McNair and Kahn Cognitive Dysfunction Scale, CDS Test - the question form
Questions: 24 · 5 minutes
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1. I forget telephone numbers.
Never
Rarely
Sometimes
Often
Very often
2. I forget what I have put where.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
3. After putting down a book, I cannot find the place where I left off.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
4. I need to make a to-do list so that I do not forget anything.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
5. I forget scheduled appointments.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
6. I forget what I planned to do on my way home.
Never
Rarely
Sometimes
Often
Very often
7. I forget the names of old acquaintances.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Very often
8. I have difficulty concentrating.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Very often
9. I have difficulty summarizing the content of a TV program.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
10. I do not recognize people I know.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
11. I have difficulty understanding what people are saying.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
12. I quickly forget the names of people I meet.
Never
Rarely
Sometimes
Often
Very often
13. I forget what day of the week it is.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
14. When someone is talking, I cannot concentrate.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
15. I double-check whether I have locked the door and turned off the stove.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Very often
16. I make mistakes when I write.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
17. I am easily distracted.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Very often
18. Before starting a new task, I need to be instructed several times.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Very often
19. I have difficulty concentrating when I read.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Very often
20. I immediately forget what I have been told.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
21. I have difficulty making decisions.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
22. I do things very slowly.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
23. My mind goes blank.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
24. I forget what today’s date is.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
1. I forget telephone numbers.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
2. I forget what I have put where.
Never
Rarely
Sometimes
Often
Very often
3. After putting a book down, I cannot find the place I was reading.
1 - Never
2 - Rarely
3 - Sometimes
4 - Often
5 - Very often
4. I need to make a list of things to do so that I do not forget anything.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
5. I forget scheduled appointments.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
6. I forget what I planned to do on the way home.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
7. I forget the names of people I have known for a long time.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
8. I have difficulty concentrating.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
9. I have difficulty retelling the content of a TV program.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
10. I do not recognize familiar people.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
11. It is hard for me to understand what other people are saying.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
12. I quickly forget the names of people I meet.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
13. I forget what day of the week it is.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
14. I cannot concentrate when someone is talking.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
15. I double-check whether I have locked the door and turned off the stove.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
16. I make mistakes when writing.
Never
Rarely
Sometimes
Often
Very often
17. I am easily distracted.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
18. Before starting a new task, I need to be instructed several times.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
19. I have difficulty concentrating when I read.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
20. I forget what I have been told right away.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
21. I have difficulty making decisions.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
22. I do everything very slowly.
Never
Rarely
Sometimes
Often
Very often
23. My mind sometimes goes blank.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often
24. I forget what today’s date is.
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Very often