Crucial Facts You Should Know Before Taking the SAGE Home Test for Alzheimer’s
Assessments for cognition issues, dementia and Alzheimers are vital if we are to spot the early warning signs of disease. Where possible, we want to be able to assess a senior’s levels of cognition, identify problems and start a course of treatment while dementia is in an early stage. If you would like to know the early warning signs of dementia you should also read this article here.
At the same time, we want an accessible, user-friendly testing procedure. The SAGE test is a great example of that. Here loved ones can perform a test on their senior relative and get the ball rolling toward a diagnosis and care package. So, what exactly can seniors and carers expect from this product? Is it an accurate approach? Also, is this a better approach than the commonly-used MoCA test?
SAGE stands for the Self-Administered Gerocognitive Exam (SAGE). The name is actually a pretty good description of what to expect as users can administer the test themselves and it covers a range of different aspects of gerocognitive health. Below we will look at some of the key areas of testing that you can expect from the assessment. We will also look at some of the benefits and disadvantages of this service compared to the well-known MoCA test for dementia used by doctors. First, let’s consider why this option is so popular with seniors and their carers.
This Self-Administered Gerocognitive Exam Provides an accessible, appealing new way to assess seniors that may be at risk
This self-administered style has a couple of important benefits for seniors. One of the appealing things about this self-administered test is that it is quick. On average, it can be done in just 15 minutes. Some users may take a little less time if they find it easy, while others may take longer if they struggle with some elements. This is no time at all for seniors. There is little risk of them becoming stressed out with long exercises or losing their concentration or attention. If seniors do still find themselves distracted or unable to focus on this task, this could be a signal of dementia.
Another reason why carers and patients will like this test is that it can be done at home. Other leading tests – such as the MoCA – need a physician to ask the questions and make an analysis of the results. The test website as also only accessible if you have the right credentials. This means a trip to a medical facility, which can be stressful for those involved. Here you can help your relatives by performing the test in the comfort of their own home. Everything about the experience can be as comfortable as possible, as though it were just another brain training puzzle.
In fact, accessibility is a big part of this assessment. Some will complete the test online via the portal on the website. It is free to sign up and anyone can have a go. There is also an option available to download the test. You can then print the test out and complete it with a pen or pencil. This is sure to be preferable for any seniors that aren’t so good with technology. It also makes more sense for some of the sequencing and drawing tests that are included.
So What Does This Test Actually Evaluate?
The best tests for Alzheimer’s are those that test a range of different cognitive functions. This SAGE test is designed to provide an understanding of all aspects. This includes:
- language
- memory
- problem-solving
Basic Medical History:
The test offers questions that challenge a series of cognition skills. Some of these are fairly basic while others are proven strategies seen in many of the leading tests for dementia and Alzheimer’s. Before subjects begin the assessment, it is important that they fill out the brief medical history section at the top. This may seem like a formality, but the information can prove useful to doctors evaluating the results.
It is important to note any incidents where seniors have suffered from a stroke, depression, memory loss or developed any personality changes. These could be indicators of early-stage dementia or highlight an increased risk of the disease developing.
Memory and Recall Skills:
There are aspects of the test that will test the memory of the user and their ability to recall names. For example, in some tests, they will have to give the names of objects in a picture or recall the names of animals. The latter is a common test in many dementia assessments.
There is also a short-term memory exercise where users have to remember a statement and then write it at the bottom of the page at the end of the test. Another exercise involves listing a series of items that relate to a given subject.
Reasoning and Sequencing:
There are also tests that determine a user’s ability to show reasoning and make connections. Some of these are language bases, some are numerical calculations and others showcase the ability to construct an argument. For example, users may have to show an understanding of the change they would receive in a transaction. This highlights mental arithmetic, but also an important real-world skill. There is also an exercise to explain the similarities between two objects – such as a bicycle and a train.
Drawing Tests:
There are also some tests that require users to draw – which is one of the reasons that it is so helpful to print out this test and use a pencil. Three of these exercises are, again, common options that are used in many national assessments. One is the cube drawing, where test subjects simply have to copy the shape of the 3D structure on the page.
Another is the clock drawing test. Subjects must draw a clock face, add the numbers in the right place and put hands at a given time. This may sound like a simple request, but it actually tests a lot of skills. Many people with dementia cannot complete this task. Then there is the trail making test where users have to draw a line in a determined route between numbers and letters.
