SAGE Test: Detecting Early Signs of Alzheimer's Disease

Introduction to the SAGE Cognitive Test

The Self-Administered Gerocognitive Examination, also known as the SAGE test, is meant for at-home administration by older adults in order to test the strength of their memory and other cognitive functions. It was originally designed by researchers at Ohio State University's Wexner Medical Center. Dr. Douglas Scharre from the Wexner Medical School created the test and published it in early 2014. Essentially, it is "designed to detect early signs of cognitive, memory or thinking impairments" (Scharre, 2014). It is meant for individuals to self-administer at home when they feel worried about losing cognitive functioning, which can be a sign of early Alzheimer's disease or dementia.

The test takes roughly 15 minutes to complete and can be used as a way to start a dialogue with one's physician regarding the potential for such conditions and how individuals can begin treating and preparing for them early on. The test is meant to warn individuals and their physicians of possible issues related to the early onset of Alzheimer's or dementia, as well as a variety of other conditions known to impact cognitive functioning, such as mild strokes and thyroid conditions. The research suggests that the "SAGE can be a helpful tool to assess if further evaluation is necessary" (Scharre, 2014). It is an easy-to-use cognitive test that can identify red flags suggesting the need for further evaluation.

Structure and Content of the SAGE Test

The test itself is deceptively simple and can be printed out and taken at home by individuals potentially worried about their cognitive functioning. It is designed for senior citizens, normally those 65 years of age and older. It features a total of 22 questions that are completed in writing by the test takers (Alzheimer's & Dementia Weekly, 2014). Questions include prompts such as "What is today's date?", "How many nickels are in 60 cents?", and "Write down the names of 12 animals." These questions are answered by hand and often require short written responses and even drawings meant to replicate normal everyday concepts and objects.

The bulk of these 22 questions are designed to measure language skills, orientation, calculation capabilities, spatial skills, problem-solving, and memory (Scharre et al., 2014). The SAGE was carefully designed to represent areas of cognitive functioning that are typically placed at greatest risk during the early stages of Alzheimer's and various forms of dementia. After the test is completed, the individual is prompted to bring the results to their physician in order to compile a more accurate score. There is therefore an increased sense of reliability built into the test's scoring methodology, because results are interpreted by trained physicians who can determine whether additional cognitive evaluations are needed (Scharre, 2014). The research explains that "missing up to six points or more on the test means there should be additional medical follow-up" (Huffington Post, 2014). Such low scores indicate that further evaluations are warranted and that physicians should begin looking more intensively for early signs of cognitive problems associated with Alzheimer's and dementia.

References

Alzheimer's & Dementia Weekly. (2014). SAGE pen and paper Alzheimer's test. News. http://www.alzheimersweekly.com/2013/02/sage-pen-paper-alzheimers-test.html

Scharre, Douglas W. (2014). SAGE: A test to measure thinking abilities. Wexner Medical Center, Ohio State University. http://medicalcenter.osu.edu/patientcare/healthcare_services/alzheimers/sage-test/Pages/index.aspx

Scharre, D. W., Chang, S. I., Nagaraja, H. N., Yager-Schweller, J., & Murden, R. A. (2014). Community cognitive screening using SAGE. Journal of Neuropsychiatry and Clinical Neuroscience, 0(0).