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SAGE: Self-Administered

Gerocognitive Examination

Test Construction

Scoring

  • scored by hand (See “Scoring Instructions” at http://www.sagetest.osu.edu/download.html?Submit=Continue+to+Download for details on how to score)
  • one can score from 0-22
  • 17+ -> normal
  • 15, 16 ->likely to have mild memory or thinking impairments
  • 14 or below ->likely to have a more severe memory or thinking condition

Theoretical Background

  • items developed based on Dr. Douglas Scharre's clinical experience and a literature review
  • cognitive domains included based on their ability to predict mild cognitive loss
  • orientation
  • language
  • memory
  • calculation
  • abstraction
  • visuospatial ability
  • executive function

Scales / Description

  • four versions of SAGE, each with 12 items that account for a total of 22 possible points

Orientation

4 points

1 item regarding the date

Language

2 points

verbal fluency item

2 points

picture naming item

Memory

2 points

Executive Function

2 points

problem solving item

2 points

item regarding modified B trails

Calculation

2 points

Abstraction

2 points

Visuospatial Ability

2 points

item regarding 3-dimensional construction

2 points

clock draw item

Standardization

  • 59 years +
  • education level: 8th grade -> PhD
  • 42 female, 21 males
  • 54 Caucasian, 9 non-Caucasian

Reliability

Administration

  • Spearman correlation between SAGE and the neuropsychological battery was 0.84
  • Spearman correlation between SAGE and MMSE scores was 0.79
  • Inter-rater reliability for SAGE scoring equaled 0.96
  • Test-retest reliability: Spearman rank correlation of 0.86
  • Receiver Operating Characteristics
  • Specificity (true negative rate) = 95%
  • Sensitivity (true positive rate) = 79%
  • Predictive Values
  • Predictive positive value = 96%
  • Predictive negative value = 71.4%

Author and Date Published: Douglas Scharre, 2010

Publisher: Ohio State University Medical Center

Length: There are four equivalent versions of SAGE, each with 12 questions. The test takes about 15 minutes to complete.

Qualification: No qualification level is required; SAGE can be administered by anyone.

Validity

  • any setting, as long as there is no accessible calendar or clock
  • complete in pen, not pencil
  • examinee must have adequate vision and English literacy at the sixth grade reading level (spelling is irrelevant)
  • 10-15 minutes to complete
  • sel-administered / can be administered by anyone
  • cannot be adapted for an interview
  • individual or group setting
  • no use of computers or internet
  • no qualification level required
  • Criterion validity was established by determining the cut-off scores according to their relation to clinical diagnosis
  • will investigate how well the cut-off scores leading to a prediction of MCI or dementia compares to a clinical diagnosis
  • Content validity was established, as SAGE correlated very well to the “gold standard” of neuropsychological testing

The Basics

Psychometric Properties

Purpose

  • identify Mild Cognitive Impairment (MCI) and early dementia
  • can provide an early indication of cognitive memory disorders
  • diagnosis and treatment planning during early stages of impairment
  • negative implications of other cognitive impairment screenings
  • self-administered
  • free

Things to Consider

Multicultural Considerations

  • no multicultural considerations are known at this time, as normative data for SAGE in multicultural groups is still needed
  • the effect of age, sex, SAGE form, clinical diagnosis, and education:
  • Age, sex, and version of SAGE had no effect
  • Clinical diagnosis had a highly significant effect
  • Education had a moderate effect

Strengths

Additional Information

  • SAGE is a valid and reliable instrument to gage cognitive impairment
  • SAGE can differentiate between normal and MCI
  • practical usability
  • is no cost involved

Weaknesses

  • four approximately equivalent forms
  • reduces potential for learning effects
  • no cost to administer or take SAGE
  • developed by D. Douglas Scharre (Ohio State University Medical Center)
  • http://www.sagetest.osu.edu/
  • only in English
  • larger norming sample
  • lack of multicultural norms
  • cannot compare to other timed neuropsychological tests
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