The field is abuzz with the word “prevention,” but how to pull off this vaunted goal? It's been held back by a strange Catch-22 of cost, time, and biomarker validation. That might change with a bold initiative led by Eric Reiman, Pierre Tariot, and others at the Banner Alzheimer's Institute. For the past two years, they have been laying the groundwork for what they hope will be an era of collaborative prevention research of shared risks and shared rewards. Their plan? They propose starting this era by offering two presymptomatic treatment trials next year to people who are cognitively normal yet face an extremely high risk of developing AD symptoms in the next few years. These people are middle-aged carriers of a deterministic AD mutation from a large set of families in Colombia, and elderly people in the U.S. and perhaps abroad who carry two copies of the ApoE4 risk gene. Start treatment trials in them, the thinking goes, and similar trials for many more at-risk people might follow.