What Does Sage Stand For
The Self-Administered Gerocognitive Exam, known as SAGE, is a brief, pen-and-paper cognitive assessment tool designed to detect the early signs of cognitive, memory, or thinking impairments. The test evaluates your thinking abilities. This can help your doctors understand how well your brain is functioning.
Douglas Scharre, MD, director of the division of cognitive neurology at The Ohio State University Wexner Medical Center in Columbus, developed the test over a five-year period based on clinical experience and review of literature.
Questions were designed to evaluate every part of a patients brain,” Dr. Scharre explains.
The scoring for SAGE was designed to give equal weight for questions that assess brain function for the front, the back, the left, and the right side of the brain, so that no area was overrepresented.
SAGE will not diagnose any specific condition. It will not tell your doctor if you have Alzheimers disease or any other condition that can impact your thinking.
But it is a helpful screening tool for mild cognitive impairment from any cause and early dementia.
Abbreviated Mental Test Score
The Abbreviated Mental Test Score assesses the possibility of dementia in elderly patients.
It involves a practitioner asking a person with suspected dementia 10 questions, such as their date of birth, address, and who the current president/monarch/head of state is. The person gets a point for each correct answer.
A score of six and below suggests dementia or delirium.
Digital Assessments May Enhance The Efficiency Of Evaluations In Neurology And Other Clinics
Adam M. Staffaroni, PhD Elena Tsoy, PhD Jack Taylor, BS Adam L. Boxer, MD, PhD and Katherine L. Possin, PhD
Alzheimer disease and related dementias are a global medical and public health challenge.1 Early and accurate diagnosis of these conditions can mitigate costs and improve medical care and quality of life.1 Cognitive assessment is an important part of ADRD diagnosis, and as we move into an age of ADRD therapeutics, accurate syndromic classification and disease monitoring will be a critical component of identifying trial participants and managing these diseases.1 Since the advent of clinical neuropsychologic assessments, these evaluations have been conducted using paper-and-pencil measures. It is becoming clear, however, that there are myriad benefits to incorporating digital technologies into assessment. Paper-and-pencil tests have typically been administered face-to-face in the clinic. The necessity of validated remote evaluations is apparent, underscored by the recent limitations on in-person visits secondary to the COVID-19 pandemic. Digital technologies are well positioned for a role in remote evaluation.
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Tell Me The Significance Of Cognitive Tests
They are important to determine if someone is suffering from cognitive impairment, such as mild cognitive disorder. By testing for cognitive impairments, therapists can better understand the severity of the condition and how to best treat it.
Early diagnosis and treatment of cognitive impairments are important to prevent the condition from progressing into something more serious, such as dementia. MemTrax has been used for over 30 years as an early detection test for short term memory impairment.
Pros & Cons Of The Mini
Pros: 1. Easy to use. The only thing you need is the test and a couple writing instruments.2. Quick to administer. The Mini-Cog should not take more than three to five minutes.3. Basic. Other tests, like the MMSE, have been found to require a certain level of education, while the Mini-Cog can be taken by anyone.4. Useful in identifying mild cognitive impairment . People in the earliest stages of dementia are harder to find, but the Mini-Cog has been shown to identify them.
Cons: 1. Not always accurate. The Mini-Cog has been shown in studies to correctly identify dementia about three-quarters of the time.2. The Mini-Cog does not identify the stage or extent of a persons dementia.3. People with sight issues have difficulty with the clock drawing.
DementiaCareCentral.com was developed with funding from the National Institute on Aging . The site is for educational purposes, medical decisions should not be based on its content and its authors assume no liability for errors or omissions. Content cannot be reproduced without permission.©1995-2022.
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Why Do I Need A Cognitive Test
If you show signs of cognitive impairment, your doctor may order or perform a cognitive test. These signs and symptoms may include:
- Becoming more forgetful when it comes to dates and events.
- Losing things more often.
- Struggling to find the right word that you usually know.
- Becoming more forgetful in conversations, movies, and books.
- Increased irritability, mood swings, more anxiety than usual.
How To Administer The Mini
Step 1 . Youll need a pencil or pen to keep score. You will also need a stopwatch or timer.
Step 2 Take the person being tested to a comfortable room that does not have distractions. Have them sit at a table and provide a pencil with an eraser. They also need a piece of paper for drawing the clock, and you can decide whether the paper is blank or if youre providing the circle.
Step 3 Look at the person being tested and say Im going to say three words. I want you to repeat them back to me, and you will need to remember them again at the end of the test. Then clearly speak three unrelated words, which are provided by the test. An example is river, nation, finger.
Step 4 Have the words spoken back by the test-taker as soon as youve said all three.
Step 5 Have the test-taker draw a clock with the time 10 past 11. You can provide the circle. Allow three minutes to complete this task. Do not help, but be friendly and encouraging.
Step 6 Ask the person What were the three words I spoke at the beginning of the test? Write down the answers.
Step 7 Compile the score.
