The Self-Administered Gerocognitive Exam (SAGE) is a test that detects the early signs of Alzheimer’s disease and dementia by measuring mental functions such as thinking, memory, and cognition.

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A person may wish to take the test if they are worried about their cognitive functions or if others have noticed changes in their thinking abilities.

This article discusses the SAGE test in more detail, including what it involves and its accuracy and reliability. It also explains how to take the test and when it is advisable to consult a doctor.

The World Health Organization (WHO) estimates that more than 55 million people live with dementia and that almost 10 million new cases occur yearly.

Dementia is the progressive loss of mental functioning. This includes functions such as:

  • thinking skills
  • memory and recall
  • reasoning and logic

According to the National Institute on Aging, approximately one-third of people aged 85 years and older have a form of dementia.


The signs and symptoms of dementia become evident when healthy brain nerve cells stop functioning properly and lose connections with other cells. Eventually, these nerve cells die, which occurs at a higher rate in people with dementia.

Some people with dementia may experience mild symptoms, whereas others may have a more severe form of the condition that causes them to depend on others to complete day-to-day tasks.

The symptoms of dementia include:

  • memory loss
  • confusion
  • difficulty with:
    • speech
    • expressing thoughts
    • reading and writing
    • making judgments
  • wandering aimlessly and getting lost in familiar neighborhoods
  • repeating questions
  • using unusual words to describe familiar objects
  • taking more time to complete daily tasks
  • losing interest in daily activities
  • hallucinations
  • paranoia
  • impulsiveness
  • problems with movement and walking, such as losing balance
  • apparent changes in personality
  • mood changes

Alzheimer’s disease

The most common type of dementia is Alzheimer’s disease, which accounts for about 70% of all dementia cases.

In this condition, brain deposits of two types of protein — tau and beta-amyloid — clump together to form plaques. This leads to the dysfunction of nerve cells.

Visit our dedicated hub to learn more about dementia.

The SAGE test detects the early signs of Alzheimer’s and dementia by measuring mental functions such as thinking, memory, and cognition.

Douglas Scharre developed the test with his team at the Ohio State University (OSU) Wexner Medical Center.

The test is slightly more difficult than other cognitive questionnaires, such as the mini-mental state examination (MMSE). This is to ensure that the test potentially picks up even very mild cognitive impairment.

Who should take the SAGE test?

A person may wish to take the SAGE test if they are worried about their cognitive functions or have noticed a decline in their thinking skills or memory.

In some cases, it might be other people, such as family or friends, who have noticed changes in the person’s cognitive abilities and expressed their concerns.

A person is able to access the test via the OSU Wexner Medical Center website.

The test only requires paper and a pen. There are four versions, but people need to do only one of them, as all the tests are interchangeable.

It involves a number of questions that will test cognition. For example, it may ask the person to state today’s date from memory and complete simple mathematic questions.

People should not look at a clock or calendar while taking the test. Although there is no time limit, the average time to complete the test is 13 minutes. A person should do the test alone and without the help of other individuals.

When a person has completed the test, they should consult a doctor to obtain a score and find out what this result may mean.

Although the test may help detect early signs of cognitive impairment, the results cannot tell a person whether they have dementia, Alzheimer’s disease, or any other condition. Certain factors such as age and educational level may also affect the test scores. Due to this, some experts have recommended that doctors add a point if a person is over the age of 80 years or has an education level of 12 years or less.

A research team conducted a study in 2021 with 665 participants. The study found that the SAGE test was able to detect mild cognitive impairment converting to dementia at least 6 months sooner than the MMSE.

The main advantage of the test is that it removes certain barriers in performing mental function assessments, as an individual is able to self-conduct the test.

The same team had already carried out a smaller 2017 study with 66 participants and found that a digital version of the SAGE test showed 90% specificity and 71% sensitivity in detecting cognitive impairment in people with no evident symptoms.

A person will need to consult a doctor to get a score for their SAGE test. The maximum score for the test is 22. A person will have a normal score if they score 17 or above.

If the person gets a lower score than expected on the test, the doctor may request further testing to determine whether there is any cognitive impairment.

A person should also speak with a doctor if they are experiencing dementia symptoms and would like to discuss further testing options.

Dementia is a condition that results in the decline of mental functions.

A person can do a SAGE test to see whether there is any decline in their cognition, thinking, and memory. They should complete it unaided and avoid using a calendar or clock.

Although people can take the test independently, they will need to consult a doctor to get their result and find out whether they require further testing for dementia.