Gaps in dementia knowledge: a nationwide study of public awareness and misconceptions in Bulgaria

Dementia is a global health concern which can be mitigated by primary prevention and improved literacy. Effective educational initiatives are informed by studies of dementia knowledge. However, most of these studies are conducted in high-income countries, leaving the Balkan region underrepresented. This study aimed to conduct the first investigation of dementia knowledge among the Bulgarian population, exploring recognition of symptoms, general dementia knowledge, and risk factors awareness.

Using an online survey we assessed the following components of knowledge: (i) recognition of dementia symptoms from a vignette; (ii) dementia literacy measured with the Dementia Knowledge Assessment Scale (DKAS); and (iii) knowledge about dementia risk factors. Demographic characteristics, previous experience with dementia, and patterns of informing about dementia were also considered in the study.

One thousand, eight hundred and ninety-six adults (mean age = 44.99; 51.79% female) completed the survey. Half of the respondents correctly recognised dementia symptoms from a vignette. The average DKAS score was 9.51. Dementia knowledge was linked to education, marital status, employment, ethnicity, experience with dementia, and informational sources. 56.7% of the respondents thought dementia was a normal part of ageing and 74.8% did not know a healthy lifestyle reduces the risk of dementia. The average number of identified risk factors was eight (out of 17), with many mistakenly citing dental fillings, laziness, and witchcraft as contributors to dementia.

The Bulgarian society has a poor understanding of dementia, highlighting the need for improved awareness and education. Policy-makers should prioritise dementia as a social issue and take coordinated actions to educate society and eradicate harmful misconceptions.