Self-administered Gerocognitive Examination (SAGE)

Objectives: To develop a self-administered cognitive assessmentinstrument to facilitate the screening of mild cognitive impairment(MCI) and early dementia and determine its association withgold standard clinical assessments including neuropsychologicevaluation.Methods: Adults aged above 59 years with sufficient vision andEnglish literacy were recruited from geriatric and memory disorderclinics, educational talks, independent living facilities, seniorcenters, and memory screens. After Self-administered Gerocogni-tive Examination (SAGE) screening, subjects were randomlyselected to complete a clinical evaluation, neurologic examination,neuropsychologic battery, functional assessment, and mini-mentalstate examination (MMSE). Subjects were identified as dementia,MCI, or normal based on standard clinical criteria and neuro-psychologic testing.Results: Two hundred fifty-four participants took the SAGE screenand 63 subjects completed the extensive evaluation (21 normal, 21MCI, and 21 dementia subjects). Spearman rank correlationbetween SAGE and neuropsychologic battery was 0.84 (0.76 forMMSE). SAGE receiver operating characteristics on the basis ofclinical diagnosis showed 95% specificity (90% for MMSE) and79% sensitivity (71% for MMSE) in detecting those with cognitiveimpairment from normal subjects.Conclusions: This study suggests that SAGE is a reliable instrumentfor detecting cognitive impairment and compares favorably withthe MMSE. The self-administered feature may promote cogni-tive testing by busy clinicians prompting earlier diagnosis andtreatment.Key Words: self-administered, cognitive screen, mild cognitiveimpairment, early dementia