You might think that when it comes to your own mental capacities, it would be impossible to report memory problems in a completely unbiased way. Therefore, self-administered exams wouldn’t be very good at detecting problems, right? Well, the logic may be sound, but it would actually lead you to an inaccurate conclusion in at least one instance. That’s because a recent study actually showed that is self-administered cognitive test detected symptoms of dementia earlier than current clinical tests.
Researchers at Ohio State University Wexner Medical Center, College of medicine and college of public health, monitored 665 consecutive patients for cognitive and memory disorders over the course of eight years. They found that the Self-Administered Gerocognitive Examination (SAGE test) accurately identified patients with mild cognitive impairment and then identified changes that indicated progression to dementia, leading to diagnosis at least six months earlier than commonly used testing methods, such as the Mini-Mental State Examination (MMSE).
164 of the participants had mild cognitive impairment at baseline. 70 of those patients developed dementia over the course of the study. That equates to a 43 percent conversion rate over three to four years, similar to rates found by other academic center-based studies. 70 percent of the dementia patients were diagnosed with Alzheimer’s disease, seven percent were diagnosed with Lewy body dementia, and nine percent had pure or mixed vascular dementia.
This research showed that the SAGE test could identify early subtle signs of dementia sooner than standard cognitive tests used in most doctors’ offices, which could be vital for getting them the best care possible.
“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,” said Dr. Douglas Scharre, director of the Division of Cognitive Neurology at Ohio State Wexner Medical Center and lead author of the study published in the journal Alzheimer’s Research & Therapy.
The SAGE test does not definitively diagnose Alzheimer’s disease or dementia, but it gives doctors a better sense of their patients’ cognitive functioning and allows them to follow changes in patients’ memory and thinking abilities over time.
“Often primary care physicians may not recognize subtle cognitive deficits during routine office visits,” said Scharre, a member of the Scientific Advisory Board.
The test is very simple and only takes 10 to 15 minutes to complete. The four interchangeable versions of the test are designed to keep test-takers from cheating by learning the test better each subsequent time they take it. The test investigates 11 items, such as the subject’s orientation, language, calculations, memory, abstraction, executive function, and constructional abilities. Some of these items are missing from the current MMSE test.
“Any time you or your family member notices a change in your brain function or personality, you should take this test,” Scharre said. “If that person 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 get a jump on identifying the causes of the cognitive loss and to make treatment decisions. Based on cognitive score changes, clinicians and families may decide it is time to act on safety and supervision needs. This might include, for example, medication oversight, financial assistance, driving limitations, setting up durable Powers of Attorney and other legal arrangements/trusts, change in living arrangements, and enhanced caregiving support.”
Luckily, you don’t have to go to your doctor’s office just to take the test. Scharre has worked with BrainTest Inc. SEZC to develop a valid digital version of the SAGE test that can be taken anywhere at any time on a tablet or touchscreen computer. The digital version of the test is also integrated with the Wexner Medical Center’s electronic medical record system in order to store self-testing data for patients and their healthcare providers.
If you’d like to take the SAGE test, go to wexnermedical.osu.edu/SAGE to get started.
Earlier diagnosis is important for effective treatment for dementia and Alzheimer’s disease. We hope to see this new test help create breakthroughs in the dementia research community.