Eye-Tracking-Based Cognitive Assessment Predicts the Risk of Memory Decline: A Community-Based Cohort Study

Identifying high-risk individuals for future cognitive decline is key for timely and efficient interventions against dementia. Although imaging and biofluid biomarkers have been developed to detect neuropathological changes and predict future disease progression, their high costs and low accessibility limit their widespread use. We previously developed an eye-tracking-based cognitive assessment (ETCA) as a novel screening tool for dementia and demonstrated its utility in detecting mild cognitive decline with high accuracy. This study aimed to investigate the ETCA's performance in predicting future cognitive decline in a community-based longitudinal study.

Community-dwelling older adults (n = 55, mean age: 57.8 (SD, 12.6) years) without a formal diagnosis of dementia were enrolled and underwent the ETCA and neuropsychological tests, including the Mini-Mental State Examination (MMSE), Addenbrooke's Cognitive Examination-III (ACE-III), and Rivermead Behavioral Memory Test (RBMT), both at baseline and at a 2-year follow-up point.

Approximately half (54.5%, 35/55) of participants showed a decline in RBMT scores during the 2-year follow-up and were defined as the memory decline group. The baseline ETCA scores were significantly lower in the memory decline group than in the memory stable group. The baseline ETCA composite subscores achieved an AUC-ROC of 0.709 in detecting future memory decline.

The ETCA offers a rapid, objective, and low-burden approach for screening for the risk of future cognitive decline, which could make a substantial contribution to the prevention of dementia.