Performance of the Benton Judgment of Line Orientation test across patients with different types of dementia

Background The Benton Judgment of Line Orientation (JLO) test is one of the most frequently used tests for assessing visuospatial function. Objective This study aimed to determine the diagnostic and differential performance of JLO for different types of dementia. Methods A total of 258 participants, including 68 patients with Alzheimer's disease (AD), 86 with subcortical ischemic vascular dementia (SIVD), 30 with frontotemporal lobar degeneration (FTLD), 22 with Lewy body dementia (LBD), and 52 cognitively unimpaired (CU) controls, were enrolled from a memory clinic. The total scores and error types in the JLO test were compared between groups. Receiver operating characteristic curve analyses were used to estimate the diagnostic and differential abilities of the JLO test for patients with different types of dementia. Results We found that the JLO score was significantly lower in patients with AD, SIVD, FTLD, or LBD than in CU controls (12.90 ± 8.72 versus 17.06 ± 6.14 versus 15.47 ± 8.39 versus 9.23 ± 8.96 versus 21.69 ± 3.72, respectively; all p < 0.05). In particular, for patients with LBD, the JLO score was significantly lower than that for patients in the other groups (all p < 0.05) and showed excellent performance in distinguishing LBD patients from CU controls, with an AUC of 0.888 (sensitivity 72.73% and specificity 94.23%) at a cutoff value of 16. Intraquadrant oblique error was the most common type of error in dementia patients. Conclusions The JLO test is an effective tool for evaluating visuospatial function in patients with dementia, particularly for identifying LBD patients.