How The Sage Test For Dementia Works
SAGE stands for Self-Administered Gerocognitive Examination and was developed by researchers at The Ohio State University Wexner Medical Center.
The SAGE test has 12 questions that cover all aspects of cognition, including memory, problem solving, and language.
There are 4 different versions of the test. Theyre similar enough, but having multiple versions means that someone could take the test once a year and wouldnt improve their score each year just from the practice of taking it before.
This way, the test is slightly different each time.
Can Dementia Be Diagnosed During A Single Visit
So can dementia be diagnosed during a single visit? As you can see from above, it depends on how much information is easily available at that visit. It also depends on the symptoms and circumstances of the older adult being evaluated.
Memory clinics are more likely to provide a diagnosis during the visit, or shortly afterwards. Thats because they usually request a lot of relevant medical information ahead of time, send the patient for tests if needed, and interview the patient and informers extensively during the visit.
But in the primary care setting, and in my own geriatric consultations, I find that clinicians need more than one visit to diagnose dementia or probable dementia. Thats because we usually need to order tests, request past medical records for review, and gather more information from the people who know the senior being evaluated. Its a bit like a detectives investigation!
Dementia Care Tips From Experienced Caregivers
Caring for someone with dementia isnt intuitive and doesnt come naturally. Theres a lot to learn, but you dont have to figure everything out the hard way.
In a helpful article at Verywell, social worker Esther Heerema shares 12 dementia care tips that caregivers have learned and wished theyd known sooner.
This advice isnt meant to add pressure or expectations to your already tough job. Theyre tips from caregivers who have been there and done that that can lighten your load, reduce stress, and help you cope with the challenges.
Here, we share highlights from Esthers article along with some of our own insights.
1. Its not worth it to argue with someone who has dementiaAlzheimers and dementia causes your older adults brain to malfunction. When they say things that dont make sense or are clearly untrue, they believe what theyre saying because its what their brain is telling them.
Its frustrating to hear things that arent true and instinctive to try to correct or remind. But that will only lead to both of you arguing or getting upset. And you simply cant win an argument with someone who can no longer use reason or logic consistently.
2. Ignoring symptoms wont make them go awayWhen you notice your older adult struggling with memory, thinking, or judgement, its scary to think that they might have dementia. Because it can be so hard to accept, many people hope that the symptoms will go away on their own or that theyre mistaken.
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At What Age Can You Test Someone For The Signs Of Dementia
There is no one particular age that someone must meet before they can be assessed for signs of dementia, although dementia is more common in people over 65. Early-onset dementia can begin in people who are in their 30s, 40s, and 50s. Diagnosing dementia in its early stages is important as early treatment can slow the progression of symptoms and help to maintain mental functions.
The Future Of Ftd Treatment
Researchers are continuing to explore the biological changes in the body, including genetic mutations and proteins, that lead to FTD and identify and test possible new drugs and other treatments. They are also developing better ways to track disease progression, so that treatments, when they become available, can be directed to the right people. Clinical trials and studies are underway to advance these efforts. People with FTD and healthy people may be able to participate. To find out more, talk to your health care provider or visit the Alzheimers.gov Clinical Trials Finder.
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Why Would Anyone Want An Early Alzheimers Diagnosis
The SAGE test is useful because it helps you understand if your concerns are something to be worried about.
If the results seem to indicate that there could be a problem, you might think theres no point in talking with the doctor because theres no cure for dementia.
The most important is that a treatable condition could be the cause of cognitive impairment. Finding out sooner means getting treatment ASAP to eliminate the cognitive symptoms.
If the cognitive impairment is caused by Alzheimers or dementia, a major benefit is that starting treatment early is far more effective in managing symptoms and delaying progression of the disease.
Can Dementia Suddenly Get Worse
The progression of dementia depends on the underlying disease. Some diseases have a rapid progression. Others progress more slowly. Any sudden change with either slow or rapid progression should be evaluated for another cause. In most cases, changes with dementia may seem like they came out of the blue when they actually may have been slowly developing in the background. The best way to prepare for changes and manage expectations is through information. Your doctor and medical team will be a valuable resource. There are a variety of educational resources that are also available through the Alzheimer’s Association.
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Questions To Ask After Getting A Dementia Diagnosis
You should feel free to ask your healthcare provider any questions you have about dementia and your diagnosis. These 12 questions are a good place to start, but it’s normal to have several waves of questions as you begin to adjust. Take time to write them down as you think of them so that you can address them at your next practitioner’s visit.
What Is Mixed Dementia
It is common for people with dementia to have more than one form of dementia. For example, many people with dementia have both Alzheimer’s disease and vascular dementia.
Researchers who have conducted autopsy studies have looked at the brains of people who had dementia, and have suggested that most people age 80 and older probably have mixed dementia caused by a combination of brain changes related to Alzheimer’s disease,vascular disease-related processes, or another condition that involves the loss of nerve cell function or structure and nerve cell death .
