The SAGE is a short test you can take on your own to help detect signs of mild cognitive impairment. But you’ll need a doctor to interpret results and perform additional tests to check whether you have dementia or Alzheimer’s.

As you get older, you might find that you can’t recall information as easily or as quickly as you once did. You might misplace things more often or forget names and dates.

Most people experience mild changes in memory and thinking as they age. Still, you might worry that these changes are a sign of a more serious condition, such as Alzheimer’s or dementia.

The Self-Administered Gerocognitive Exam (SAGE) is a free online screening tool for early stage dementia. Developed by researchers at Ohio State University, it can detect cognitive issues that may be a sign of a more serious condition.

This article tells you everything you need to know to take the test.

You may want to take the SAGE if you are concerned about thinking and memory issues in yourself or a loved one. The test can detect mild cognitive impairment (MCI), which is often one of the earliest signs of dementia.

MCI is associated with a slight but noticeable decline in memory and thinking. People with MCI might miss appointments or fall behind on their mortgage or bill payments.

It can also affect executive function, which includes your ability to plan ahead, follow instructions, and use judgment. However, MCI is usually mild enough that people who have it can still take care of themselves and complete most day-to-day activities.

MCI sometimes leads to dementia or Alzheimer’s, but it can also be a sign of another treatable condition. If you think you or a friend or loved one might have MCI, the SAGE is a good place to start.

The SAGE starts with questions about your background and health. Test questions ask you to name images, categorize objects, and do simple math. Other questions require you to remember instructions and recall basic information, such as the names of countries or animals.

It features several tests of visuospatial ability and executive function, such as the clock-drawing test. This classic dementia test requires you to draw the face of an analog clock and position the hands at a specific time.

It’s important to complete the SAGE without assistance. If you don’t understand one of the questions, answer it to the best of your ability.

How to take the SAGE test

The SAGE is available for free online in a dozen different languages.

You can choose any of the four different versions of the test available in each language. The questions on each version are slightly different. It doesn’t matter which version you choose, as they are all equal in difficulty level.

To complete the pen-and-paper version of the test, you will need to download and open a PDF and print it from your computer.

Here’s where you can download the SAGE.

If you can’t print the test, a digital version is also available. You can sign up for a free trial to take the test using an app. However, keep in mind that your credit card may be charged once the trial period is over.

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The SAGE was first introduced in 2010. One of the test’s developers, Douglas Scharre, conducted an initial study along with other researchers that evaluated the test’s effectiveness on 254 older adult participants. The study found that:

  • The SAGE detected cognitive impairments in 79% of people who actually had cognitive impairments.
  • The SAGE did not detect cognitive impairments in 95% of people who did not have cognitive impairments. In other words, the false positive rate is 5%.

An additional 2014 study conducted by Scharre and others assessed the use of the SAGE in community settings, which included independent living facilities, centers for older adults, and assisted living facilities. The researchers found that the SAGE identified cognitive impairments in approximately 28% of 1,047 people over age 50 years who took the test, with an average age of about 73 years.

For comparison, the authors of a 2023 systematic review featuring 53 articles and a total of 376,039 people from countries around the world found that 21.2% of adults between the ages of 64 to 87 years and living in nursing homes had mild cognitive impairment.

The SAGE can reliably identify cognitive concerns that are sometimes a sign of early stage dementia. It’s important to keep in mind, though, that the test is not a diagnostic tool. It cannot tell you whether you have Alzheimer’s disease or another type of dementia.

One key benefit of the SAGE is that almost anyone can take it. It’s more accessible than most other cognitive tests because you don’t need to visit a healthcare professional to take it. That said, you do still need to visit a doctor to get your results.

People often compare the SAGE to the Mini-Mental State Examination (MMSE). The MMSE takes around 10 minutes and is widely used in healthcare settings to screen for dementia.

In a 2021 study, Scharre and other researchers compared results from the two tests over an 8-year period among 665 people who visited a memory disorder clinic.

They found that changes in SAGE scores over time could reliably predict cognitive impairments that progressed to dementia around 6 months earlier than the MMSE.

How long does the SAGE test take?

The SAGE takes approximately 10 to 15 minutes to complete. You will need paper and a printer to print out the test after you download it and a pen to complete it.

You should take the test without any assistance, ideally in an environment free of noise and distractions.

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After completing the test, you should take it to a doctor. They can score the test and help you interpret the results.

If your result suggests cognitive decline, your doctor might recommend additional tests or monitoring.

The SAGE is a freely available test that screens for cognitive decline. If you’re worried about changes in your own or a loved one’s ability to think or remember, you might decide to take the test.

The test detects MCI, a condition that often precedes dementia. But it can’t tell you whether you have dementia because MCI has other potential causes.

After taking the test, you’ll need to make an appointment with a doctor to learn what your score means.