SAGE is available at https://wexnermedical.osu.edu/brain-spine-neuro/memory-disorders/sage.
"We found in general that if the individual was steady on their SAGE test scores, they were not at risk for developing dementia," Dr. Douglas Scharre of Ohio State University Wexner Medical Center in Columbus told Reuters Health by email. "However, (those who) dropped 2-3 points over 12-18 months on SAGE were likely to eventually develop dementia."
"This allows practitioners time to mitigate and treat those individuals at an early stage when treatments are more effective," he said. "It allows patients and families to get a jump on controlling their brain health."
"Identification of cognitive issues at an early stage may also help clinicians and families decide it is time to act on safety and supervision needs for the patient," he added. "This might include, for example, medication oversight, financial assistance, driving limitations, setting up durable powers of attorney and other legal arrangements/trusts, change in living arrangement, and enhanced caregiving support."
As reported in Alzheimer's Research and Therapy, Dr. Scharre and colleagues compared the annual rate of change in SAGE test scores and MMSE scores in different diagnostic subgroups.
For the single-center study, 424 individuals with at least two visits six months apart were classified as subjective cognitive decline (SCD), mild cognitive impairment (MCI), or Alzheimer's disease (AD) dementia. Mean ages ranged from 69 for SCD to 77 for AD; sex ranged from 40% women for SCD to 61% women for AD. Almost all participants (93%-96%) were white.
Of the 70 patients who converted from MCI to dementia, 49 developed AD dementia and 21 were diagnosed with other non-AD causes of dementia, such as Lewy body, vascular, normal pressure hydrocephalus, vasculitis, mixed small vessel vascular dementia and chronic kidney disease.
SAGE scores declined at annual rates of 1.91 points/year for MCI converters to dementia, and 1.82 points/year for those with AD dementia.
By contrast, MMSE scores declined at annual rates of 1.68 points/year for MCI converters to AD dementia, and 2.38 points/year for those with AD dementia.
Statistically significant declines from baseline scores in SAGE occurred at least six months earlier than MMSE for MCI converters to AD dementia (14.4 vs. 20.4 months); MCI converters to non-AD dementia (14.4 vs. 32.9); and AD dementia individuals (8.3 vs. 14.4).
Both scores remained stable for SCD and MCI non-converters.
Dr. Scharre noted, "SAGE cannot diagnose any specific condition. That must be done by the health practitioner. SAGE does provide data on the cognitive abilities of the person and if there is a change over time. The medical professional can use the SAGE results in combination with the patient's medical history, lab testing, neuroimaging, and symptoms to determine the diagnosis."
Dr. Heather Snyder, Alzheimer's Association vice president of medical and scientific relations, called the study "interesting."
"While it's good to see this research was done longitudinally over eight years, the study population was relatively small for what we'd need to see with this sort of evaluation," she said in an email to Reuters Health. "It's important to study this test in much larger, more diverse populations to better understand how it works in a real-world setting."
"If asked about this particular test by their patients, or about self-testing in general, clinicians should explain that testing for Alzheimer's should be done in a medical office in the presence of a skilled doctor using validated testing tools," she said. "This ensures that the process of assessment and diagnosis is done accurately through a qualified healthcare professional."
"Clinicians can also play a role in educating their patients about how an Alzheimer's diagnosis is currently made (https://bit.ly/3mncser), " she added. As Dr. Scharre also noted, Dr. Snyder said, "This would include neurological exams, mental cognitive status testing and, if appropriate, brain imaging."
SOURCE: https://bit.ly/33ri40u Alzheimer's Research and Therapy, online December 6, 2021.
By Marilynn Larkin
Posted on
site created by:
© 2024 Medicom Medical Publishers. All rights reserved. Terms and Conditions | Privacy Policy