Age-related cognitive impairment represents a critical stage in the continuum of neurodegenerative disorders, including Alzheimer’s disease (AD), highlighting the need for objective and non-invasive physiological indicators of early neurological change. This study investigates the simultaneous analysis of microsaccadic eye movements and pupil size variations as ocular biomarkers associated with age-related cognitive impairment using eye-tracking technology. A total of 70 participants were recruited and categorized into three age groups: individuals in their 20s, 60s, and 70s. Participants in their 70s were further categorized based on MMSE-K scores into cognitively normal (≥24) and impaired (≤23) subgroups. Quantitative analyses showed a significant age-related increase in microsaccade frequency along both axes, with significantly higher microsaccade frequencies (p < 0.01) among individuals with lower cognitive scores within the same age group. Pupil size variation, including constriction and dilation rates, declined with age, while response speed remained relatively unchanged across all age groups. These findings highlight a clear association between age related-cognitive decline and involuntary ocular responses. The proposed dual-biomarker method offers a non-invasive and quantitative framework that may complement traditional cognitive screening tools. Future studies involving larger cohorts and clinically diagnosed AD populations are required to determine the diagnostic utility of these ocular biomarkers.
Oh et al. (2026) studied this question.