What Is the SAGE Test?

The SAGE test, short for Self-Administered Gerocognitive Exam, is a free pen-and-paper screening exam developed by Dr. Douglas Scharre and his team at The Ohio State University Wexner Medical Center to detect early signs of cognitive, memory, or thinking impairments. Its defining feature is in the name: you take it yourself, at home, in about 10 to 15 minutes, then bring the completed four-page form to your physician for scoring. It is scored out of 22 points. SAGE is a screening tool, not an IQ test, and Ohio State is explicit that it does not diagnose any specific condition.

There are four forms of the SAGE test, and they are interchangeable; you only need to take one. The average completion time is 10 to 15 minutes, but there is no time limit. The questions cover orientation, language, memory, reasoning, visuospatial abilities, and executive function, the same broad territory clinician-administered screens cover, packaged so that no examiner is needed.

Ohio State instructs takers not to score the exam themselves: "SAGE should be scored by your physician." Scoring requires judgment on items such as drawings, and the result only means something as the start of a conversation with a doctor who can order follow-up testing.

• 17 to 22: Suggests normal thinking and memory skills.

• 15 to 16: Suggests possible signs of thinking and memory problems, consistent with "mild cognitive impairment," a decline that is noticeable but does not yet interfere much with daily life.

• 14 and lower: Suggests signs of more serious thinking and memory issues that call for a medical evaluation without delay.

In the 2010 validation study, SAGE showed 95 percent "specificity" (correctly clearing people without impairment) and 79 percent "sensitivity" (correctly flagging people with impairment), against 90 percent and 71 percent for the MMSE. Scores on SAGE also correlated 0.84 with a full neuropsychological battery, which is strong agreement for a brief self-administered form.

A 2021 longitudinal study followed 424 patients from the Ohio State memory clinic and found that SAGE detected the conversion from mild cognitive impairment to dementia at least six months sooner than the MMSE: at 14.4 months on average, versus 20.4 months. Earlier detection matters because it moves forward the conversation about treatment and planning.

SAGE has a 22-point ceiling and no IQ norms. It cannot produce an IQ score, and it was never built to rank healthy adults. A "normal" result of 17 to 22 is compatible with any IQ from below average to gifted; all it tells you is that impairment is unlikely. Ohio State is equally direct about the other end: "SAGE does not diagnose any specific condition. The results of SAGE will not tell you if you have Alzheimer's disease, mini-strokes or any number of other disorders." It is also worth remembering that some slowing with age is normal; our article on how IQ changes as a person ages covers the difference between typical aging and impairment.

The three screens trade speed, depth, and supervision differently. SAGE is the only one designed for self-administration at home. The MoCA is a 30-point, roughly 10-minute screen administered by a trained clinician, with harder recall and executive items. The Mini-Cog takes about three minutes in a doctor's office. None of them diagnoses anything; a positive result on any of them leads to the same place, a full medical and neuropsychological workup. Research on IQ and dementia also suggests that people with higher prior ability can mask early decline, which is one reason clinicians look at change over time rather than a single number.

SAGE is scored out of 22 points. Scores of 17 to 22 suggest normal thinking and memory, 15 to 16 suggest possible mild cognitive impairment, and 14 or lower suggests more serious impairment. Ohio State says the test should be scored and interpreted by your physician.

No. SAGE screens for early signs of cognitive impairment. It has a 22-point ceiling and no IQ norms, so a normal result tells you impairment is unlikely, not how intelligent you are. Measuring ability across the normal range is the job of a full-scale IQ test.

Yes, that is its defining feature. It is self-administered with pen and paper, takes 10 to 15 minutes on average with no time limit, and comes in four interchangeable forms downloadable free from Ohio State. You then bring the completed test to your doctor for scoring.

In the 2010 validation study it showed 95 percent specificity and 79 percent sensitivity, and it correlated 0.84 with a full neuropsychological battery. A 2021 study found SAGE detected conversion from mild cognitive impairment to dementia at least six months sooner than the MMSE.

No. Ohio State states plainly that SAGE does not diagnose any specific condition. A low score means you should see a physician for a proper evaluation, which may include labs, imaging, and comprehensive neuropsychological testing.

SAGE checks whether something may be going wrong; it says nothing about where you stand on the ability scale. If the second question is the one you want answered, a normed assessment such as the Reasoning and Intelligence Online Test measures cognitive ability across the full adult range with standardized scores. You can take the free RIOT IQ test online.

1. Scharre, D. W., Chang, S.-I., Murden, R. A., Lamb, J., Beversdorf, D. Q., Kataki, M., Nagaraja, H. N., & Bornstein, R. A. (2010). Self-administered Gerocognitive Examination (SAGE): A brief cognitive assessment instrument for mild cognitive impairment (MCI) and early dementia. Alzheimer Disease & Associated Disorders, 24(1), 64-71. pubmed.ncbi.nlm.nih.gov

2. Scharre, D. W., Chang, S.-I., Nagaraja, H. N., Wheeler, N. C., & Kataki, M. (2021). Self-Administered Gerocognitive Examination: Longitudinal cohort testing for the early detection of dementia conversion. Alzheimer's Research & Therapy, 13, 192. pubmed.ncbi.nlm.nih.gov

3. The Ohio State University Wexner Medical Center. (n.d.). SAGE: A test to detect signs of Alzheimer's and dementia. wexnermedical.osu.edu

4. Cleveland Clinic. (n.d.). SAGE test: What it is, purpose & interpreting results. my.clevelandclinic.org

5. National Institute on Aging. (n.d.). Assessing cognitive impairment in older patients. nia.nih.gov