Americans want cognitive screening and cannot access it.
Source: AARP / RAND / GAO
Free · Caregiver-administered · Browser only
Dementia doesn't wait. Nor should you.
A free, three-gate cognitive screening protocol built from validated instruments. Caregivers use it to screen for dementia. The site generates a clinician-ready handoff packet — not a diagnosis, but the start of one.
The gap
24M
10M
7M
A diagnosable, treatable problem is going undiagnosed and untreated.
Adults over 65 living with mild cognitive impairment.
Source: Mattke et al. 2023
People who have dementia and don't know it.
Source: Mattke et al. 2023
Why screening doesn't happen
The reason is structural.
Primary care physicians have 15 minutes per visit, inadequate reimbursement for cognitive assessment, and no protocol for what happens after a positive screen. So screening doesn't happen.
That gap now has a price tag.
Two FDA-approved Alzheimer's treatments, lecanemab and donanemab, only work in early-stage disease. Once someone progresses past that window, they're no longer eligible.
Early detection of mild cognitive impairment is a medical necessity, not a preference.
The treatment window
Two drugs. One window. It closes.
Both anti-amyloid therapies are indicated only for patients in the MCI or mild-stage window. Late identification means ineligibility — permanently.
FDA approved · 2023
Lecanemab
brand: Leqembi · Eisai / Biogen
Anti-amyloid monoclonal antibody. Slows clinical decline in early Alzheimer's by clearing beta-amyloid plaques.
Window · MCI to mild AD
FDA approved · 2024
Donanemab
brand: Kisunla · Eli Lilly
Anti-amyloid monoclonal antibody. Once-monthly infusion targeting plaques in early symptomatic disease.
Window · MCI to mild AD
What this is
A free, three-gate screening protocol built from validated cognitive instruments.
First Signs Health does not diagnose dementia. It identifies people who need further evaluation — and gives them something specific to bring to their doctor.
How it works
Three gates. Designed to escalate only if needed.
Each gate uses validated public-domain instruments. Most people stop after Gate 1.
Gate 01 · Triage
Is there reason for concern?
~10 minutes · caregiver-administered
Two short tests check whether thinking and memory performance fall within expected ranges. If scores look normal, you skip to Gate 3 and check in every six months.
SLUMS
Short IQCODE
Gate 02 · Closer look
What kind, how severe?
~15 minutes · caregiver-administered
A longer assessment that maps which areas of thinking are affected and by how much. You'll get a score sheet that tells you how urgently to see a doctor — and gives that doctor something specific to work with.
ACE-III
5 cognitive domains
Gate 03 · Monitoring
Is anything changing?
~15 minutes · every 6 months · self-administered
A self-administered test you take on your own every six months to track changes over time. Four parallel forms prevent practice effects.
SAGE
4 parallel forms
Honest scope
What this screener does not do.
A clear-eyed list of boundaries. This is an upstream tool, not a diagnostic.
Diagnose any conditionNo.
FDA-clearedNo.
Replace clinical evaluationNo.
Collect, store, or sell your dataNo.
Give your doctor a better starting point than "I'm worried about my memory."Yes.
You don't need permission to start.
Set aside 20 minutes. Sit with the person you're worried about. Begin Gate 1.
Start the screener