Towards Culturally Responsive Dementia Management for First Nations Australians: A Scoping Review Identifying Gaps and Opportunities

Background: Dementia poses a significant health concern among Australia’s First Nations peoples, who experience higher prevalence and earlier onset compared to non-First Nations populations. Despite growing research attention, the overall scope and characteristics of existing literature on dementia in these communities remain unclear. Objective: This scoping review aimed to map and synthesise existing evidence on the burden of dementia among First Nations peoples, focusing on associated risk factors and culturally responsive approaches to prevention, intervention, and care. Methods: Following the PRISMA Extension for Scoping Reviews guidelines, a comprehensive search was conducted across Scopus, EMBASE, PubMed, PsycINFO, CINAHL, the Indigenous Studies Portal, and Google Scholar for English-language studies published between 2004 and 2025. Search terms combined dementia and cognitive impairment with First Nations, Indigenous peoples, and related concepts, alongside terms for risk factors, intervention, prevention, care strategies, and health disparities. Two reviewers independently screened studies and extracted data using a standardised template. Of the 620 records identified, 324 were screened, 130 were assessed in full, and 75 met the inclusion criteria. Data were narratively synthesised to identify key themes and evidence gaps. Results: The review revealed a disproportionate burden of dementia among First Nations peoples, characterised by earlier onset and higher prevalence than in non-First Nations populations. Major modifiable risk factors included social determinants of health, lifestyle behaviours, and inequitable access to healthcare. Studies emphasised the importance of culturally safe, community-led, and multidisciplinary approaches; however, many interventions remain poorly adapted to the diverse cultural contexts of First Nations communities. The review also identified gaps in diagnostic tools, culturally appropriate care pathways, and the integration of traditional knowledge and digital innovations in dementia management. Conclusions: Addressing dementia inequities among First Nations Australians demands transformative, community-driven action that extends beyond descriptive research. Future work should prioritise co-designed, culturally grounded interventions that embed First Nations knowledge systems, strengthen healthcare capacity, and foster long-term community empowerment. Embedding cultural safety within policy and clinical frameworks, and shifting toward preventive, strengths-based approaches, will advance equity in dementia care and provide valuable insights for First Nations health systems globally.