What Is the SAGE Test for Dementia?

Have you ever read an unfamiliar phone number online or on a piece of paper and, without writing it down, started to dial it only to forget the last three or four digits? Such a memory lapse could be common, particularly as you age.

However, struggling to recall telephonic digits you use all the time — like your mom’s number — could be a sign that you should have an assessment for possible cognitive issues, says Jessica Caldwell, neuropsychologist and director of the Women’s Alzheimer’s Movement Prevention Center at Cleveland Clinic.

Previous generations of patients concerned about their cognitive well-being would need to make an appointment with a health care provider, who would administer an exam and evaluate the results. Today, anyone with a computer and access to a printer can in a matter of about 15 minutes take the four-page SAGE Test, a cognitive assessment tool developed by Dr. Douglas Scharre, director of the division of cognitive neurology at Ohio State University Wexner Medical Center. SAGE is an acronym for Self-Administered Gerocognitive Examination.

[See: 8 Early Signs of Dementia.]

What Is the SAGE Test?

The SAGE Test is a cognitive assessment tool that provides a snapshot of a patient’s cognitive health, Scharre says. There are four versions of the test. Once someone has taken the test, he or she gives the completed exam to a health care provider, who assesses the results and determines whether the individual should undergo additional evaluations for diagnosis of cognitive issues. The test isn’t a diagnostic tool, but the results can help health care providers identify signs that the patient is at risk for dementia or other cognitive issues and should undergo further exams.

Research suggests the SAGE Test is an effective tool for detecting serious cognitive changes more efficiently than another widely used test. A study published in 2021 in the journal Alzheimer’s Research & Therapy concluded that the SAGE exam detected conversion from mild cognitive impairment to dementia at least six months sooner than the Mini-Mental State Examination. The study included 424 patients from the Ohio State University Memory Disorders Clinic.

Unlike the SAGE exam, the MMSE is not designed to be self-administered — a health care professional administers the MMSE by asking a patient a series of questions that are designed to test a range of everyday mental skills, according to the Alzheimer’s Association. The MMSE is a commonly used assessment tool, according to the association.

The test was initially developed in the 1970s. Some clinicians have critiqued the MMSE for an inability to differentiate disease severity, limited detection ability of certain patterns of impairment and a large number of false positives, says says Dr. Scott Kaiser, a board-certified geriatrician and director of Geriatric Cognitive Health for the Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, California.

Identifying and eventually diagnosing potential cognitive problems sooner is why Scharre worked for about four years in the 2000s to develop the SAGE exam. The first version of the test, which individuals can print out and take, was published in 2010. A digital version became available in 2017.

“It was frustrating to me to see patients who were much further down the course of dementia and other cognitive issues,” Scharre says. “We needed a better tool to identify these problems sooner.” Detecting potential cognitive issues earlier would allow physicians to diagnose issues and begin treatment sooner.

The digital version of the exam is called BrainTest. To access it, consumers can sign up for a plan that provides one free test plus 30 days of free access to the application. After the free trial period, customers will get a new test every six months to monitor their brain health. The six-month price is $25.02. Among other things, the test asks you to do such things as name certain well-known items and do basic math equations.

[See: 9 Foods That Can Keep Your Brain Sharp.]

A Growing Problem

In the U.S., the number of people living with Alzheimer’s is growing, according to the Alzheimer’s Association. In 2021, 6.2 million Americans were living with Alzheimer’s dementia. (Alzheimer’s is one type of dementia.) Overall, one in nine people age 65 or older have dementia.

While there’s no cure for dementia, there are a number of approaches and treatments that can help stave off or mitigate its effects, says Kaiser.

Individuals age 65 and older should undergo regular cognitive screening with a test like the SAGE exam, he says. “Because people’s brains age at different rate and their baseline risk profiles vary,” he adds, “there’s an argument to be made to move it further up. It may even make sense for some people to do the test in their 50s — especially if they have many risk factors for dementia, a strong family history, or significant concerns about their memory.”

It’s important to keep in mind that not all cognitive issues stem from dementia. For example, a lack of sleep or certain medications — such as sleeping pills — can affect your brain function.

Early Signs of Cognitive and Brain Dysfunction

Wexner’s SAGE website describes early signs of cognitive and brain dysfunction:

— Memory loss.

— Language problems.

— Disorientation to time.

— Impaired sense of direction.

— Changes in mood or personality.

— Executive impairment.

Memory loss. Forgetting recently learned information and conversations, including names, and misplacing items could be a sign of deteriorating memory.

Language problems. Difficulty finding the right word or words for what you want to say.

Disorientation to time. Everyone loses track of time now and then. Forgetting the day of the week or the date could indicate cognitive or brain dysfunction.

Impaired sense of direction. Getting lost in a familiar place that you’ve been to before.

Changes in personality or mood. If you’re usually outgoing and become withdrawn, or usually upbeat and start feeling down most of the time, that could be a sign of a cognitive or brain issue.

Executive impairment. Impaired organizational skills, difficulties with making decision and using poor judgment may suggest cognitive or brain issues.

Ways to Boost Your Brain Health

While there’s no cure for dementia, there are a number of approaches that can help stave it off and boost your cognitive health:

Eating a brain healthy diet. Avoiding refined sugars and trans fats is good for your brain health, as is consuming foods rich in antioxidants. Fruits, veggies and the Mediterranean diet are generally good for your brain health.

Not smoking. Smoking is a huge risk factor for developing cognitive issues.

Getting good sleep. A lack of good, quality sleep is a risk factor for developing dementia.

Keeping your weight in check. Having obesity puts you at greater risk for dementia. To mitigate this risk, maintain a healthy weight.

Treating depression. Suffering from depression is a risk factor as well. “This is a modifiable risk factor,” Kaiser says. “Getting screened and treated for depression can help protect your cognitive health.”

Update 06/13/22: This story was previously published at an earlier date and has been updated with new information.

Related Categories:

Latest News

More from WTOP

Log in to your WTOP account for notifications and alerts customized for you.

Sign up