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Alzheimer's researchers have seen one promising therapy after another fail in late-stage clinical trials, raising doubts about the field's guiding hypothesis: that the accumulation of a protein fragment called β amyloid in the brain is a key step in the disease process that ultimately kills neurons and robs people of their memories and the ability to think clearly. Another interpretation, however, is that anti-amyloid therapies have so far disappointed because patients got them too late. If these same therapies were given before irreversible brain damage occurs, perhaps the disease could be prevented. Three new trials, expected to get under way next year with support from pharmaceutical companies, the National Institutes of Health, and private philanthropies, will be the sternest test yet for the amyloid hypothesis.