Education Level Does Not Affect Prevalence of Dementia in a Bulgarian Population

Low education is commonly regarded as a risk factor for dementia, its role being confirmed in numerous studies. Some investigators, however, have reported only partial association between education and dementia, or no association at all. No studies on this topic have been performed in Bulgaria. The aim of our study was to assess whether prevalence of dementia varies among subgroups of Bulgarian citizens with different education degrees. Questions on the level of education, according to the national educational standards, were included in the screening interview of the first two-phase prevalence study of cognitive disturbances in the town of Varna, Bulgaria. We assessed the relationship between education and dementia, diagnosed according to DSM-IV criteria, as well as between education and neuropsychological test performance. While education affected MMSE scores, no statistically significant relationship with the diagnosis was found. Our results do not conform to the common conception stating that dementia prevalence is inversely related to the level of education. A larger study with a more uniform distribution of subjects according to education may be required in order to confirm these findings.