Eye-movement patterns in face recognition are associated with cognitive decline in older adults.

The Hidden Markov Modeling approach for eye-movement data analysis is able to quantitatively assess differences and similarities among individual patterns. Here we applied this approach to examine the relationships between eye-movement patterns in face recognition and age-related cognitive decline. We found that significantly more older than young adults adopted "holistic" patterns, in which most eye fixations landed around the face center, as opposed to "analytic" patterns, in which eye movements switched among the two eyes and the face center. Participants showing analytic patterns had better performance than those with holistic patterns regardless of age. Interestingly, older adults with lower cognitive status (as assessed by the Montreal Cognitive Assessment), particularly in executive and visual attention functioning (as assessed by Tower of London and Trail Making Tests) were associated with a higher likelihood of holistic patterns. This result suggests the possibility of using eye movements as an easily deployable screening assessment for cognitive decline in older adults.