Keel vs. the SAGE Test: Which Is Right for You?
The SAGE is a self-administered clinical screening tool developed at Ohio State. Keel is a daily personal monitoring habit. Both are designed for home use — but for very different purposes.
What each tool does
The SAGE (Self-Administered Gerocognitive Examination) is a paper-based cognitive screening test developed at Ohio State University. Unlike the MoCA and MMSE, the SAGE is specifically designed for self-administration at home — patients complete it themselves and bring it to their doctor, who then scores and interprets it. It covers orientation, language, memory, reasoning, and visuospatial function, and takes about 15 minutes. It is available for free download from the Ohio State Wexner Medical Center.
Keel is a digital daily cognitive baseline tracker. Five brief tests each morning build a personal trend across five cognitive domains. Like the SAGE, Keel can be done at home without a clinician present. Unlike the SAGE, it is not a periodic assessment — it is a daily monitoring habit that builds a longitudinal trend over weeks and months.
Key differences
The SAGE and Keel share the advantage of being usable at home, but they serve very different purposes and are used very differently.
- SAGE: self-administered paper test, taken periodically (every 6-12 months); Keel: digital daily monitoring, taken every morning
- SAGE: produces a score brought to a doctor for interpretation; Keel: produces a personal trend you monitor yourself and can optionally share
- SAGE: designed as a clinical screening tool, validated against clinical populations; Keel: designed for personal wellness monitoring, not clinical screening
- SAGE: 15 minutes, administered as a test; Keel: 4 minutes, administered as a daily habit
- SAGE: one snapshot in time, compared to clinical norms; Keel: longitudinal trend compared to your own baseline
- SAGE: free, paper-based; Keel: free tier for 30 days, Pro subscription for full history
Who each is best for
The SAGE is genuinely useful as a periodic screening tool, particularly for someone who wants a structured assessment they can bring to their doctor. Because it was designed for self-administration, it removes some of the clinical-visit friction of tools like the MoCA. If you want a validated clinical-style result without scheduling a visit, the SAGE is a good option — just remember that it still needs to be interpreted by a physician.
Keel is better for ongoing daily monitoring. If you want to know whether you are the same person cognitively that you were three months ago — and you want to watch that trend in real time rather than waiting for a periodic assessment — Keel provides that. The two serve different time horizons: SAGE for the periodic clinical snapshot, Keel for the daily trend.
The case for daily baseline tracking
The SAGE, taken every six to twelve months, can detect whether a significant change has occurred over that period. But the gap between assessments is long. If you are changing, you will not know it for months. If a stressful period in October caused a temporary dip that resolved by December, the SAGE taken in January will miss it entirely.
Daily tracking provides granularity that periodic assessment cannot. You see the shape of your cognitive performance across the year — the seasonal patterns, the impact of a bad illness, the improvement after starting regular exercise. This is richer information than two annual data points.
The SAGE and Keel are natural complements. Do your SAGE every six months and bring it to your doctor. Do Keel every morning to stay aware of your own trend between those appointments. The combination covers both the clinical screening goal and the personal monitoring goal.
Frequently asked questions
Where can I get the SAGE test?
The SAGE test is available for free download from the Ohio State Wexner Medical Center website (wexnermedical.osu.edu). You print it, complete it yourself, and bring it to your doctor for scoring and interpretation. There are multiple versions to avoid memorization if repeated.
Can I score the SAGE myself?
The SAGE is designed to be brought to a physician for scoring — the scoring rubric requires clinical judgment for certain items. Self-scoring introduces error and misses the clinical interpretation context. Keel, by contrast, is designed for self-monitoring: your trend is visible to you directly, without requiring clinical interpretation for the monitoring itself.
If I use Keel daily, do I still need the SAGE?
Keel and the SAGE serve different purposes. If your doctor recommends periodic clinical screening with the SAGE, continue doing that — a validated clinical assessment is valuable independent of home monitoring. Keel's daily data enhances what you bring to the clinical assessment; it does not replace it.
Related resources
Start tracking your cognitive baseline
Four minutes a day. Five short tests. One trend line that builds over weeks and months so you can see where you stand — and separate a bad day from a real change.
Free to start. No account required. Not a diagnostic tool.