Digital Versus Paper Self-Administered Gerocognitive Examination (SAGE) (P6.206)

Abstract

Objective: To validate a digital version of the Self-Administered Gerocognitive Examination (eSAGE) made for tablet use and compare it to the traditional paper SAGE (pSAGE) version. Background: pSAGE is a valid and reliable cognitive assessment tool used to identify individuals with cognitive impairment or dementia. Having equivalent pSAGE and eSAGE assessments would be very helpful in identifying or following cognitive impairment. Methods: Subjects aged over 50 were recruited from community and clinic settings. After pSAGE screening, subjects were randomly selected to participate in a clinical evaluation including neuropsychological evaluations. pSAGE and eSAGE were administered using a crossover design. Associations were investigated using Spearman correlations and linear regression. Results: 317 participants completed pSAGE screening. Thirty-seven subjects evaluated so far in this ongoing study were 70.3[percnt] female, 10.8[percnt] non-white, and had mean age 75.0±8.9 (SD) years, mean education 15.5±2.9 years, mean MMSE score 27.2±2.2 (range: 22-30), mean MoCA score 20.5±4.6 (8-29), mean pSAGE score 16.1±4.2 (7-22), and mean eSAGE score 14.6±4.8 (3-22). Spearman correlation of pSAGE versus eSAGE is 0.831 (p<0.0001); they are related by the formula: eSAGE score = -1.70+1.01×pSAGE score. Since the slope is very close to 1 (p=0.904) there is strong evidence that the scaling is identical between eSAGE and pSAGE (no scale bias). eSAGE scores are lower by an average of 1.7, but the decrease is not statistically significant (p=0.255). Correlations of SAGE scores to neuropsychological batteries show no significant difference between paper and digital format. Correlations of pSAGE and eSAGE to MoCA (0.729 and 0.741) and MMSE (0.548 and 0.654) are all highly significant (p<0.0005). Conclusions: At this juncture in our subject recruitment for validation purposes, tablet based eSAGE is performing similarly with neuropsychological batteries and shows no scale bias compared to validated pSAGE.

Disclosure: Dr. Scharre has received personal compensation for activities with Eli Lilly, BrainTest, Inc, Lundbeck, and Avanir as a consultant. Dr. Scharre has received royalty payments from BrainTest, Inc. Dr. Scharre has received research support from Biogen, Lund Dr. Chang has nothing to disclose. Dr. Nagaraja received financial support for research activities from the Mangurian Foundation and from BrainTest, Inc. Dr. Vrettos has nothing to disclose.