EEG-based assessment of sustained attention in geriatric inpatients: a feasibility study

Stagneth, Lina; Geritz, Johanna; Hermann, Gesine; Dahl, Lea; Zuber, Leoni; Neumann, Christian; Lassen, Josephine; Maetzler, Corina; Kranczioch, Cornelia; Welzel, Julius; Maetzler, Walter · 2026 · Crossref

DOI: 10.1007/s11357-026-02406-5

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Summary

This study evaluates the procedural and methodological feasibility of using electroencephalography (EEG) to assess sustained attention in geriatric inpatients undergoing early rehabilitative geriatric complex treatment (ERGCT). Sustained attention is a critical cognitive function that often declines with age and neurological disease, yet the applicability of high-resolution EEG assessments in multimorbid, hospitalized older adults remains poorly characterized. The research aimed to determine whether EEG-based cognitive testing could be practically integrated into clinical settings and whether the resulting data possessed sufficient signal quality for valid analysis. The study recruited 173 patients referred to the ERGCT program, of whom 43 met inclusion criteria and were enrolled. Participants completed standardized neuropsychological tests, including the Montreal Cognitive Assessment (MoCA) and Trail Making Test, alongside two computerized attention tasks: the Psychomotor Vigilance Task (PVT) and a cued Go-NoGo task. EEG data were recorded using a 32-channel system during these tasks and during resting-state periods. Feasibility was assessed through procedural indicators, such as recruitment rates and protocol completion, and methodological indicators, specifically signal-to-noise ratios (SNR) and the identification of event-related potential (ERP) components P100 and P300. Data preprocessing involved filtering, artifact removal via Independent Component Analysis, and spectral analysis of resting-state alpha-band power. Procedural feasibility was limited by substantial selection bias and attrition; only 25% of referred patients were included, and complete data across all assessment domains were available for just 35% of participants. Missing data were primarily due to health instability, exhaustion, or conflicting clinical appointments. Methodologically, EEG recordings yielded adequate signal quality for a subset of patients. Grand-average ERPs clearly identified P100 and P300 components in both tasks. Statistical analysis revealed significantly higher SNR for the P300 compared to the P100. Exploratory analyses indicated a significant negative correlation between resting-state alpha-band SNR and PVT reaction times, suggesting that higher alpha signal quality was associated with faster responses. However, no significant associations were found between ERP SNRs and global cognition, executive function, or age. The findings indicate that while EEG-based assessment of sustained attention is methodologically feasible in a selected subgroup of clinically stable geriatric inpatients, its broader implementation is constrained by procedural burdens. The high rate of exclusion and incomplete protocol completion suggests that extended, repeated EEG assessments are difficult to sustain under current clinical conditions. Consequently, while the technique yields valid neural markers in compliant patients, its utility as a routine clinical tool for this population requires optimization to reduce participant burden and improve recruitment and retention rates.

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• neuro workload indices

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• Empirical Findings: physiological data