Frank Rupnik, in whom early-stage Alzheimer’s disease has been diagnosed, answers cognitive ability questions on a tablet at his home. He’s using BrainTest, which is the digital equivalent of the Self-Administered Gerocognitive Examination (SAGE) developed by researchers at the Ohio State University Wexner Medical Center. (Image courtesy of the Ohio State University Wexner Medical Center)
A 15-minute self-administered test developed by researchers at the Ohio State University Wexner Medical Center identified the early, subtle signs of dementia sooner than standard testing, allowing earlier treatment to slow disease progression, according to researchers.
The Self-Administered Gerocognitive Examination (SAGE) test does not definitively diagnose Alzheimer’s disease, but it allows doctors to see a baseline of someone’s cognitive functioning. Repeat testing over time provides a way to follow memory and thinking abilities, according to a study published late Monday in the journal Alzheimer’s Research & Therapy.
The study followed 665 patients in Ohio State’s Center for Cognitive and Memory Disorders over eight years. Researchers found that the SAGE test accurately identified patients with mild cognitive impairment — who eventually progressed to a dementia diagnosis — at least six months earlier than the commonly used Mini-Mental State Examination testing method.
The screening test can be taken anywhere, takes about 10 to 15 minutes, and measures 11 cognitive domains, including orientation, language, calculations, memory, abstraction, executive function and constructional abilities. The MMSE does not test abstractions or executive function abilities.
Douglas Scharre, M.D., director of the medical center’s Division of Cognitive Neurology and lead author, worked with BrainTest Inc SEZC to develop a digital version of the SAGE test — Brain Test — that can be taken on a tablet or touch screen computer.
“Any time you or your family member notices a change in your brain function or personality, you should take the SAGE test,” Scharre said in a news release. “If that patient takes the test every six months and their score drops two or three points over a year and a half, that is a significant difference, and their doctor can use that information to evaluate if there should be a diagnosis or to make decisions on treatments.”
The screening test could help clinicians and families make earlier decisions about medication oversight, financial assistance, driving limitations, legal arrangements, living arrangements and caregiving support, according to researchers.
In the study, 164 patients were identified with baseline mild cognitive impairment through the SAGE test. Of those, 70 developed dementia — a 43% conversion rate over three to four years, similar to rates from other academic center-based studies. The diagnoses included Alzheimer’s disease (70%), Lewy body dementia (7%) and pure / mixed vascular dementia (9%).
The number of Americans in whom Alzheimer’s disease is diagnosed is expected to increase from 6 million today to 13 million by 2050, according to the Alzheimer’s Association. Deaths from Alzheimer’s and other dementias increased 16% during the pandemic.
Earlier detection of dementias by the SAGE test, researchers said, is critical to effective treatment.
“New disease modifying therapies are available, and others are currently being evaluated in clinical trials, and we know that the earlier cognitive impairment is detected, the more treatment choices a patient has, and the better the treatments work,” Scharre said.
