Registering eye movements during reading in Alzheimer disease: difficulties in predicting upcoming words

Abstract

Reading requires the fine integration of attention, ocular movements, word identification, and language comprehension, among other cognitive parameters. Several of the associated cognitive processes such as working memory and semantic memory are known to be impaired by Alzheimer’s disease (AD). This study analyzes eye movement behavior of 18 patients with probable AD and 40 age-matched controls during Spanish sentence reading. Controls focused mainly on word properties and considered syntactic and semantic structures. At the same time, controls’ knowledge and prediction about sentence meaning and grammatical structure are quite evident when we consider some aspects of visual exploration, such as word skipping, and forward saccades. By contrast, in the AD group, the predictability effect of the upcoming word was absent, visual exploration was less focused, fixations were much longer, and outgoing saccade amplitudes were smaller than those in controls. The altered visual exploration and the absence of a contextual predictability effect might be related to impairments in working memory and long-term memory retrieval functions. These eye movement measures demonstrate considerable sensitivity with respect to evaluating cognitive processes in Alzheimer’s disease. They could provide a user-friendly marker of early disease symptoms and of its posterior progression.