimer’s Association also provides several assessment tools (scroll down). https://www.alz.org/careplanning/overview.asp
The Australian Society for the Study of Brain Impairment offers 3 free assessment tools for download (one is for school-age children): https://assbi.com.au/Assessments-to-Download.
An SLP from the Medical SLP Forum Facebook group just told me about these cognitive screening tools:
ALS Cognitive Behavioral Screen (ALS-CBS). (Form can be found on search.) Poster with cut-offs here: bcm.edu/neurology-apps/pdf/poster_other_ALS-CBS.pdf
Edinburgh Cognitive and Behavioural ALS Screen (ECAS). https://ecas.psy.ed.ac.uk/ecas-international/ The UK version at least has been validated for Parkinson’s disease, Progressive Supranuclear Palsy, and Young Onset Dementia in addition to ALS.
The UK’s NHS has published a new cognitive assessment tool, the Free-Cog: https://www.gmmh.nhs.uk/free-cog
There’s a telehealth version as well.
According to the research study (available for free through the link above), they haven’t definitively defined a cut-off score. Table 3 on page 6 of the PDF lists different cut-off scores and the sensitivity and specificity associated with each one. Based on this information, I’m going to start off using 27 as a cut-off score. If you choose a different cut-off, I’d love to hear about it!
The University of Sydney offers cognitive diagnostic tests for clinicians:
https://www.sydney.edu.au/brain-mind/resources-for-clinicians/dementia-test.html
Thanks to the speech-language pathologist who shared the link with me!
Hi, can these tests be recreated on websites to be used by the general public? Or will it be considered copyright infringement?
Hi, I have the same concern, which is why I’m sharing links to where to find the tests in most cases instead of recreating them to share. I believe you would need to consult with an attorney or contact the owners of the tests directly before reproducing the tests and placing on your website, unless it was clear that permission was already given to share or the material is in the public domain.
I just came across the Parkinson’s Disease- Cognitive Rating Scale (PD-CRS). It’s a free assessment tool that allows you to separately score 9 different areas of cognition. It’s available in multiple languages.
https://www.movementscales.com/pd-crs-en-sp
You can use this tool to assess cognition in people who have Huntington’s disease, using the cut-offs from:
https://link.springer.com/article/10.1007/s00415-020-09730-6
I heard about this assessment tool from The Informed SLP. https://www.theinformedslp.com
Here is the PD-CFRS (Parkinson’s disease Cognitive Functional Rating Scale). 12 questions, multiple languages
https://www.movementscales.com/pd-cfrs-en-sp
The Oxford Cognitive Screener (OCS) and OCS-Plus are free to use. Currently normed and validated for people who have had a stroke.
https://www.ocs-test.org/
Clarification: the OCS and OCS-Plus are free for the UK English version, for publicly funded clinical and research use, with a fee for translated forms (including into American English)
The Quick Dementia Rating Scale – there is a patient version and an informant version. See PDFs at the end of this article: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0240422
The FEMAT (Functional External Memory Aid Tool) has 11 tasks for your patient to perform. Request access to the FEMAT here: https://sites.udel.edu/recall-lab/femat/
Open access paper: The Functional External Memory Aid Tool Version 2.0: A How-To Clinical Guide https://pubs.asha.org/doi/10.1044/2022_AJSLP-22-00178
Yet another find from The Informed SLP: The Roland Universal Dementia Assessment Scale (RUDAS), a culturally-robust cognitive screening tool.
https://www.dementia.org.au/resources/rowland-universal-dementia-assessment-scale-rudas