SPINK5 and Alzheimer disease: These findings are consistent with recent multiancestry analyses highlighting the relevance of barrier-related genetic variants and the importance of accounting for population diversity.14 While FLG and SPINK5 are well established in AD etiology, our synthesis quantitatively confirms their impact across diverse populations and reveals significant associations of variants such as R501X and 3321delA in Spanish and South Korean cohorts, respectively.