This dissertation addresses critical gaps in dementia research in Native Hawaiian and Pacific Islander (NHPI) communities. Focusing on Samoan and Tongan communities, the study successfully adapted and validated the AD8 informant interview and the Clinical Dementia Rating (CDR) scale in native languages, establishing these instruments as reliable tools for detecting cognitive impairment in these populations. The research process prioritized meaningful community engagement and forged partnerships with indigenous professionals, ensuring alignment with and responsiveness to the specific needs of the community. These invaluable connections were the foundation of making this difficult work possible. Subjects assessed with these adapted instruments were enrolled in the largest NHPI dementia study to date. Evaluation of this cohort led to new Insights into dementia prevalence and potential risk factors among NHPIs including assessment of APOE isoform frequencies and other genetic data. The ɛ4 allele was found to be much more frequent in NHPIs than in other ethnic groups, and does not appear to show association with dementia risk. NHPI Early-onset Alzheimer's disease families were also studied using whole genome sequence data, setting a foundation for future genetic studies. Future efforts should focus on disseminating these adapted tools, expanding genetic studies across diverse NHPI sub-populations, and conducting longitudinal studies to track cognitive changes. Collaborations between clinical, scientific, and cultural experts are encouraged for comprehensive, culturally-sensitive research strategies. In summary, this dissertation serves as a bridge between current Alzheimer's research and a promising future for new efforts in NHPI populations. It also creates a roadmap for adapting other clinical and research instruments into new languages and cultures. Through linguistic adaptations, genetic insights, and epidemiological investigations, it demonstrates a more precise, culturally relevant approach to Alzheimer's research that can significantly impact healthcare practices and the overall well-being of NHPI communities.