Exploratory Study Associates Eye Tracking with Cognitive Performance in Older Adults

Eye-tracking measures, specifically area-of-interest viewing proportion and antisaccade latency, showed preliminary associations with continuous global cognitive performance in an exploratory cross-sectional study of 38 community-dwelling older adults. In primary analyses applying Benjamini–Hochberg false discovery rate control, the area-of-interest viewing proportion (AOI%) was positively associated with continuous scores on the Montreal Cognitive Assessment (MoCA; Spearman’s rho = 0.489, q = 0.004) and the Japanese version of the Mini-Mental State Examination (MMSE-J; rho = 0.520, q = 0.003).

Antisaccade latency demonstrated a negative association with MMSE-J scores (rho = -0.414, q = 0.013), while its association with MoCA was weaker. In secondary exploratory discrimination analyses comparing groups defined by relatively lower and higher screening scores—which were not classified as clinical diagnostic categories—AOI% demonstrated an area under the receiver operating characteristic curve (AUC) of 0.780 for the lower-MoCA group (< 26) and 0.763 for the lower-MMSE-J group (≤ 27). Antisaccade latency showed AUCs of 0.672 for lower MoCA and 0.785 for lower MMSE-J, while exploratory incremental models yielded optimism-corrected AUCs across Models 1 through 3 of 0.633, 0.769, and 0.831 for lower MMSE-J, and 0.664, 0.764, and 0.752 for lower MoCA.

Although these findings support further investigation of brief eye-tracking assessments as an instrumentally measured approach toward low-burden repeated monitoring, the cross-sectional results do not establish early detection, sensitivity to longitudinal cognitive change, diagnostic accuracy, home-based feasibility, or incremental clinical utility beyond the MoCA or MMSE-J. The authors concluded that larger longitudinal investigations using clinically characterized outcomes and externally validated measurement systems are required.

Subject of Research: Eye-tracking measures and global cognitive performance in older adults

Article Title: Associations of eye-tracking measures with global cognitive performance in community-dwelling older adults: an exploratory cross-sectional study

Article References: Zheng, Y., Sonoda, Y., Mukunoki, T., Hiroe, M., Kumagai, R., Nakayama, M., Nagamatsu, T., & Kowa, H. (2026). Associations of eye-tracking measures with global cognitive performance in community-dwelling older adults: an exploratory cross-sectional study. BMC Geriatrics. https://doi.org/10.1186/s12877-026-08526-z

Image Credits: AI Generated

DOI: 10.1186/s12877-026-08526-z

Keywords: eye tracking, cognitive performance, older adults, MoCA, MMSE-J, antisaccade latency, area of interest, cross-sectional study, Associations, eye-tracking, measures, global