The Alzheimer's disease (AD) research landscape is dominated by efforts to predict and prevent the condition. In clinical practice, it is difficult to establish normal aging from pathological cognitive deterioration and “imaginaries of deterioration” tied to “loss of self” take on a material form and impact assessment and diagnostic practice. Drawing on qualitative data gathered across a memory service in the UK, this paper captures practitioners’ reflections on the utility and potential impact of prediction and earlier detection. Practitioners maintain that this biological framing may reinforce uncertainties associated with sociocultural depictions of the condition and reify normative values concerning cognition and age; provoking questions concerning what kinds of values are produced by, and aligned with, bioscientific agendas. Overall, there emerges a paradox entangled in biologically redefining AD: purported precision and prediction on the one hand and increasing uncertainty on the other entwined with sociocultural imaginings of a future with AD.