Cognitive Decline Risk Assessment Quiz | Center For Functional Medicine

1. Have you noticed changes in memory over the past 3 years?

No noticeable change Mild occasional forgetfulness Frequent forgetfulness Increasing difficulty remembering conversations or events

2. Do you experience brain fog or difficulty concentrating?

Rarely Occasionally Frequently Almost daily

3. Has anyone in your family been diagnosed with Alzheimer's disease or dementia?

No Yes — distant relatives Yes — parent or sibling

4. Do you experience any of the following metabolic risk factors? (check all that apply)

prediabetes or diabetes weight gain around the abdomen high cholesterol high blood pressure

5. How would you rate your sleep quality?

Excellent Good Fair Poor or frequently interrupted

6. Do you experience digestive issues such as: (Gut health strongly influences brain health.)

7. How often do you experience mental fatigue or lack of focus?

rarely occasionally frequently daily

Cognitive Risk Assessment Quiz