Kate Swaffer was diagnosed with young-onset dementia shortly before her 50th birthday. A former nurse, chef and health care sales professional, she could have accepted the standard script: leave your job, prepare to die in 9–10 years, and wait for a miracle drug.
Instead, she became one of the world’s most outspoken activists for people living with dementia, co-founding Dementia Alliance International, serving on the board of Alzheimer’s Disease International, and delivering the first keynote by a person with dementia at a World Health Organization Ministerial conference.
Yet after more than a decade inside the system, Swaffer never believed in the “cure” narrative. In a recent interview she told me bluntly: “I’ve never had hope for a cure, ever. What those of us diagnosed need, is adequate post diagnostic care and disability support. There’s like 150 or 160 different types or causes of dementia. So if you haven’t got the particular Alzheimer’s that they’ve been researching, you’re screwed anyway.”
Her frustration is not abstract. It is rooted in what she has witnessed: tiny, unrepresentative studies hyped by media, research participants and dementia advocates gagged by agreements not to speak negatively of the charity they advocate, charities addicted to the “suffering narrative”, and pharmaceutical companies that profit from chronic illness rather than cures.
The result, she says, is a sector that feels like “a gravy train” for insiders while delivering nothing meaningful for the 55–60 million people living with dementia worldwide.
The moment the curtain was pulled back
Swaffer’s disillusionment crystallised at the Alzheimer’s America International conference in 2018, where a young researcher presented a “new therapy” that had been trialled on just five people.
Media declared it exciting. Care providers all over the world wanted to roll it out. “How is that necessarily good for everybody?” Swaffer asks. “The cohort sizes in care research are usually so small that the data analysis and the outcomes are not significant.”
Worse, many participants funnelled to researchers via platforms such as Dementia Australia are often the same dementia advocates, who have signed agreements not to criticise the dementia advocacy organisations that they align with, and who are almost professional advocates, who have also have lost insight into what the early experiences during or after their own diagnosis was like. “You may not actually be getting valid data,” Swaffer says. It is hard to know if people with dementia are being unintentionally manipulated?
She describes dementia conferences as career launch pads where “organisations pay for most delegates to attend. In my experience, they are exclusive, and more about networking and socialising than creating real change, and more like an annual ‘round-a-bout’ of the same people and the same promises to improve things.”
Amyloid orthodoxy
Swaffer’s disillusion with the current state of dementia research were fortified after delving into Charles Piller’s 2025 book Doctored: Fraud, Arrogance, and Tragedy in the Quest to Cure Alzheimer’s.
Piller, an investigative journalist for the world’s most well respected science literature publication, Science magazine, documented how hundreds of influential Alzheimer’s papers relied on manipulated or fabricated data.
The cornerstone of this controversy was a 2006 Nature paper by Sylvain Lesné and Karen Ashe claiming a specific amyloid-beta oligomer (Aβ*56) directly caused memory impairment in mice. The paper was cited thousands of times and helped lock the field into the amyloid hypothesis, the idea that toxic amyloid plaques drive Alzheimer’s. Image sleuthing by neuroscientist Matthew Schrag and others revealed apparent Photoshop doctoring. The paper was eventually retracted, but not before billions in funding and clinical trials had flowed from it.
Piller exposed similar issues in work linked to high-profile researchers, including NIH officials and companies like Cassava Biosciences. The fraud reinforced a dominant paradigm even as anti-amyloid drugs, such as Biogen’s Aduhelm and lecanemab, delivered only marginal slowing of decline at best, never a cure.
Swaffer says nothing shocks her anymore, when referring to questionable and nefarious practices in dementia research and advocacy: “I expect it.” She points to career incentives: “researchers look up to one or two people in their field. If they want to get promoted, it appears they have to agree.” Funders, including Big Pharma, shape outcomes. Dementia Alliance International refused pharmaceutical funding precisely because “the expectations of doing business with Big Pharma is to promote their drugs and conduct research with an outcome already in mind.”