Scientists are investigating how the underlying disease processes in mixed dementia start and influence each other. Further knowledge gains in this area will help researchers better understand these conditions and develop more personalized prevention and treatment strategies.
Other conditions that cause dementia-like symptoms can be halted or even reversed with treatment. For example, normal pressure hydrocephalus, an abnormal buildup of cerebrospinal fluid in the brain, often resolves with treatment.
Researchers have also identified many other conditions that can cause dementia or dementia-like symptoms. These conditions include:
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Benefits Of Getting A Diagnosis
Early detection and diagnosis of Alzheimers disease or another dementia is critical to ensuring proper support, care and treatment of the illness. It is also important because it allows people with the disease and their families to make key financial and care decisions while they are still functioning at the highest possible level.
The diagnosis of dementia often comes as a complete shock. However, many people feel relieved once they have identified the source of their worries after a diagnosis has been made.
Getting an early diagnosis will help you to move forward and gain more control over your life by taking the necessary steps to live better with the disease. Receiving an early diagnosis allows a person to:
- Understand the symptoms they are experiencing, and the changes that they can expect
- Gain access to information, resources and support
- Benefit from and explore treatment options
- Plan for the future
- Develop and engage support networks
- Maximize their quality of life.
When Is Memory Loss A Problem
Do you keep asking the same questions over and over? Are you having difficulty following easy, simple instructions, such as how to put together a recipe? Do you keep becoming more and more mixed up over people and places.
Alzheimers Disease, as we all know, can lead to memory loss, but not all memory loss is linked to Alzheimers and related dementias. And, in some cases, it can be treated once the cause has been found.
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Some Questions You May Wish To Ask You Doctor Regarding Tests Used In Diagnosing Dementia
- What tests will be conducted?
- Who will be performing the tests and how long will it take?
- Should I prepare for the tests in any way?
- Will any of the tests involve pain or discomfort?
- Will there be any cost involved?
- What follow-up will be necessary and who will follow up?
- How will I be informed of the test results and the diagnosis?
Conditions With Symptoms Similar To Dementia
Remember that many conditions have symptoms similar to dementia, so it is important not to assume that someone has dementia just because some of the above symptoms are present. Strokes, depression, excessive long-term alcohol consumption, infections, hormonal disorders, nutritional deficiencies and brain tumours can all cause dementia-like symptoms. Many of these conditions can be treated.
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Free Ohio State Sage Tests
The Ohio State University Medical Center’s Department of Neurology has developed several free tests which you can download and use for free here Sage Test. There are several versions of this test that you can use. They are more complex than the oral tests above and might be good for someone who would resist having you test them, but might be willing to take a written test.
Mental Ability Tests To Diagnose Dementia
People with symptoms of dementia are given tests to check their mental abilities, such as memory or thinking.
These tests are known as cognitive assessments, and may be done initially by a GP.
There are several different tests. A common one used by GPs is the General Practitioner Assessment of Cognition .
Although these tests cannot diagnose dementia, they may show there are memory difficulties that need further investigation.
Most tests involve a series of pen-and-paper tests and questions, each of which carries a score.
These tests assess a number of different mental abilities, including:
- short- and long-term memory
- language and communication skills
- awareness of time and place
It’s important to remember that test scores may be influenced by a person’s level of education.
For example, someone who cannot read or write very well may have a lower score, but they may not have dementia.
Similarly, someone with a higher level of education may achieve a higher score, but still have dementia.
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Vascular Dementia: Causes Symptoms And Treatments
Vascular dementia refers to changes to memory, thinking, and behavior resulting from conditions that affect the blood vessels in the brain. Cognition and brain function can be significantly affected by the size, location, and number of vascular changes.
Symptoms of vascular dementia can begin gradually or can occur suddenly, and then progress over time, with possible short periods of improvement. Vascular dementia can occur alone or be a part of a different diagnosis such as Alzheimer’s disease or other forms of dementia. When an individual is diagnosed with vascular dementia, their symptoms can be similar to the symptoms of Alzheimer’s.
How Does A Doctor Test For Alzheimers
When you see a doctor regarding memory loss, they will conduct a series of tests to determine the symptoms and causes of the changes in your behavior. These tests are not an exact science yet, but they will help the doctor develop an overall picture of your brain health. You should take these tests as soon as possible to receive the best treatment and plan for the future. When in doubt as to whether to see the doctor, it is best to lean on the side of caution.
Your doctor will not rely on one or two test results alone. There are several diagnostic tools that he or she will use to pinpoint any memory loss problems.
The first thing any doctor will do is get your complete medical history, including any medication you are taking. This data will include your familys medical history as well to determine any genetic risks.
This history gathering will be following by laboratory tests to eliminate any causes of the memory loss, such as thyroid problems, diabetes and kidney issues, and faulty drug interactions. These lab tests usually involve blood and urine tests, and the taking of vital signs. The doctor will have a thorough discussion about lifestyle and habits.
