Braintest App Has Equivalent Sensitivity and Specificity as SAGE Test for Mild Cognitive Impairment


There is an app (BrainTest, Columbus, OH) used to detect mild cognitive impairment (MCI). It is a clinically validated, digital version of the paper and pen Self-Administered Gerocognitive Exam (SAGE) test often used in physicians’ offices to measure MCI. In a large clinical trial of 400 patients, the app version demonstrated its equivalency to SAGE.   The app is self-administered on an iPad or Android tablet and available at, the Apple app store, the Google Play store, or the Amazon app store. The digital app version is self-administered and takes about 15 minutes to complete. Both the SAGE test and the BrainTest app have 95% specificity and 79% sensitivity for MCI.

At the recent American Alzheimer International Conference 2018 in Chicago IL, the creator of the SAGE test, Douglas Scharre MD, explained his motivation for developing the SAGE test. As a clinician and investigator, he was often frustrated by the delay in people coming in to consult with him about cognitive symptoms. People with cognitive dysfunction often know they have problems, or their family knows they have problems, but that doesn’t mean they come in for a formal assessment. There is a need for something that is practical, easy to give, and gets these patients to come in and have the conversation with their physician.

Although the app can be used as a tool by primary care doctors, ideally, people would use the tool on their own because they or a family member noticed an issue. For example, consider the young woman who got a really nice birthday card from her grandmother with money in it, and then a few days later got another card from her grandmother, also with money in it. When the patient and family presented for care, everyone remembered it and they also remembered thinking, “oh, people just forget.”

If instead, family members get the idea that there is something out there, they may be more likely to address it. This will hopefully lead to both earlier identification of people with cognitive impairments, increased early referrals to tertiary care centers, and a larger pool of patients for clinical trials. Dr. Scharre also noted that it can help reassure the “worried well.” 


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