How to Score the Mini-Cog
There are five total points a person can score on the Mini-Cog: Give one point for each word that was correctly remembered. Give two points for a correctly drawn clock, meaning the numbers are in roughly the correct locations and two hands are pointed to the 11 and the 2. The length of the hands does not matter.
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How The Moca Works
The MoCA checks different types of cognitive or thinking abilities. These include:
- Orientation: The test administrator asks you to state the date, month, year, day, place, and city.
- Short-term memory/delayed recall:Five words are read. The test-taker is asked to repeat them. After completing other tasks, the person is asked to repeat each of the five words again. If they can’t recall them, they’re given a cue of the category that the word belongs to.
- Executive function/visuospatial ability: These two abilities are checked through the Trails B Test. It asks you to draw a line to sequence alternating digits and letters . The test also asks you to draw a cube shape.
- Language: This task asks you to repeat two sentences correctly. It then asks you to list all the words in the sentences that start with the letter “F.”
- Abstraction: You are asked to explain how two items are alike, such as a train and a bicycle. This checks your abstract reasoning, which is often impaired in dementia. The proverb interpretation test is another way to measure these skills.
- Animal naming: Three pictures of animals are shown. The person is asked to name each one. This is mainly used to test verbal fluency.
- Attention: The test-taker is asked to repeat a series of numbers forward and then a different series backward. This task tests the ability to pay attention.
- Clock-drawing test: You’re asked to draw a clock that reads 10 minutes past 11:00.
Who Uses These Tools
Most of these tools are meant to be used by trained health professionals. It is our responsibility to learn how to administer the tool and interpret the results. Some tools are designed to be taken by anyone, and Ill point those out.
As always, if you have any concerns about your health or the health of a loved one, you should seek guidance from your doctor or seek an evaluation by a speech-language pathologist . Remember that these tools do not diagnose dementia or any other cognitive impairment.
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Blood Tests To Check For Other Conditions
Your GP will arrange for blood tests to help exclude other causes of symptoms that can be confused with dementia.
In most cases, these blood tests will check:
- haemoglobin A1c
- vitamin B12 and folate levels
If your doctor thinks you may have an infection, they may also ask you to do a urine test or other investigations.
Read more about blood tests.
Assessment Of Behaviour And Psychological Symptoms Of Dementia
Almost all patients with dementia experience BPSD these are also referred to as neuropsychiatric, non-cognitive symptoms. The symptoms vary between patients and over time and can include:
- Mood disturbances
- Hyperactivity-type symptoms
- Psychotic symptoms
- Other behavioural symptoms
These symptoms become more common as the dementia progresses and present a major cause of stress to carers.
When BPSD occur, assess factors that may cause, aggravate or reduce the behaviour. Assessment should first exclude physical causes, such as delirium , urinary tract infections or a drug interaction. Other factors, such as the environment and behaviours of others, should also be considered.
The assessment should ideally consider:
- Frequency of behaviour over time
- Context and consequences of the behaviour
- Factors in physical environment
- Possible undetected pain or discomfort
For more information about BPSD assessment and clinical support services for your patients, please go to the dbmas website or phone their national 24-hour helpline on 1800 699 799.
DBMAS provides 24-hour advice, assessment, education, intervention and specialised support to carers and care workers who provide support for people with dementia with moderate to severe behaviours of concern.
Other DBMAS resources:
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Copyright And User Requirements
To the best of my knowledge it is fine to use these tools as long as you dont modify the tool itself. Ive made a careful effort to be sure that citations are included with each PDF. But if you have any concerns, try contacting the authors or publisher.
A quick word about user requirements. I dont know if this is true for you as well, but in the past, I sometimes began using a new tool without reading about it. There are two commonly-used tests in particular that have user requirements that I didnt know about until recently: the Montreal Cognitive Assessment and the SLUMS.
The MoCA now requires paid training and certification, mandatory as of 9/1/19. And the SLUMS requires free yearly video training.
What Is Cognitive Testing For Dementia
Cognition is a combination of different brain processes that include thinking, memory, judgment, language, and what helps you to learn new things. If you have problems with cognition, it is referred to as cognitive impairment. You could be diagnosed with mild to severe cognitive impairment. Cognitive testing for Dementia will help check for cognitive problems.
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Early Testing For Dementia
Dementia is challenging to diagnose, especially in the early stages.
Many people do not seek help until a family member, friend, or healthcare professional notices significant memory loss, confusion, or difficulty with communication.
Now, a new test, known as the Self-Administered Gerocognitive Exam , might help detect early signs and allow for treatment in the beginning stages.
The test evaluates your thinking abilities and gives your doctor a way to see how they change over time, according to Dr. Douglas Scharre, a professor of clinical neurology and psychiatry at the Wexner Medical Center at The Ohio State University.
For people who dont yet have symptoms or have mild symptoms, the first test is the baseline, Scharre told Healthline. Tests are then completed every 6 months, so your doctor can track symptoms. Losing a few points between tests, or over several years, could indicate the person might eventually develop dementia.
