Frontotemporal dementia (FTD) is one of the leading causes of dementia before age 65 and often manifests as abnormal behavior (in behavioral variant FTD) or language impairment (in primary progressive aphasia). FTD's exact clinical presentation varies by culture, language, education, social norms, and other socioeconomic factors; current research and clinical practice, however, is mainly based on studies conducted in North America and Western Europe. Changes in diagnostic criteria and procedures as well as new or adapted cognitive tests are likely needed to take into consideration global diversity. This perspective paper by two professional interest areas of the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment examines how increasing global diversity impacts the clinical presentation, screening, assessment, and diagnosis of FTD and its treatment and care. It subsequently provides recommendations to address immediate needs to advance global FTD research and clinical practice.

Objective: Emotion recognition tests are essential for differential diagnostics when assessing patients with Alzheimer’s disease (AD) dementia. However, there remains a lack of emotion recognition tests appropriate for culturally and educationally diverse populations. The aim of this study was to develop an emotion recognition test (the TIE-93) appropriate for these populations. We then examined whether the TIE-93 could reduce emotion recognition performance differences between populations with a native French versus a culturally and educationally diverse background (participants who had immigrated to France). This was assessed by comparing performance between controls of each cultural group. We also assessed the effect of demographic variables on TIE-93 test performance and whether performance in an AD patient group was consistent with the research literature. Methods: Fifty-seven patients with AD dementia and 240 healthy controls, from native French and culturally and educationally diverse backgrounds, were included in the study. The TIE-93 is composed of eight panels with photos of actors displaying six basic emotions. Participants were asked to identify which of the six facial expressions displayed matched an oral description of a context. Results: When comparing French and culturally and educationally diverse controls, Quade’s ANCOVA revealed that there remained an effect of culture and education on TIE-93 test performance. Nonetheless, while controlling for years of education, age, sex, and cultural group, patients with AD dementia scored significantly more poorly than controls, specifically for most negative emotions. Conclusion: The TIE-93 represents a first step toward developing appropriate emotion recognition tests for culturally and educationally diverse populations.

There remains a lack of appropriately adapted neuropsychological tests for culturally, linguistically and educationally diverse populations, particularly for the evaluation of social cognition, as its assessment is essential for the early diagnosis of diseases such as frontotemporal dementia and Alzheimer's disease. To address this gap, we designed the TIE‐93, an emotion recognition test based on Ekman's emotion recognition test, which was adapted to be better suited for culturally, linguistically and educationally diverse populations. However, in a previous study, we found that despite modifications to the test format, culture still had a significant effect on TIE‐93 test performance. The present study aimed to further investigate this effect by comparing performances and analysing item‐level accuracy and error patterns between participants from individualistic and collectivistic cultures. In total, 205 participants from individualistic countries and 91 participants from collectivistic countries, aged 50 to 90, were included in this study. Results were mostly consistent with existing research literature and showed that the individualistic group performed significantly better than the collectivistic group. However, unlike our previous findings, education—rather than culture—accounted for the largest proportion of variance (34.91%), followed by age (14.94%) and, finally, cultural group (4.2%). This study highlights the importance of considering both educational and cultural factors in the development of emotion recognition tests for diverse populations.

Underrepresented populations in dementia prevention research, including minoritized racial/ethnic groups, individuals with lower socioeconomic status, and others facing social and structural disadvantages, are disproportionately affected by dementia risk. This scoping review examined barriers and facilitators to recruitment, engagement, and retention of these populations in Alzheimer's disease and related dementias (ADRD) prevention studies, synthesizing evidence from both empirical studies and review articles. Guided by PRISMA-ScR and the conceptual structure described by Gilmore-Bykovskyi et al., findings were synthesized from 19 reviews and 53 empirical studies. Findings were interpreted with attention to how overlapping factors-such as ethnicity, age, gender, and structural inequities-may influence study participation. Studies originated primarily from the United States (U.S.). Five key themes were identified: 1) mistrust, 2) stigma and limited research literacy, 3) logistical and financial constraints, 4) communication gaps and lack of team diversity, and 5) systemic-level barriers. Facilitators included culturally tailored outreach, long-term community partnerships, and inclusive study design. Retention strategies remain underreported, and little is known about the non-U.S. context. These findings highlight the need for context-specific, multi-level strategies that address the intersecting barriers faced by underrepresented groups to support equitable participation in dementia prevention research, and ultimately, dementia prevention.