I don't use anything other than Q&A for registration and user group promotion after the first 5 posts, which means there has never been a single spam post on my installation.
My site is primarily focussed towards F1 so they are all F1 related.
Non-English speakers seem to have no problems - we have a significant percentage of them.
It's not that hard to work out what the answer is when using key words such as driver and team names, and particular years.
For those that still can't work them out, there's always Google Translate.