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Culturally sensitive CLEAR guidelines on disclosing and communicating a diagnosis of dementia
Ismail Z, Sivananthan S, Main S, Ménard A, McLaren-Beato J, Chambers LW, Welch V, Vedel I, Smith EE, Ewa V, et al.. Alzheimer's & Dementia, 2025-10-14
Topic: Risk, prevention and care in population studies
Providing a dementia diagnosis is challenging, especially in primary care and considering diverse patient backgrounds. The Alzheimer Society of Canada (ASC), the College of Family Physicians of Canada, and the Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD) guideline group partnered with patients, care partners, and clinicians to generate contemporaneous guidance for primary care practitioners. While relevant to all communities, Black and Chinese Canadians were formally represented in working groups. A literature review identified needs areas. Informed by Guidelines International Network (GIN) principles and through iterative group meetings with all partners, these needs were explored and incorporated into guidance. The Compassionate Language and Empathetic Approaches for Respectful Dementia Disclosure (CLEAR) offers recommendations on: holistic engagement, fostering hope, acknowledging care partners, identifying disclosing clinicians, appointment structure and environment, person-centered communication, specific discussion topics, and emotional supports, all through a cultural competence lens. These guidelines address communication challenges in disclosing a dementia diagnosis and enhancing care and support for persons living with dementia and their care partners. HIGHLIGHTS: Healthcare practitioners (HCPs) struggle with disclosing and communicating dementia diagnoses. Guidance is limited in primary care and different patient ethnocultural groups. We developed culturally sensitive guidelines with scripts and practical materials. Appropriate communication techniques and terminology are recommended in Compassionate Language and Empathetic Approaches for Respectful Dementia Disclosure (CLEAR). Patient-centered and holistic approaches for the patient and care partner are emphasized.
Key findings
- HIGHLIGHTS: Healthcare practitioners (HCPs) struggle with disclosing and communicating dementia diagnoses.
- Guidance is limited in primary care and different patient ethnocultural groups.
- We developed culturally sensitive guidelines with scripts and practical materials.
- Appropriate communication techniques and terminology are recommended in Compassionate Language and Empathetic Approaches for Respectful Dementia Disclosure (CLEAR).
- Patient-centered and holistic approaches for the patient and care partner are emphasized.
Why it matters
These guidelines offer recommendations for disclosing a dementia diagnosis in primary care, with attention to culturally diverse patient backgrounds. They cover holistic engagement, fostering hope, communication techniques, and emotional supports, and were developed with input from patients, care partners, and clinicians including Black and Chinese Canadians.
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Study details
- Study designsystematic-review
- Evidence strengthEarly
Limitations
Consensus-based guidance without outcome evaluation; developed for the Canadian primary care context; only two ethnocultural communities formally represented.
How this study scored 50/100
Published in a leading specialty journal, and it is a systematic review of all the studies on the question. Scored zero for sample size, effect reported and studied in people because the record does not state it. We have no data on free to read, so that was left out: it earned 49 of the 98 points we could judge it on, which is 50 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Alzheimer's & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 2 / 5 | Rated “early” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Sid Feldman: h-index 11 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Toronto: institution h-index 1,923 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 13 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41085169) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 49 / 98 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 49 of the 98 points we could judge it on is 50 out of 100. |
| Total | 50 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — PubMed Central lists this copy as free to read: the link above (checked 10 Oct 2026).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Ismail, Z., Sivananthan, S., Main, S., Ménard, A., McLaren-Beato, J., Chambers, L. W., et al. (2025). Culturally sensitive CLEAR guidelines on disclosing and communicating a diagnosis of dementia. Alzheimer's & Dementia. https://doi.org/10.1002/alz.70744
Vancouver
Ismail Z, Sivananthan S, Main S, Ménard A, McLaren-Beato J, Chambers LW, et al. Culturally sensitive CLEAR guidelines on disclosing and communicating a diagnosis of dementia. Alzheimer's & Dementia. 2025. doi:10.1002/alz.70744. PMID: 41085169.
BibTeX
@article{ismail2025-41085169,
author = {Ismail, Z. and Sivananthan, S. and Main, S. and Ménard, A. and McLaren-Beato, J. and Chambers, L. W. and Welch, V. and Vedel, I. and Smith, E. E. and Ewa, V. and others},
title = {{Culturally sensitive CLEAR guidelines on disclosing and communicating a diagnosis of dementia}},
journal = {Alzheimer's \& Dementia},
year = {2025},
doi = {10.1002/alz.70744},
pmid = {41085169},
url = {https://doi.org/10.1002/alz.70744}
}
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