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
Executive Function
2 points
problem solving item
2 points
item regarding modified B trails
Calculation
Abstraction
Visuospatial Ability
2 points
item regarding 3-dimensional construction
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