To compare PCP visits with and without using SAGE to determine differences in diagnoses, treatment, and management of new cognitive disorders.

50%-75% of dementia cases are undiagnosed, untreated, and unmanaged. Cognitive assessments are time consuming and difficult to incorporate into time-limited PCP visits. SAGE is a cognitive assessment not requiring administrator time.

Subjects aged 65-89 without diagnosed cognitive disorders completing a non-acute office visit were enrolled. Two physically separate PCP offices conducted the visits as they normally would for 100 consecutive subjects each. One office used SAGE in an additional 100 subjects and asked available informants about cognitive changes over the previous year. Chart reviews were conducted 60 days later. One-way analysis of variance and Fisher exact tests were used to compare the groups and outcomes.

There were no differences in age, race, or gender between intervention (n=100) and control (n=200) subgroups. When SAGE was utilized, the PCP documented detection of new cognitive conditions/concerns six times (9% versus 1.5%) as often (p=0.003). The intervention group detection rate was nearly 4-fold for those with cognitively impaired SAGE scores (p=0.034). Individuals having both impaired SAGE and informant concerns were 15-fold as likely to have new cognitive conditions/concerns documented (p=0.0007). In a sample of providers using SAGE, 86% would recommend SAGE to colleagues but approximately 25% felt it took up too much time during routine visits. Providers recommended that SAGE may be better utilized if given outside of exam rooms and at Annual Wellness Visits to prevent workflow disruption and allow for discussion time.

SAGE was easily incorporated into PCP visits and resulted in significantly increased awareness of new cognitive conditions/concerns leading to new diagnoses, treatment, or management changes. Detection rate increased 15-fold for those with impaired SAGE scores combined with informant reports of significant cognitive declines over a year.