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Clinical Manifestations.

Matthew S Welhaf1,2, Andrew J Aschenbrenner1,2, John C Morris1,2

  • 1Washington University in St. Louis, St. Louis, MO, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Early Alzheimer's disease (AD) impairs arousal-based sustained attention, with deficits appearing in both arousal and executive functions. Mind wandering increases in early AD during executive tasks, highlighting complex attentional changes.

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Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Gerontology

Background:

  • Attentional deficits are early indicators of cognitive decline in Alzheimer's disease (AD).
  • Sustained attention, crucial for daily activities, is understudied in AD compared to response inhibition.
  • It remains unclear if AD-related attention deficits stem from executive control failures or reduced arousal.

Purpose of the Study:

  • To investigate sustained attention differences in very early Alzheimer's disease.
  • To differentiate between executive-based and arousal-based sustained attention deficits.
  • To explore the role of mind wandering in attentional changes associated with AD.

Main Methods:

  • Compared sustained attention in young adults, cognitively normal older adults, and older adults with very mild AD.
  • Utilized the Sustained Attention to Response Task (SART) for executive-based attention and the Psychomotor Vigilance Task (PVT) for arousal-based attention.
  • Assessed sustained attention via response time variability, lapses, and mind wandering rates.

Main Results:

  • Older adults with very mild AD showed worse performance on both SART and PVT compared to younger adults.
  • Significant differences between cognitively normal older adults and those with very mild AD were found only in the PVT (arousal-based).
  • Older adults with very mild AD reported more mind wandering during the SART (executive-based) compared to cognitively normal older adults.

Conclusions:

  • Very early Alzheimer's disease impacts arousal-based sustained attention.
  • Mind wandering is elevated in the earliest stages of AD during executive-based attention tasks.
  • Sustained attention deficits in early AD involve both arousal and executive components, manifesting differently based on measurement.