SAGE Test to Detect Alzheimer’s and Dementia

If you're concerned about your memory (or that of a loved one), you might want to take the Self-Administered Gerocognitive Exam (SAGE). The test was developed by researchers at The Ohio State University Wexner Medical Center as a tool to detect early signs of cognitive (memory or thinking) impairments.It can accurately identify early symptoms of Alzheimer’s and dementia.

An older person taking a cognitive test at home
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What Is the SAGE test?

SAGE is a self-administered test available online. It has been scientifically evaluated in comparison with other common dementia tests and has been found to be an accurate tool to identify signs of memory and thinking impairment. While not meant to replace a clinical assessment, the SAGE test can be helpful in identifying cognitive losses earlier, when treatment may be most effective.  

The SAGE test contains a series of questions that measure cognitive functioning. There are actually four different tests to choose from, and they are all interchangeable. If you took all four (you only need to take one), you should score essentially the same on each test. The different options are available to reduce the chances of inaccurate scoring that can result from re-taking the same test too frequently.

SAGE Test Sample Questions

Here are examples of three questions you might encounter on the SAGE test:

  1. You are purchasing $13.45 worth of groceries. How much change would you receive back from a $20 bill?
  2. Draw the face of a clock and put in the numbers. Position the hands for 5 minutes after 11 o'clock, On your clock, label the long hand with an "L" and the short hand with an "S."
  3. Write down the names of 12 different animals.


How to Take It

Unlike other tests that charge a fee per use or require significant training for those who administer them, the SAGE test is both freely available and user-friendly. It can be taken in as little as 10 to 15 minutes (although there is no time limit).

It's available online and in print versions you can access by going to The Ohio State University Wexner Medical Center site. You can take the test at any time on your own, or it may be administered by a healthcare provider.

How It Works

The SAGE test measures:

  • Orientation (month, date, and year)
  • Language (verbal fluency and picture naming)
  • Reasoning and simple math skills
  • Visuospatial orientation
  • Executive function
  • Memory

There is a maximum score of 22 on the SAGE test. Researchers suggest adding one point to the score when the participant is over the age of 80, and another point if the participant has fewer than 12 years of education.

SAGE Scoring

  • Scores of 17 to 22 are within the normal range.
  • Scores of 15 to 16 indicate likely mild cognitive impairment.
  • Scores of 14 and below indicate a more serious cognitive problem.

How Accurate Is It?

SAGE test scores are considered an accurate indicator of the symptoms of dementia, suggesting that the SAGE test is a reliable instrument for detecting cognitive impairment. In studies, it compares favorably with the Mini-Mental State Exam (MMSE), a standard exam for testing cognitive ability that must be administered by someone else.

In terms of accuracy in diagnosing dementia, the SAGE test has higher sensitivity than the MMSE (95% vs. 90%) as well as higher specificity (79% vs. 71%).

Sensitivity refers to a test's ability to correctly identify a disease, while specificity refers to a test's ability to correctly identify those without a disease.

When to See Your Healthcare Provider

After taking the SAGE test at home, it's important to bring a copy to your healthcare provider for evaluation. While the SAGE test does not diagnose any specific condition, the results can help your healthcare provider know if further evaluation is needed and provide a baseline score to compare with future scores.

Healthcare provider evaluation is recommended for anyone scoring below 17 points on the SAGE test.

Frequently Asked Questions

Who can take the SAGE test?

Anyone can take the SAGE test free of charge, whenever it's convenient. The test can be downloaded online.

How many points are possible on the SAGE test?

The highest possible score on the SAGE test is 22. Add one additional point if the person taking the test is 80 or older, and one point if they have fewer than 12 years of education.

What does my SAGE test score mean?

Scores between 17 and 22 are within the normal cognitive range; 15 and 16 suggest likely mild memory or thinking impairments; 14 and below indicate a more severe memory or thinking condition. Healthcare provider evaluation is recommended for anyone scoring below 17.

A Word From Verywell

The SAGE test is a convenient way to assess your cognitive function if you are concerned about your memory, word-finding abilities, or other cognitive skills. However, it's important to show your healthcare provider your results so that they can be interpreted accurately.

Early detection of cognitive concerns can identify possible reversible causes of forgetfulness and also allows for earlier and hopefully more effective treatment if dementia is present.

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Article Sources
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  1. Ohio State University Wexner Medical Center. SAGE: A test to detect signs of Alzehimer's and dementia.

  2. SAGE Advice: Helping Patients Spot AD Earlier. A Q&A with Douglas Scharre, MD. Practical Neurology. Published April 2014.

  3. Scharre DW, Chang SI, Nagaraja HW, et al. Community cognitive screening using the Self-Administered Gerocognitive Examination (SAGE). J Neuropsychiatry Clin Neurosci. 2014;26(4):369-375. doi:10.1176/appi.neuropsych.13060145

  4. Self-Administered Gerocognitive Examination-SAGE Test 1.

  5. The Ohio State University Wexner Medical Center. Explanation of SAGE Scoring.

  6. Scharre DW, Chang SI, Murden RA, et al. Self-administered gerocognitive examination (SAGE): a brief cognitive assessment Instrument for mild cognitive impairment (MCI) and early dementia. Alzheimer Dis Assoc Disord. 2010;24(1):64-71. doi:10.1097/WAD.0b013e3181b03277