Wearable Eye-Tracking Metrics From Smart Glasses for Cognitive Assessment: A Prospective Digital Health Study (Preprint)

Le résumé fourni par la source

BACKGROUND Reading performance is closely associated with cognitive function, and eye-tracking metrics have emerged as sensitive, non-invasive indicators of cognitive processes. Recent advances in wearable technologies, such as smart glasses, enable continuous and scalable measurement of eye movements in real-world settings. However, rapid, accessible, and objective tools for cognitive screening remain limited. Integrating wearable eye-tracking with multidomain cognitive assessment may provide a scalable digital approach for early detection of cognitive impairment. OBJECTIVE To evaluate the association between wearable eye-tracking metrics and cognitive performance and to assess the feasibility of a smart glasses–based reading task as a rapid digital screening tool. METHODS In this prospective observational study, Mandarin-literate adults were recruited from Taipei Veterans General Hospital between May to August 2025. Participants completed a standardized reading task while wearing J7EF Gaze smart glasses. Eight eye-tracking metrics were recorded, followed by the six-domain cognitive assessment using gaze-based interaction. Associations were analyzed via multivariable regression adjusted for age and sex. RESULTS A total of 134 participants were enrolled (mean age 68.2 ± 13.4 years). Age correlated with all six cognitive domains and the total score, while sex exhibited smaller, domain-specific effects. In unadjusted analyses, total reading time showed the strongest associations with all cognitive domains (p < 0.001), while fixation duration, fixation frequency, and long or ultra-long fixations showed selective associations with orientation. After adjusting for age and sex, total reading time, total fixation time and average fixation time remained significant predictors. CONCLUSIONS Total reading time emerged as a robust, age-independent eye-tracking marker of cognitive performance. Fixation-related metrics showed domain-specific associations, particularly with the puzzle game hobbies domain of the cognitive assessment. Wearable smart glasses with integrated eye tracking may provide a rapid, non-invasive, and scalable approach for digital cognitive screening in clinical and real-world settings.

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