General Orientation:
Finally, there will also be some basic questions on orientation. This means providing the current date – with the month, day and year – without looking at a calendar. The problem with an online version of this test is that it would be too easy to read the correct date from the corner of a screen.
Determining SAGE Score
The test has a scoring system with a maximum of 22 points, which is different from the 30 point scheme of the MoCA system. There is a general scale here where 22 is a perfect result, 15 indicates mild cognitive impairment and 14 and below shows the potential presence of dementia. Those that score around 20 and higher have nothing to be concerned with. Those that are a little lower around 15 to 17 may not have any clear signs of dementia. However, it could be worth retesting them at a later date to see if there is any deterioration. Those that score 14 and below should seek help for dementia treatment because there is a good chance that they have the early stages of the disease. As with other tests, marks are given in different categories of cognition.
Is the Self-administered Gerocognitive Exam Accurate?
The accuracy rates of this test are pretty high. Studies have shown that it will highlight mild cognition and memory issues 80% of the time. At the same time, 95% of people without problems will get a normal score. This does mean that there is a risk of error. However, this is a pretty high average for a simple at-home test that only takes 15 minutes. There have been some studies into the accuracy of the test in different groups across the US. One study took 1000 participants over the age of 50 from 45 community events. The SAGE test average score for the group was 17.8%. This is mid-way between a perfect score and mild cognitive impairment. The test found that 71.6% of the test subjects had normal cognition. 10.4% had some form of mild cognitive impairment and 18% had dementia.
Benefits of SAGE Test
Another benefit to this test is that there are actually four different examples that you can choose between. This doesn’t mean that seniors have to pass every test. Instead, this allows them to take more than one test over time. You could download the first test as a trial and then choose another a couple of months later if you are unsure about your relative’s performance.
Also, seniors could take the test annually for four years without any need to repeat the questions. The idea here is that this reduces the chance of people practicing the same test multiple times and giving remembered answers. This is a better way to test their cognitive abilities.
Downsides to the SAGE Test
The first drawback here is that you can’t score the test yourself. Therefore, you can complete the assigned tasks and fill out the form, but there is no immediate indication over whether or not there are signs of dementia or Alzheimer’s. When you print out the test, there is no score sheet provided. The reason for this is that there could be different answers and interpretations to some of the questions. This includes some of the questions on reasoning. A relative may not have the training to determine the right score here. They may also show some bias if they score the test themselves. Some may say that the answer was “close enough” because they don’t want their parent to get a bad score. Others may be overly cautious and undermark because they want their parent to seek professional help. This is why the SAGE test is scored by a doctor.
Another potential issue here is that the SAGE test can – as of the time of writing – only be downloaded in a small selection of languages. This list is English (US), English (New Zealand), Dutch, Spanish, Italian and Croatian. Therefore, it is not as wide-reaching as other tests and doesn’t cover many major languages. There could be seniors that are immigrants that would benefit from a version of the test in a variety of other languages.
You can download SAGE Tests here.
How Does it Compare to the MoCA?
There are some similarities here between the SAGE test and the MoCA exam that many doctors now use. There are some advantages to this test for those that want a comprehensive test in a safer space. But, there are those drawbacks with the scoring. This isn’t a complete process until seniors visit their physician and discuss the results. The MoCA can be administered and evaluated at the same time, which could prove to be a time-saving approach for those at risk. The exams themselves also have many of the same approaches to the questions, so there is no concern that one option is more reliable than the other.
What Happens Next?
If you decide to print out one of these tests and administer it to a relative with possible dementia symptoms, you need to follow up on the exam. Take the results to a doctor for that accurate score. They can then perform any additional tests they feel are important. If the score is high, there may be no further need for treatment or assessment. If the score is low, they can look at referring your relative to other specialists to determine the cause. If the score is in the middle, your doctor can still offer guidance and information on the best course of action.
The SAGE Test isn’t Perfect, But it is One of the Best Options Around
The SAGE test could use a few more languages and a little more support to appeal to all demographics. However, there is still an accessible nature to the test, and the website, that is refreshing. It doesn’t take long at all to go over these exercises with a loved one in the comfort of their home. You can be sure that the questions are broad enough to cover all kinds of cognition issues – without making the test overly complicated. Give the test a go, pass the results to your doctor and see if it can help you understand the cognitive health of your senior relatives.