Will Alzheimer’s disease, a terrible degenerative brain disease with no treatments and no clear guidelines for diagnosis before its end stages, become like heart disease? That might mean early markers of risk, analogous to high cholesterol levels, that predict who is likely to get it. And it might mean drugs that actually prevent it. That is the hope behind new diagnostic guidelines being proposed by the National Institute on Aging and the Alzheimer’s Association. In July, when the groups first announced their proposed guidelines, they were met with some skepticism and anger. Why suggest ways of diagnosing the disease before a person even has symptoms? Why tell people they are doomed? And are those early diagnosis guidelines just a sop to pharmaceutical companies so they can start marketing expensive, and perhaps not very effective, new drugs?