Timely detection of cognitive changes can lead to earlier diagnoses and treatment and increased supervision of the individual. Researchers retrospectively compared longitudinal Self-Administered Gerocognitive Examination (SAGE) scores to those of the Mini-Mental State Examination (MMSE), which is not self-administered, in five different diagnostic subgroups.

A retrospective chart review was performed on 655 consecutive patients who were seen at a university memory disorders clinic and completed the SAGE and MMSE during at least two visits approximately six months apart. Of the 424 patients included in the analysis, 40 had subjective cognitive decline, 94 were classified as mild cognitive decline nonconverters and 70 as mild cognitive decline converters, and 220 had Alzheimer disease dementia. Of those who converted from mild cognitive decline to dementia, 49 developed Alzheimer disease dementia and 21 developed non-Alzheimer disease dementia.

Both SAGE and MMSE scores declined significantly over time at annual rates of 1.91 and 1.68, respectively, for mild cognitive decline converters to Alzheimer disease dementia and 2.33 and 1.83, respectively, for mild cognitive decline converters to other types of dementia. SAGE and MMSE scores remained similar over time in those who had subjective cognitive decline and in mild cognitive decline nonconverters. Significant changes in SAGE scores occurred at least six months earlier than significant changes in MMSE scores for the converter groups and for those who had Alzheimer disease at baseline.

The authors point out limitations inherent in this study, including that their research involves a retrospective chart review from an academic memory disorders clinic with referral and sampling biases. They note the need for more studies of other populations and for tests to be given in other than a clinic setting. The researchers advise that a decline of two to three points or more in the SAGE score over 12 to 18 months may be significant and should trigger the provider to consider additional diagnoses, evaluations, or management changes.