It’s normal to become slightly more forgetful as we age. And sometimes, it can be hard to tell when memory loss is simply age-related, and when it’s more serious. But what if healthcare providers could easily tell the difference between ordinary decline, and the warning signs of dementia? New research demonstrates that The Self-Administered Gerocognitive Exam (SAGE) can do exactly that. Here’s everything you need to know about the SAGE test for dementia.
What is dementia?
Dementia is a general term for the group of symptoms that characterize cognitive decline. In other words, dementia isn’t a specific disease. A dementia diagnosis can mean a decline in memory and thinking, but it can also affect a person’s personality, mood, and behavior. Common symptoms of dementia may include (but aren’t limited to), forgetting the date or time, repetition of comments or questions, struggling to find the right words, mood shifts, and experiencing a loss of interest in hobbies. Alzheimer’s is the most common form of dementia, but dementia can also occur in people with Parkinson’s Disease. Other potential causes of dementia include vascular disorders (strokes), HIV, depression, and long-term drug and alcohol use. Most types of dementia are treatable to some degree, but these symptoms usually can’t be reversed once they’ve progressed.
The SAGE Test
The SAGE is a written dementia evaluation developed by The Ohio State University Wexner Medical Center’s College of Medicine and College of Public Health. The test includes questions based on mental, emotional, and physical competence in an effort to assess cognitive, thinking, and/or memory impairments. The conditions of the test include that it must be taken alone and that there cannot be any clocks or calendars present. It can usually be completed within 10-15 minutes. Like most tests of its kind, the SAGE exam evaluates cognitive functioning. It also asks questions related to physiological changes, like balance, while watching for psychological warning signs, like depression. For instance, let’s say someone signals on the test that they’ve been feeling depressed—yet their memory still appears normal to those around them. If this change differs from normal (like the person doesn’t have a history of depression), it could raise a red flag for healthcare providers to pay closer attention to that individual’s cognitive functioning. According to Joel Salinas, MD, MBA, who specializes in dementia and Alzheimer’s disease at NYU Langone Health, evaluating for psychological abnormalities is a step in the right direction for furthering Alzheimer’s detection. “Many don’t assess behavioral or mood-related changes that might be associated with early expression of the disease process going on, like new-onset anxiety, social withdrawal, or impulsivity,” Salinas adds. SAGE also works to assess all of these changes over time. So if there’s a significant score drop during a six-month period, it’s a flag to pursue further interventions, like medication. That’s why this test helps show signs of dementia earlier than traditional evaluations—it seeks to identify more subtle cues involving the whole picture of a person’s daily functioning that may otherwise be overlooked.
Why early detection matters
The insidious and all-encompassing nature of dementia are what makes it so devastating. Yet, Salinas says that tests like SAGE offer hope. “Early detection of disease that can lead to dementia is important because the current evidence suggests that by the time clinical symptoms develop, enough damage has already happened in the brain that many of these symptoms might be irreversible,” he says. By the time a person develops obvious and severe signs of dementia—things like struggling with daily grooming tasks, hallucinations, and agitation—it’s often too severe to intervene. But if healthcare providers can identify symptoms early, they can take steps to mitigate disease progression and foster a greater quality of life for the patient. “The best strategy would likely be one where there is early detection followed by early intervention to prevent someone from developing any cognitive impairment, and definitely before it crosses the threshold into dementia.” The fact that SAGE can be accessed from anywhere also creates the potential for greater equality in the field of dementia research. “Having an opportunity to do an unsupervised/self-administered screening assessment has promise, and would benefit from being studied further in more population-based samples rather than at a single site or sampling from a community that is not almost entirely made of White individuals,” Salinas explains. Providing the SAGE test to a patient pool that’s more representative of the entire population can improve disease understanding—and outcomes—for everyone. Next up: Everything You Need to Know About Cleveland Clinic’s Brain Study
Sources
OSU SAGE ExamCleveland Clinic, DementiaDavid J. Levidow, Assistant Professor of Neurology at NYU Langone Health
