At the Bedside: UTHealth Houston gives hope to man living with Alzheimer’s disease

In 2023, Lance McNeel, now 68, was driving home when he suddenly realized he had no idea how to get there.

“I was just a few blocks away, and all of a sudden, everything was unfamiliar,” Lance said. “I had to call my wife and ask her how to get back to our own home.”

Lance’s wife, Liz McNeel, became familiar with Alzheimer’s disease from working with older adults in her real estate practice, many of whom showed signs of cognitive decline. Wanting to better support her clients, she sought out educational resources through the Alzheimer’s Association. This growing knowledge made her more attuned to the signs of cognitive changes, and she began to notice subtle symptoms in her own husband.

“As a volunteer community educator, we would always talk about what changes to look out for, and I started seeing that in Lance,” Liz said. “I thought, ‘This is not normal,’ and I knew something wasn’t right.”

In July, Lance had an appointment to see a neurologist who conducted a series of cognitive tests that assessed his cognitive impairment, orientation, memory, language, and executive function. The test involves a series of questions and tasks, such as naming objects, repeating phrases, following instructions, and drawing geometric shapes. It is a widely used screening tool to identify individuals who may be experiencing cognitive decline and warrant further evaluation.

The results showed that Lance had signs of mental decline, and he was diagnosed with early Alzheimer’s disease. 

“It is not something that’s easy to go through, but we try very hard to make the best of it, and every day we get up and say, okay, today we’re going to create some new pathways, some new memories, because Lance is very aware, and we are very aware that this is a fatal disease,” Liz said. “We want to keep him here, as Lance, for as long as possible.”

While there is currently no cure, Lance and Liz knew they needed to take action to slow the progression of the disease as quickly as possible. 

They searched nationwide for the latest advances in medications, such as Leqembi, a breakthrough treatment for Alzheimer’s disease, and came across UTHealth Houston’s extensive groundbreaking research on the drug. Liz called and asked for the best of the best. In November, Lance met with David Hunter, MD, assistant professor in the Department of Neurology at McGovern Medical School at UTHealth Houston.

“Lance had already gotten all of the work up that existed at that time for Leqembi, so we immediately started talking to him about the risks and benefits of the drug,” Hunter said. “He was one of the first patients that I had taking Leqembi.”

First approved by the U.S. Food and Drug Administration through an accelerated process in January 2023, Leqembi, the name brand for lecanemab-irmb, is a drug used to treat early-stage Alzheimer’s disease. The drug targets abnormal clumps of a protein called beta-amyloid in the brain, which form what are known as amyloid plaques. Researchers believe the plaques, which build up between nerve cells, interfere with cognitive function and cause Alzheimer’s disease. These plaques can populate in the brain 20 years before someone exhibits symptoms.

With Hunter’s approval, Lance began Leqembi infusions in January 2024, just six months after his diagnosis. Today, he is on infusion number 36. In a study of 702 patients with Alzheimer’s disease, the average decline in cognitive test score was 2.15 points per year during the first two years. After that, the decline accelerated to 3.83 points per year during the subsequent three years. Two years after Lance’s diagnosis, his cognitive test score has only dropped by one point. 

Hunter says during clinical trials, those that received the drug had significantly slower cognitive decline than those who received the placebo. “That’s exactly what we’ve been hoping to see. We know we can’t stop the disease right now with medical intervention; that doesn’t exist yet,” Hunter said. “But Lance’s disease course shows us that even though the Alzheimer's is progressing, we have slowed it down.”

Lance and Liz could not believe the results and knew they were right to trust Hunter’s guidance. As a lifelong painter, Lance shares his experience through art, from his diagnosis to his treatment.

“He started a series called ‘Living with Dementia.’ Every day, Lance paints and paints and paints and paints. It’s all great for his mind because he does calculations to make sure he’s got everything drawn right on the painting, and it’s capturing a memory in real-time,” Liz said.

Lance and Liz raise awareness of Alzheimer’s disease within their community and work to break the stigmas surrounding the disease.

“We have met so many people who lose hope and just decide, ‘Well, there is no cure, so why would I seek treatment,’ and that’s a stigma we don’t believe in,” Lance said. “I want to stay myself for as long as possible and keep making new memories, don’t you?”

Hunter and his team are hopeful for the future diagnosis and treatment of Alzheimer’s disease and the progress made so far. Currently, Hunter is working to bring in more patients from rural areas for advanced therapies like Leqembi. Patients must be closely monitored for the first 18 months because the infusions pose a risk of brain swelling and bleeding, and they must also receive an MRI with each treatment. Hunter is working with hospitals around Texas to make this possible for patients.

“It’s the first time in human history that we’ve had an effect on Alzheimer’s,” Hunter said. “We want everyone to have the best shot, just like Lance.” 

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