JMIR Publications

ABSTRACT

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:

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:

Twelve participants aged 60–85 years with MCI (Korean version of the Montreal Cognitive Assessment [K-MoCA] ≤22) completed baseline and post-intervention 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 (20.3→21.8, p<0.001, d=1.44) and MMSE-K by 1.2 points (21.9→23.2, p<0.001, d=1.35). Fixation duration decreased (r=–0.248, p=0.003), and saccade velocity increased across tasks (r=0.258, p=0.002), while “Look at the Bell” showed a 21.72-ms reduction in saccade duration and “Calendar Memory” a 114.54-unit increase in saccade velocity.

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, non-invasive tools for cognitive support in aging populations. Clinical Trial: This study was conducted at a single clinical institution and approved by the Institutional Review Board (IRB) of Daejeon University Hospital (IRB No. DJUMC-2024-BM-02). The research was carried out at Daejeon University Cheonan Oriental Medicine Hospital until December 2024, following the date of IRB approval.