Abstract
Objective: To validate a digital version of the Self-Administered Gerocognitive Examination (eSAGE) made for tablet use and compare it to MMSE, MoCA, and neuropsychological batteries.
Background: The traditional paper Self-Administered Gerocognitive Examination (SAGE) is a valid and reliable cognitive assessment tool used to identify individuals with mild cognitive impairment or early dementia. We converted the identical test questions into electronic format in order to provide a practical digital solution to early cognitive detection, its change-over-time, and progression prediction.
Design/Methods: Subjects aged 50 and over were recruited from community and clinic settings. After SAGE screening, subjects were randomly selected to participate in a clinical evaluation including neuropsychological evaluations. Associations were investigated using Spearman correlations and linear regression.
Results: 426 participants completed SAGE screening. Sixty-six subjects evaluated were 66% female, 89% white, and had mean age 75.2±7.3 (SD) years, mean education 15.1±2.7 years, mean MMSE score 26.9±2.6 (range: 20–30), mean MoCA score 20.7±4.5 (8–29), mean SAGE score 15.5±4.5 (4–22), and mean eSAGE score 14.3±5.0 (2–22). Correlations to neuropsychological batteries, all highly significant (p<0.0001), are 0.729 for eSAGE, 0.727 for MoCA, and 0.587 for MMSE. Correlation of eSAGE to MoCA is 0.758 and to MMSE is 0.671; all highly significant (p<0.0001). Correlation of SAGE versus eSAGE is 0.882 (p<0.0001); they are related by the formula: eSAGE score = −1.05 + 0.99 × SAGE score. There is strong evidence that the scaling is identical between eSAGE and SAGE (no scale bias).
Conclusions: eSAGE performed similarly with neuropsychological batteries, MoCA, and MMSE and shows no scale bias compared to the validated SAGE. eSAGE has the advantage of self-administration, brevity, four interchangeable forms and potential widespread availability to be a major factor in overcoming the many obstacles in identifying early cognitive changes in individuals.
Study Supported by: BrainTest, Inc.
Disclosure: Dr. Scharre has received personal compensation from Eli Lilly and BrainTest, Inc for consulting activities and serving on their scientific advisory board. Dr. Scharre has received royalty payments from BrainTest, Inc. Dr. Scharre received research support from Axovant, Biogen, Lundbeck, Merck, Eli Lilly, AstraZeneca, Envivo, BrainTest, AstraZeneca, Phylogeny, Bristol-Myers Squibb, and Pfizer. Dr. Chang has nothing to disclose. Dr. Nagaraja has received research support from Mangurian Foundation and BrainTest, Inc. Dr. Vrettos has nothing to disclose.
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