Early-onset frontotemporal dementia (EO-FTD) presents before age 65 and is frequently misdiagnosed as psychiatric or behavioural disorders, delaying care.

This scoping review synthesizes research on EO-FTD’s earliest cognitive symptoms from patients, companions (family and friends), healthcare professionals, and cognitive tests to promote early detection.

A systematic search of six databases (Medline, Embase, CINAHL, PsycInfo, Scopus, and Proquest Dissertations and Theses) identified 2197 studies of which 16 met inclusion criteria, encompassing 663 EO-FTD participants.

A total of 35 unique cognitive symptoms were identified. Memory, attention, and executive dysfunction were most frequently reported. Symptom terminology varied widely, often mirroring cognitive test phrasing, limiting clinical applicability. Many studies relied on cognitive test scores rather than detailed symptom descriptions, with patient and companion reports underrepresented.

The findings underscore the need for standardized nomenclature, improved assessment tools, and greater inclusion of patient and companion perspectives to enhance EO-FTD early diagnosis and intervention strategies.