关键词: 轻度认知障碍, 痴呆, 认知功能评估, 眼动追踪, 认知筛查, 护理

Abstract:

Objective To explore the application value of visual paired comparison tasks based on eye-tracking technology in cognitive function assessment，and to provide an effective tool for large-scale early cognitive screening in community populations. Methods A cross-sectional study design was employed using convenience sampling. A total of 325 participants were recruited from the outpatient and inpatient departments of the Neurology Department at a tertiary A hospital in Guiyang City between December 2024 and October 2025. According to cognitive status, they were divided into the dementia group，the mild cognitive impairment group，and the cognitively normal group. After undergoing assessments using the Mini-Mental State Examination（MMSE） and the Montreal Cognitive Assessment（MoCA），participants simultaneously completed the visual paired comparison task using eye-tracking technology. The Wilcoxon rank-sum test was used to compare differences in eye movement parameters among the 3 groups. Receiver operating characteristic（ROC） curve analysis was conducted to evaluate the discriminatory performance of the visual paired comparison task based on eye-tracking technology assessment and its combined use with traditional scales for the 3 groups. Results The final study included 110 participants in the cognitively normal group，120 in the mild cognitive impairment group，and 95 in the dementia group. Comparisons of multiple eye-tracking indicators across the 3 groups revealed statistically significant differences（P<0.05）. The visual paired comparison task based on eye-tracking technology achieved an accuracy of 81.9%，a sensitivity of 74.2%，and a specificity of 77.3% in distinguishing between cognitively normal individuals and those with mild cognitive impairment. The accuracy increased to 97.1% when combined with traditional scales. When distinguishing between cognitively normal individuals and those with dementia，the accuracy of the standalone assessment was 91.4%，and 98.8% when combined with traditional scales. However，the accuracy for distinguishing between mild cognitive impairment and dementia was lower，at 64.3%，and increased to 71.7% after combined assessment. Conclusion The visual paired comparison task based on eye-tracking technology demonstrates high accuracy in distinguishing between cognitively normal and cognitively impaired individuals. However，for individuals already identified as cognitively impaired，their ability to distinguish between mild cognitive impairment and dementia is limited. It is recommended to combine this approach with traditional neuropsychological scales for a comprehensive assessment to improve the accuracy of clinical diagnosis.

Key words: Mild Cognitive Impairment, Dementia, Cognitive Function Assessment, Eye Tracking, Cognitive Screening, Nursing Care