Big Pharma, she argues, “do not want curative drugs. They want us on drugs for the rest of our lives.” She notes the same pattern in other diseases: billions spent, yet no cures for heart disease or diabetes, only disease-modifying treatments. Swaffer also claims that drugs that appeared curative for other diseases may have been buried.
Alternative paths: Beyond amyloid
Piller’s book questions whether amyloid even plays a central role and spotlights researchers long marginalised for challenging the orthodoxy.
Promising alternatives include:
Infection hypothesis: latent viruses such as herpes residing in the brain may trigger or accelerate neurodegeneration.
Inflammation and metabolic approaches: GLP-1 receptor agonists, the class behind weight loss drugs like Wegovy, show early signals of slowing cognitive decline, possibly through anti-inflammatory or neuroprotective effects.
Vascular and lifestyle factors: controlling blood pressure, cholesterol and adopting healthy lifestyles, already proven to reduce risk, receive far less funding than amyloid drugs.
Still fighting
Swaffer has long demanded the same for dementia that stroke patients receive, including immediate referrals to rehabilitation including speech therapy, occupational therapy, physiotherapy and exercise physiology, disability assessments and support, and ongoing support to return to work or community life.
At diagnosis she was told she would be dead in a decade and then she was sacked by her employer. “If I’d had a stroke at age 49, I wouldn’t have left hospital without a rehab programme. Instead, you get diagnosed with dementia, and advised that’s the end.”
She has campaigned for dementia to be recognised as an acquired disability under the UN Convention on the Rights of Persons with Disabilities (CRPD). Her PhD and the Dementia Justice Project, with Associate Professor Linda Steele, call for reparations for harms in congregate aged care, deinstitutionalisation and enforcement of human rights guidelines.
For families and policymakers seeking real hope, Swaffer’s message is clear: stop pouring money solely into cure research built on what she believes are shaky foundations. Demand disability rights, rehabilitation, evidence-based lifestyle interventions and open funding for alternative neurodegeneration theories.
Click HERE to visit Kate Swaffer’s blog.
I commend and respect Kate Swaffer’s critique of the dementia industry. Charles Piller’s book, alongside Karl Herrup’s How Not to Study a Disease, by Karl Herrup, and George and Whitehouse’s American Dementia: Brain Health in an Unhealthy Society all reveal aspects of the underside of the treatment, research and care of people with dementia and their families. But none of these books has been taken seriously enough to have any impact.
Kate’s message could give an opportunity for change for so many lives, and the possibility of money being properly spent for millions of people’s well-being. It’s high time.
Absolutely right, Maxine ! The analogy with post stroke patients and their rehab plans, as opposed to those of us with dementia, is very marked.
Kate has hit the nail on the head again.
There is no cure and I question “modifiable factors”.
What interests me is that dementia has become one of the most researched diseases yet the number of people being diagnosed is increasing so rapidly.
We have to ask is early diagnosis one of the reasons for the high incidence of dementia or would something else have been our diagnosis if there was not so much money being given to dementia.
Dear Kate, I am so sorry and sad reading your article. I have worked with you under Glen Rees and I haven’t stop working hard, advocating for much needed improvements in every aspect of dementia: Diagnosis. Life . Enablement. Care. On many topics raised by you I fully agree with you but I strongly disagree that advocates get anything in return for thousands of hours of voluntary work we do over years. Maybe some do. Good luck to them. I don’t, I am exhausted, and many of my friends living with dementia don’t advocate to receive any benefits. We can’t stop our work, so much has to improve. I respect and admire you greatly and wish you all the best. Danijela
Important critique; particularly on post-diagnostic neglect and cure narratives.
But it risks overcorrecting; the amyloid issues are real, not the whole story. And while there have been serious scientific and pharmaceutical failings, it is too simple to suggest the sector does not want cures … a genuinely effective one would be the most valuable outcome of all.
The deeper question is ‘who holds authority?’ The diagnosed experience is still too often curated; sometimes even within advocacy itself.
We may yet solve the biology; but answer the wrong question rather well …