Martineau et al. ^{Reference Martineau, Conant and Myers Barnett1} provide a timely investigation of the realities faced by persons and caregivers living with frontotemporal dementia (FTD) in Canada. Compared to Alzheimer’s disease (AD), evidence demonstrates that diagnostic delays of >15 months exist for behavioural variant FTD, while semantic dementia diagnosis is delayed by >10 months. ^{Reference Ambikairajah, Foxe and De Lange2} Martineau et al. ^{Reference Martineau, Conant and Myers Barnett1} not only confirm diagnostic delays but also demonstrate how they emerge within the context of fragmented care and limited awareness of FTD. These studies reinforce that clinical diagnostic pathways remain poorly aligned with FTD diagnosis.

FTD is challenging to diagnose. Its marked clinical, genetic and pathological heterogeneity means that clinical presentations may be mistaken for primary psychiatric illness or AD. ^{Reference Ducharme, Dols and Laforce3} The prolonged diagnostic “journey” is therefore not surprising. The burden of this delay affects FTD patients and caregivers who must navigate uncertainty, repeated consultations and evolving care needs before reaching an appropriate diagnosis and meaningful care plan. ^{Reference Tan, Lo and Ho4}

In FTD, early loss of independence and prominent neuropsychiatric symptoms, including disinhibition and agitation, increase caregiver burden. These symptoms determine whether a person can remain safely at home, and whether community supports can be easily provided. Caregiver burden is not often formally assessed and highlights a key knowledge gap in routine care. ^{Reference Besser and Galvin5}

The sex findings in Martineau et al. ^{Reference Martineau, Conant and Myers Barnett1} are noteworthy: women caregivers reported longer diagnostic delays than men. The authors suggest that diagnostic experience may be shaped not only by clinical features of FTD but also by caregiving roles, and how symptoms are perceived and communicated within families and at clinical encounters.

While these findings are interesting, they must be interpreted with caution due to inherent methodological limitations. Specifically, the use of an online survey to collect data may restrict participation to certain demographic groups, such as ethnically White groups. Non-White and ethnoculturally diverse caregiver participants who are less often to be connected with dementia care networks may not have the same degree of access. This narrows the applicability of the results because barriers to diagnosis, access and caregiver support are unlikely to be experienced uniformly across diverse populations. ^{Reference Tsoy, Kiekhofer and Guterman6} Furthermore, diagnosis was obtained by caregiver report, thus introducing potential diagnostic inaccuracies.

Despite these limitations, Martineau et al. ^{Reference Martineau, Conant and Myers Barnett1} provide important new information about barriers to FTD diagnosis and access to care, which can be used to design prospective, longitudinal observational studies to address these questions in more detail. This study and future ones can help to develop new policies to improve the care provided to persons with FTD and their families.