How Accurate Is the Online SAGE Dementia Test?

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People often want to know if they can just take a test at home to assess their cognitive functioning. If you're concerned about your memory (or that of your loved one) and want to briefly evaluate your thinking ability, this test is for you. It's called the SAGE (Self-Administered Gerocognitive Exam) test and was developed by the Ohio State University Wexner Medical Center.

This online, at-home, self-screening dementia tool has been scientifically evaluated, and it's demonstrated good results in accurately identifying cognitive deficits.

Overview

The SAGE test contains a series of questions that assess your cognitive functioning. There are actually four different tests from which you can choose, 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.

Four different tests allow you to be able to take more than one test over time. For example, you could take the test annually for four years in a row. Different tests reduce the chance of inaccurate scores that can result from "practicing" the same test multiple times.

The SAGE test involves questions in several different areas, including:

Prior to the test, there should be a review of your medical history to better contextualize the results. If the test is taken at home, the results should be shared with your doctor who can review your symptoms and medical history.

The SAGE is available in English (United States), English (New Zealand), Dutch, Spanish, Italian and Croatian. A digital version of the SAGE test is also available and has been shown to produce similar scores in participants of a research study designed to test its validity.

Procedure

Unlike other tests that charge a fee per usage or require significant training for those who administer them, the SAGE test is free to use and does not require any training to administer.

You can find the SAGE test here: Ohio State University's SAGE Test. On this website, there is an option available to download the test. You can then print the test out and complete it with a pen or pencil. Most people complete the test within 15 minutes, but there is no time limit.

Physician follow-up is recommended if you take the SAGE test at home. Without a review of your medical history and current symptoms, the test is less able to provide an insightful result.

Scoring

There is a maximum score of 22 on the SAGE test and points are given for correct answers. The researchers suggest adding one point to the score when the participant is over the age of 80 and another point if the participant has less than 12 years of education.

SAGE Scoring

  • Scores of 17-22 are in the normal range.
  • Scores of 15-16 indicate mild cognitive impairment is likely.
  • Scores of 14 and below is indicative of a more serious cognitive problem, such as dementia.

Interpretation

The maximum score on the MMSE is 30. According to validity and normative data outlined by Ohio State University's Wexner Medical Center, a score of 19.8 (plus or minus 2.0) on the SAGE is in the normal range and is equivalent to an MMSE score of 28.7 (plus or minus 1.1).

A SAGE score of 16.0 (plus or minus 3.2) indicates possible mild cognitive impairment and is comparable to an MMSE score of 27.7 (plus or minus 2.2).

Dementia is correlated with a SAGE score of 11.4 (plus or minus 3.9) which is equivalent to a score of 22.1 (plus or minus 3.5) on the MMSE.

Accuracy

When compared to other cognitive screening tests, the SAGE has demonstrated significant accuracy in being able to correctly identify people with cognitive concerns. It contains some more difficult questions than other cognitive tests and thus should be able to identify those with early memory and thinking problems that other screens might not detect.

In terms of accuracy in diagnosing dementia, the SAGE 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.

A Word From Verywell

Be sure to follow up with your physician if you have concerns about your memory, word-finding abilities or other cognitive functions. 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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  1. Scharre DW, Chang SI, Nagaraja HN, Vrettos NE, Bornstein RA. Digitally translated self-administered gerocognitive examination (eSAGE): relationship with its validated paper version, neuropsychological evaluations, and clinical assessments. Alzheimers Res Ther. 2017;9(1):44. doi:10.1186/s13195-017-0269-3

  2. 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