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It is still not clear whether a low level of education increases the risk of developing Alzheimer's disease (AD). Two common problems in cohort studies involving an elderly population and a two-step diagnostic procedure are the loss to follow-up without data on the presence of AD, and the fact that, in general, people with higher levels of education perform better on traditional cognitive tests, such as the Mini-Mental State Examination (MMSE). Both phenomena may lead to misclassification, resulting in a biased association between level of education and AD. This study investigated to what extent these selection mechanisms may influence this association.

Education and incident Alzheimer's disease: a biased association due to selective attrition and use of a two-step diagnostic procedure?