Gaze behavior during walking in older adults: A systematic review of eye-tracking research.

OBJECTIVE: Visual information is highly important for walking, a complex skill involving coordination of sensory, cognitive, and motor systems. Older adults exhibit changes in visual processing and eye movements, as well as gait. However, only recently has measuring eye movements during walking been widely accessible with wearable eye trackers. The objective of this review is to evaluate eye tracking metrics that can be collected during walking tasks and eye movements associated with walking in older adults. METHODS: We conducted a systematic search to identify eligible studies examining eye movements during walking in older adult adults, up to April 2025. RESULTS: We identified 53 studies that assessed gaze during simple walking, dual-task walking, obstacle avoidance, precision stepping, turning, stair-walking, and navigation. Overall, studies showed age-related changes in gaze behaviors, particularly more and longer fixations at immediately relevant locations and less time engaging in exploratory gaze behaviors. Results regarding eye movement timing were mixed, but most pronounced in older adults who were at high risk of falls and certain patient populations. CONCLUSION: Previous studies have used a wide range of eye tracking measures, particularly metrics related to fixations and eye movement timing, which offer different strengths and limitations regarding both experimental design and generalizability. Different walking tasks have been used, highlighting the flexibility of mobile eye tracking. The results of this review are useful to researchers interested in using wearable eye-trackers in studies of walking, and broaden our understanding of attention and other cognitive processes during walking, providing future directions for research.