Studying neurocognitive systems for sustained attention in neurogeriatric patients: protocol of the SENSE-AGE study

Background: Sustained attention is a complex cognitive function required for the successful performance of tasks such as walking, cycling, driving, conversations and other prolonged tasks. Deficits of this function are associated with frailty, falls, and general cognitive decline in older adults. Sustained attention declines with age and is impaired in many neurological disorders. However, little is known about the underlying neurophysiological characteristics of sustained attention deficits in neurogeriatric patients and their interaction with other cognitive domains. Electroencephalography (EEG) provides a non-invasive and scalable method to assess neural dynamics with high temporal resolution. EEG parameters have shown promise as objective markers of cognitive dysfunction in aging and neurodegenerative conditions, but their specific relevance as surrogate markers of sustained attention in neurogeriatric patients remains unclear. Identifying reliable EEG-based surrogate markers could facilitate early detection, risk stratification, and targeted interventions. Therefore, this study aims to investigate EEG-based parameters as potential surrogate markers of sustained attention in neurogeriatric patients. Methods/design: The study "Studying Neurocognitive Systems for Sustained Attention in Neurogeriatrics Patients" (SENSE-AGE) is a prospective, explorative, observational study and will include 120 geriatric participants. At admission, participants will perform a Go-NoGo task, a Psychomotor Vigilance Task (PVT) and resting-state condition during EEG recording, using a 32-channel system. Task-based event-related potentials (ERPs) and frequency-band power will be extracted. Neuropsychological tests characterize global and domain-specific cognition and will examine associations between sustained attention, broader cognitive performance, and EEG parameters. Questionnaires will assess fatigue, sleep, health-related quality of life, and subjective cognition. A subgroup of 50 participants will be re-evaluated at the end of the inpatient stay, after 2-3 weeks of standardized geriatric complex treatment. The main hypotheses of the study are: sustained attention (i) correlates with ERP amplitude and latency; (ii) correlates with EEG power; (iii) improves after an inpatient multiprofessional complex treatment at both the task-performance and neurophysiological level. Discussion: The study protocol describes an experimental approach to investigate sustained attention in a neurogeriatric cohort combining a behavioral approach with EEG recordings. The results may help defining objective and quantitative surrogate markers of sustained attention in this vulnerable cohort.