The SAGE test is available on the Wexner Medical Centers website. It includes questions about your current health, asks you to identify pictures of everyday items, complete simple math problems, and complete thinking tasks.
The exam can be downloaded and completed at home and then brought to your doctor for scoring. You can also print out the test and fill it out with your doctor present.
There is an online version that automatically scores the exam, but Scharre said, the test is meant to be reviewed by your doctor.
What Is Needed To Bring This Test Into Current Practice
Even a self-administered test that individuals can do at home will still require training for primary care providers, to understand how the test should be used and how to interpret the results. There is no question, however, that such training will be worthwhile. Once the training is complete, the knowledge gained should be able to save literally thousands of hours of clinician time, in addition to missed or improper diagnoses.
Another question is how individuals will react when they are told that they need to perform a 10-to-15-minute cognitive test at home and bring the results to their doctor. Will they do it? Or will the ones who need the test the most avoid doing it or cheat on it? My suspicion is that people who are concerned will do the test, as will people who generally follow their doctors instructions. Some individuals who would benefit from the information that the test provides may not do it, but many of those individuals wouldnt do the “regular” pencil-and-paper testing with the doctor or clinic staff either.
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Who Should Be Evaluated For Cognitive Impairment
There are several reasons why a doctor may suggest a cognitive test. These may include the following reasons.
- Patients have memory concerns and have other symptoms of cognitive impairments.
- May also include changes in personality, depressions, balance issues, falling more often.
Part of an Annual Wellness visit.
Cognitive Screening And Assessment
Why is an assessment for cognitive impairment and dementia so important? It is because an early diagnosis means early access to support, information and medication.
There is no single definitive test for diagnosing dementia. Assessment will account for behavioural, functional and psychosocial changes, together with radiological and laboratory tests. The assessment process may take three to six months to achieve.
Assessment:
Assess cognition if you have any indication or suspicion of impairment in your patient. This is the first step in determining whether or not your patient needs further evaluation.
DSM-5 definition and warning signs.
Take note of the history regarding cognition and function from informant:
It is important to take notes about the history of the patient from an “informant”. An informant is someone who knows the patient well and has observed their cognition and function over time, for instance, a family member or close friend.
You could ask the ‘informant’ about the following in relation to your patient:
- Risk factors – vascular disease , alcohol, head injury, mood disorders, behavioural and psychological symptoms, recent illness, medications
- Activities of Daily Living , instrumental ADLs, cognitive complaints, mood, driving, safety
- Information from carer, family regarding changes and functional decline
Informant tools:
The General Practitioner assessment of Cognition
Mini-Mental State Examination
Clock Drawing Test
Kimberly Indigenous Cognitive Assessment
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Free Cognitive Assessment Tools
If you work with older individuals, you may find some of these cognitive assessment tools to be useful. In general, you can quickly use these tools to determine if someone requires further assessment, but you may find the results sufficient for your purpose. Check out the comments for many more assessment tools!
Free DIRECT download: 18 assessment tools for cognition .
Dementia Severity Rating Scale
The Dementia Severity Rating Scale was developed by Clark & Webank and updated by Webank et al . You can administer this multiple-choice questionnaire to determine whether a person has a mild, moderate, or severe impairment. In addition, it can be used to predict rate of decline over time.
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How Accurate Is The Moca
Studies have found MoCA to be about 94 percent accurate in telling whether a person has dementia or not. This means 94 percent of people who have dementia scored less than 26 out of 30 on MoCA . MoCA is therefore a useful and mostly accurate tool for identifying dementia.
Significantly for people who take the test because theyre worried they may be in the earliest stages of Alzheimers disease , MoCA is much more effective at identifying Mild Cognitive Impairment which is often considered the earliest stage of dementia. Some of the questions on the MoCA are intended to test executive function, which is the ability to focus and reason through a sequential task. In one section, this means moving from numbers to letters and back and forth in order . If youre wondering whether increased forgetfulness is a result of Alzheimers or just normal aging, this means MoCA is the best test to take.
Remember, however, that the test is meant to be administered and graded by a doctor. If you want to take a test at home, the SAGE is accurate and designed to be administered by a loved one rather than a medical professional.
Can A Diy Test Reveal Signs Of Alzheimer’s
In the months after her husband died unexpectedly, Liz Arledge found it hard to focus and mingle with others. Was it a natural part of grieving, she wondered, or signs of something else? Her younger brother had dementia, and her mother had lived for 12 years with Alzheimer’s. Was she following in their footsteps?
“‘I’ve got to know where I stand,'” Arledge says she thought to herself. “I had to know: ‘Am I going to turn into my mother?'”
For an answer, Arledge, who lives in Circleville, OH, took an at-home Alzheimer’s test called the Self-Administered Gerocognitive Exam — or SAGE, for short. It was designed by researchers at The Ohio State University Wexner Medical Center and it checks for memory or thinking problems that could be early signs of the disease.
Why would want to learn you’ve got it?
“When the disease is caught early, existing treatments are much more effective,” says Douglas Scharre, MD, director of the division of cognitive neurology at Wexner Medical Center.
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