OBJECTIVES: To investigate whether there are groups of older adults who express different preferences for treatment benefits and risks for delaying the onset of Alzheimer’s disease (AD). METHODS: A total of 1004 older adults in the US completed a web-enabled discrete-choice survey in which they were to suppose that they would develop AD in the future without medication. Choice tasks presented the option of no medication or a hypothetical AD treatment that would extend time with normal memory or time with cognitive impairment prior to developing AD. 12 or 16-year timeframes were used. Treatment benefits were combined with daily nausea and increased risks of disabling stroke and of death in the first year of treatment according to an experimental design. Choice data were analyzed using scale-adjusted latent-class analysis (LCA) in Latent GOLD. RESULTS: LCA revealed three distinct classes of respondents. Class one (42% of study sample) generally preferred medication, traded between all benefits and risks, was relatively younger, and was not likely to be a current AD caregiver. Class two (30%) preferred no medication, was more concerned about treatment risks than benefit, had no self-reported illnesses, and was somewhat more likely to be a current AD caregiver. Class three (28%) strongly preferred medication, was more concerned about treatment benefits than risks, was relatively older, and more likely to be a current AD caregiver. CONCLUSIONS: While most respondents (70%) were willing to accept treatment risks to reduce time with cognitive impairment or AD, 30% of respondents were risk averse with strong preferences for no AD treatment. LCA was useful for detecting heterogeneity of treatment preferences and may explain different rates of treatment uptake.