Study: Test detects signs of dementia at least six months earlier than standard method

A study released Monday concluded that a self-administered test detected signs of potential dementia, including Alzheimer’s disease, at least six months ahead of the standard testing method, suggesting the exam may help doctors diagnose patients sooner. 

The self-administered gerocognitive examination (SAGE) test picked up on signs of cognitive impairment months earlier among patients than the often used mini-mental state examination (MMSE), according to the research published in the journal Alzheimer’s Research & Therapy.

The study involved more than 600 participants who visited the Ohio State University’s Center for Cognitive and Memory Disorders over eight years, who had at least two visits six months apart and who took both the SAGE and MMSE tests. 

Among those who developed dementia during the study period, researchers determined that the first “significant decline” in SAGE scores occurred in an average 14.4 months after first taking the tests. 

MMSE scores, on the other hand, for those eventually diagnosed with Alzheimer’s saw the first “significant decline” at an average of 20.4 months since the initial tests. Among those later diagnosed with another form of dementia, the standard test detected the decline at an average of 32.9 months after the first tests.

Those who had Alzheimer’s when they took the first tests saw their first major decline about 8.3 months from the initial SAGE test, compared to 14.4 months for MMSE results. 

Lead author Douglas Scharre, the director of the division of cognitive neurology at Ohio State University, told The Hill that he helped develop the SAGE test due to his “frustration” when patients came in with a condition that had worsened in recent years. 

“They were just coming in too late, and I figured we needed something better, something that was accurate but more practical,” Scharre said. “And so the way to do that is self-administered.”

“By the time it’s obvious to everyone they’ve usually progressed further than we want,” he added. “And so now that we have potential disease modifying treatments that are actually available, the need to identify people earlier is really critical.”

The SAGE test intends to track the patients’ thinking processes and to spot cognitive impairment symptoms beyond normal aging. 

But the exam itself is not diagnostic and cannot determine whether a patient has Alzheimer’s or another form of dementia, and scientists recommend patients take the test into their doctors’ office for analysis. 

Patients who develop mild cognitive impairment do not automatically develop Alzheimer’s or another type of dementia. 

The SAGE test would signal “significant” cognitive decline if a patient’s score falls two or three points within about 12 to 18 months, Scharre said. 

As a self-administered test, the SAGE test can be taken in any location, including at home or in waiting rooms, and therefore does not take up physicians’ time. 

The paper version of the SAGE test is free. The digital version is available through BrainTest. 

Research on the SAGE test comes after the Food and Drug Administration (FDA) authorized the first Alzheimer’s drug in almost 20 years in a controversial decision. Biogen’s drug Aduhelm is designed for those with mild cognitive impairment. 

But the FDA’s decision has come under scrutiny with two House committees investigating the authorization that came after an advisory panel unanimously opposed the drug. 

Aduhelm, priced at $56,000 per year, is also linked in part to an expected increase in Medicare premiums for 2022. In response, Sen. Bernie Sanders (I-Vt.) called on President Biden last week to delay Medicare’s approval for use for Aduhelm.