Self-Administered Test for Cognitive Impairment

Educational Objectives

Summary

A Self-Administered Test for Cognitive Impairment

When patients present to primary care practices with concerns about memory, a screening instrument such as the Mini-Mental State Examination (MMSE https://www.dementiacarecentral.com/mini-mental-state-exam/online-version-questions/) or the Montreal Cognitive Assessment (MoCA https://www.mdcalc.com/montreal-cognitive-assessment-moca) might be administered. However, some busy clinicians likely omit these tests because of the time required to administer them. In a retrospective study from an academic memory disorders clinic, researchers compared the MMSE and the Self-Administered Gerocognitive Examination (SAGE), a validated 11-item instrument that they have developed. As indicated in its name, SAGE is self-administered; patients complete it by themselves, usually in 10 to 15 minutes. Findings appear in the December 6, 2021 issue of Alzheimer’s Research & Therapy (https://doi.org/10.1186/s13195-021-00930-4).

Both the MMSE and SAGE were completed at each 6-monthly visit by 220 patients with mild Alzheimer dementia at baseline, 94 patients with mild cognitive impairment (MCI) who didn’t progress to dementia during follow-up, 70 patients with MCI who converted to dementia during follow-up, and 40 patients with only subjective cognitive impairment. During average follow-up of 3 to 4 years, SAGE scores declined at least 6 months earlier than MMSE scores in patients with Alzheimer disease and in MCI converters, suggesting greater sensitivity to detect progression. For patients with only subjective cognitive impairment or nonprogressive MCI, both SAGE and MMSE scores remained unchanged.

SAGE appears to compare favorably with MMSE and has the advantage of patient self-administration at home or in the medical office. For clinicians who wish to use this instrument, SAGE (https://wexnermedical.osu.edu/brain-spine-neuro/memory-disorders/sage) is freely available for download (along with instructions on how to interpret it).

Allan S. Brett, MD

Readings

Disclosures

Acknowledgements

CME/CE INFO

Accreditation:

The Audio- Digest Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Audio- Digest Foundation designates this enduring material for a maximum of 0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Audio Digest Foundation is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's (ANCC's) Commission on Accreditation. Audio Digest Foundation designates this activity for 0 CE contact hours.

Lecture ID:

JW330425

Expiration:

This CME course qualifies for AMA PRA Category 1 Credits™ for 3 years from the date of publication.

Instructions:

To earn CME/CE credit for this course, you must complete all the following components in the order recommended: (1) Review introductory course content, including Educational Objectives and Faculty/Planner Disclosures; (2) Listen to the audio program and review accompanying learning materials; (3) Complete posttest (only after completing Step 2) and earn a passing score of at least 80%. Taking the course Pretest and completing the Evaluation Survey are strongly recommended (but not mandatory) components of completing this CME/CE course.

Estimated time to complete this CME/CE course:

Approximately 2x the length of the recorded lecture to account for time spent studying accompanying learning materials and completing tests.

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