As a final option, the doctor will suggest and/or perform cognitive tests.
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How Accurate Is The Mmse
Studies have shown that the MMSE is better at ruling out dementia than telling someone whether they have it. Very rarely will the MMSE tell someone who does not have dementia that they do have the disease . It is more common for someone who does have dementia to achieve a score that would indicate they dont have the disease. This happens more than 20 percent of the time, because people who are highly educated or only in the early stages of the disease can still score above 24 even if Alzheimers is present in the brain. Again, the MMSE should not be used alone as a tool for diagnosing dementia.
Stage : Moderately Severe Dementia
When the patient begins to forget the names of their children, spouse, or primary caregivers, they are most likely entering stage 6 of dementia and will need full time care. In the sixth stage, patients are generally unaware of their surroundings, cannot recall recent events, and have skewed memories of their personal past. Caregivers and loved ones should watch for:
- Delusional behavior
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Can Dementia Be Inappropriately Diagnosed In A Single Visit
Sadly, yes. Although its common for doctors to never diagnose dementia at all in people who have it, I have also come across several instances of busy doctors rattling off a dementia diagnosis, without adequately documenting how they reached this conclusion.
Now, often these doctors are right. Dementia becomes common as people age, so if a family complains of memory problems and paranoia in an 89 year old, chances are quite high that the older person has dementia.
But sometimes its not. Sometimes its slowly resolving delirium along with a brain-clouding medication. Sometimes its depression.
It is a major thing to diagnose someone with dementia. So although its not possible for an average doctor to evaluate with as much detail as the memory clinic does, its important to document consideration of the five essential features as listed above.
Where To Get Help
- Your local community health centre
- National Dementia Helpline Dementia Australia Tel. 1800 100 500
- Aged Care Assessment Services Tel. 1300 135 090
- My Aged Care 1800 200 422
- Cognitive Dementia and Memory Service clinics Tel. 1300 135 090
- Carers Victoria Tel. 1800 242 636
- Commonwealth Carelink and Respite Centres Australian Government Tel. 1800 052 222
- Dementia Behaviour Management Advisory Service Tel. 1800 699 799 for 24-hour telephone advice for carers and care workers
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Why Take A Test For Dementia
It is crucial that the symptoms of memory loss are diagnosed as early as possible. This helps to get the best treatment possible. A do at home dementia test can help a person come to terms with the fact that they may be suffering from dementia.
By taking a simple do at home dementia test you should be able to determine if the person may have a problem with their memory. If they show signs if difficut during the test you should encourage them to seek further help fro their GP. There Doctor can then check for problems such as early stages of Alzheimers disease or dementia.
Cholesterol Lipid Panel And Blood Pressure
Almost everyone who reaches middle age will have regular cholesterol-lipid panel tests and blood pressure readings as part of a yearly physical. Most doctors will help you to treat high cholesterol and/or high blood pressure in order to make sure your heart is healthy. Another reason to keep your cholesterol in the right range is because elevated cholesterol levels and high blood pressure also are an indicator of risk for Alzheimer’s.
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If You Are Diagnosed With Dementia
Obtaining an early and accurate diagnosis can improve the quality of life for people with dementia.
Talk to your doctor about treatment and ongoing assessment.
Support and information is available through the National Dementia Helpline on 1800 100 500.
Thanks to Associate Professor David Ames for reviewing this material.
Other Scans And Procedures To Diagnose Dementia
Other types of scan, such as a SPECT scan or a PET scan, may be recommended if the result of your MRI or CT scan is uncertain.
However, most people will not need these types of scans.
Both SPECT and PET scans look at how the brain functions, and can pick up abnormalities with the blood flow in the brain.
If a specialist is worried that epilepsy may be causing the dementia symptoms, an EEG may be taken to record the brain’s electrical signals , but this is rare.
Page last reviewed: 3 July 2020 Next review due: 3 July 2023
When To See A Doctor
Forgetfulness and memory problems dont automatically point to dementia. These are normal parts of aging and can also occur due to other factors, such as fatigue. Still, you shouldnt ignore the symptoms. If you or someone you know is experiencing a number of dementia symptoms that arent improving, talk with a doctor.
They can refer you to a neurologist who can examine you or your loved ones physical and mental health and determine whether the symptoms result from dementia or another cognitive problem. The doctor may order:
- a complete series of memory and mental tests
- a neurological exam
- brain imaging tests
If youre concerned about your forgetfulness and dont already have a neurologist, you can view doctors in your area through the Healthline FindCare tool.
Dementia is more common in people over the age of 65, but it can also affect younger people. Early onset of the disease can begin when people are in their 30s, 40s, or 50s. With treatment and early diagnosis, you can slow the progression of the disease and maintain mental function. The treatments may include medications, cognitive training, and therapy.
Possible causes of dementia include: