Silhouettes, number Location, and cube analysis tests from the VOSP battery reveal visual object and space perception deficits in early Alzheimer’s disease

The Visual Object and Space Perception Battery (VOSP) is a widely used tool for evaluating higher visual processing. However, limited information exists regarding its diagnostic utility in differentiating mild cognitive impairment (MCI) and mild dementia (MD) due to Alzheimer’s disease (AD) from cognitively normal older adults (CG). This study aimed to evaluate VOSP tests for object perception (silhouettes) and space perception (number location and cube analysis) as diagnostic tools for the early detection of AD. This study included 81 participants (28 with MD, 27 with MCI, and 26 in the CG). Our findings indicate that performance on the silhouettes, number location, and cube analysis tests showed good diagnostic properties in distinguishing CG from individuals with MCI or MD: AUC = 0.8, 0.79, and 0.82, respectively. Incorporating number location or cube analysis results into a multinomial regression model that included sex, age, education, and ADAS-Cog 13 scores improved correctly classified CG, MCI, and MD cases (from 76.5% to 80.2%). These results confirm that silhouettes, number location, and cube analysis tasks are suitable as additional tools for early diagnosis of AD, and space perception tasks improve diagnostic accuracy.