A Young Missionary with Problems Quoting the Bible

Abstract

1.2 Clinical History The patient came to the consultation accompanied by his wife who provided most of the history. She described her husband as a priest with persuasive and eloquent oratory, which was highly appreciated by their religious community. However, during the last 3 years, there was a clear impoverishment of the patient’s ability to preach. During the services, he also started losing the thread of his narratives and getting confused on quoting the bible. His ability of multitasking in the church was impaired. A year later, he clearly acquired difficulties in retaining information regarding conversations as well as a hard time in organizing his day and accomplishing all the commitments of his agenda. Soon after, he started to forget contents of conversations and lost the ability to deal with calculations, and consequently, his financial affairs. He became unable to write. His wife also remarked the patient’s inability to focus attention on his tasks. He also had a little insight regarding his present limitations. Apart from a general reduction in motivation and social isolation, from the neuropsychiatric perspective, there was no history of disinhibition, reduced impulse control, substance-related disorders, stereotypical or ritualistic symptoms, hallucinations, or delusions. He was previously evaluated by a neurologist who diagnosed him with Alzheimer’s disease (AD) based on clinical history, MRI, positron emission tomography (PET) using [F]fluorodeoxyglucose (FDG; Figure 1.1), and results of biomarkers from the cerebrospinal fluid (CSF). He was on 10 mg of donepezil every morning.