Effects of an Eye-Tracking Digital Serious Game on Cognitive Function in Mild Cognitive Impairment: Pilot
Sang-Woo Lee1, Jun-Su Kim2, Seung-Jae Kim2
1InTheTech Inc., Daegu, Republic of Korea.
Background:
Cognitive decline in aging populations underscores the need for early interventions in mild cognitive impairment (MCI), where pharmacological treatments show limited benefit. Eye-movement metrics serve as sensitive markers of cognitive deficits in MCI, and digital programs integrating these tasks offer scalable, data-driven training approaches.
Objective:
This study aimed to evaluate the effectiveness of a digital cognitive training program incorporating eye-movement tasks in individuals with MCI, and to determine whether eye-movement indicators can serve as objective markers of cognitive improvement.
Methods:
A total of 12 participants aged 60-85 years with MCI (Korean version of the Montreal Cognitive Assessment [K-MoCA] score of ≤22) completed baseline and postintervention assessments using the K-MoCA and Mini-Mental State Examination-Korean version (MMSE-K). Longitudinal changes in visuospatial attention and oculomotor performance were examined using Spearman correlations across sessions, and pre-post comparisons of eye-tracking metrics were conducted to assess training-related improvements.
Results:
Cognitive scores improved significantly, with K-MoCA increasing by 1.5 points (from mean 20.3, SD 1.1 to mean 21.8, SD 1.7; P=.004; Cohen d=1.38) and MMSE-K by 1.3 points (from mean 21.9, SD 2.0 to mean 23.2, SD 2.2; P=.002; Cohen d=1.29). Fixation duration decreased (r=0.248; P=.003), and saccade velocity increased (r=0.258; P=.002), indicating enhanced visual processing efficiency and faster attentional shifts, whereas fixation count and saccade amplitude showed no consistent changes. In addition, saccade duration decreased by 21.72 ms, and saccade velocity increased by 114.54 °/s.
Conclusions:
Digital cognitive training yielded measurable gains in visuospatial attention and oculomotor efficiency in MCI, with optimized fixation and saccade patterns indicating enhanced attentional control and information processing. These findings support eye-movement metrics as sensitive indicators of cognitive change and highlight digital interventions as scalable, noninvasive tools for cognitive support in aging populations.
