Several factors seem to influence the onset and rate of cognitive decline, including genetics (Trump’s family tree is filled to capacity with Alzheimer’s sufferers including his father), lifestyle factors, overall health, education level, and environmental influences. Additionally, different cognitive functions may decline at different rates and may be affected by different factors. While there’s no specific age at which cognitive decline typically begins, some studies have suggested that subtle changes in cognitive function may begin to occur in middle adulthood— 40s and 50s. These changes usually involve declines in processing speed, memory, and executive function.
One way doctors say cognitive function can be prolonged and the onset of decline delayed is by regular physical exercise, a healthy diet, cognitive stimulation… all things that Trump abhors.
There have been numerous academic studies that investigate the relationship between stress, age, and cognitive decline in men. Researchers have conducted studies using various methodologies, including longitudinal studies, cross-sectional studies, and experimental studies, to explore how stress affects cognitive function. Several studies have found a link between chronic stress and cognitive decline in both men and women. Long-term exposure to stress hormones, such as cortisol, has been associated with changes in brain structure and function, including impaired memory and executive function. It’s been understood for a long time that as people age, they tend to become more vulnerable to the effects of stress on cognitive function. Numerous studies have shown that older adults may be more susceptible to cognitive decline under conditions of chronic stress compared to younger adults. Not everyone responds to stress in the same way and susceptibility to cognitive decline is influenced by genetics, personality traits, coping strategies, and social support networks. Techniques that are thought to likely mitigate the effects of stress on cognitive function, including regular physical activity, maintaining a healthy diet, getting adequate sleep, and practicing stress-reduction techniques such as mindfulness meditation. Mindfulness meditation and Trump? Sure.
Chauncey DeVega dug deeper with Dr. John Gartner, a psychologist, former professor at the Johns Hopkins University Medical School and a contributor to the 2017 bestseller The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. DeVega reminds his readers that Señor T “has demonstrated, in repeated and dangerous ways, that he appears to be profoundly unwell mentally and emotionally. Some of the country’s and world’s leading mental health professionals have concluded that based on his behavior, Trump is likely a sociopath if not a psychopath. Whatever one may think about the specifics of his policies, President Joe Biden, on the other hand, is a responsible leader and an institutionalist who believes in America and the democratic experiment. By comparison, Donald Trump hates democracy, attempted a coup on Jan. 6, and is a megalomaniac who believes that he is some type of godfather or messiah... ‘President Biden is old’ is an easy, lazy, familiar, and comfortable narrative for the mainstream news media. It is sensational and gossipy (which means more ad revenue and attention), and maintains false balance, ‘fairness,’ bothsidesism and ‘objectivity’ in their coverage. This maneuvering also allows the mainstream news media as an institution, or so its leaders incorrectly believe, some measure of protection against retaliation by Trump and his regime, if he takes power in 2025. In all, a focus on Biden’s mental health and age is but another way of normalizing Donald Trump and the neofascist movement and a continuation of the years of failure(s) by the American news media that helped to birth the vile Trumpocene.”
Gartner makes the point, convincingly, that it’s Trump, not Biden who’s “showing diminished mental acuity and dangerous behavior related to aging,” explaining that “Trump’s escalating dangerousness is connected to what he believes is a diseased mind that will only get worse.” Gardner told DeVega that “the 2024 election might turn on this issue of who is cognitively capable: Biden or Trump? It's a major issue that will affect some people's votes. Not enough people are sounding the alarm, that based on his behavior, and in my opinion, Donald Trump is dangerously demented. In fact, we are seeing the opposite among too many in the news media, the political leaders and among the public. There is also this focus on Biden's gaffes or other things that are well within the normal limits of aging. By comparison, Trump appears to be showing gross signs of dementia. This is a tale of two brains. Biden's brain is aging. Trump's brain is dementing.”
DeVega: What evidence do you have for that conclusion?
Gartner: Phonemic paraphasias"— the substitution of non-words for words that sound similar— are not normally seen until a patient enters the moderate to severe stages of Alzheimer’s.
Some examples of Trump’s non-words: Beneficiaries becomes “benefishes.” Renovations become “renoversh.” Pivotal became “pivobal." Obama became “obamna.” Missiles became “mishiz.” Christmas became “Crissus.” Bipartisan became “bipars.”
This is a fundamental breakdown in the ability to use language. If you were talking to your father on the phone and he did this you would think he is having a stroke. There is no healthy older person who speaks that way.
Trump also engages in what we call "tangential speech." He just becomes incomprehensible when he engages in free association word salad speech that is all over the place. Again, that's a sign of real brain damage, not being old, not being slow, not losing a step not being, but of severe cognitive deterioration. What I don’t understand is why those clips aren’t replayed over and over in the mainstream media. Isn’t Trump babbling incoherently the most newsworthy part of his rally? You can be sure it would be if it were Biden.
Biden has been excoriated for forgetting names, which can be a normal part of aging. But Trump isn’t just forgetting names, he’s forgetting and combining people. Trump believes Nikki Haley is Nancy Pelosi. He has said repeatedly that Obama is still president. He said his father was born in Germany when that was his grandfather.
There is also a person's baseline. This is an essential tool for evaluating a person's mental decline. If you look at Trump's interviews and speeches from the 1980s for example, he may have always been a bit of a jerk, but he was articulate and polished. Now if you look at Trump there is great deterioration. By comparison, Biden has never been the most articulate person; he always had a stutter. He always made gaffes. But Biden has a good heart and good judgment. Over the decades we have not seen much evidence of deterioration in Biden's speaking.
…Trump is what we would clinically describe as "hypomanic." Trump is a man who is sending out messages on what used to be Twitter and also on his Truth Social platform at three in the morning, sometimes dozens of them in a row. A hypomanic personality has certain strengths and weaknesses. But a lot of it is like a vector of force that depends on where you direct it. Trump has directed his energy in purely destructive and hateful ways. What appears to be endless reserves of energy feeds the incorrect impression that somehow Trump is stronger because he has the vitality of someone who is in a crazed state, who's running amok. There's energy in that apparent crazy behavior. But in the end that is not the type of person who we want as a leader. Such a person will not keep us safe. Trump and people who act like him are not going to have good judgment.
DeVega: What distinguishes “hypomania" from a high energy personality?
Gartner: Bipolarity exists on a spectrum. On the lower end of the spectrum, at the high end of normal limits, it manifests as an exuberant, confident person and energetic person. At the other end of the scale are people with bipolar type 1 who have psychotic delusions of grandeur.
As I’ve written about, Trump has a hypomanic temperament as his baseline, but it can become inflamed to the point where he does appear to bear psychotic delusions of grandeur. With Trump, in my opinion, we are seeing this second, very unhealthy and dangerous manifestation of hypomania. There is also a sense of entitlement. Oftentimes arrogance goes with temperament. Charisma as well and a high sex drive. There is also a high drive for dominance. There is also something else very concerning and potentially quite dangerous about hypomania. Those who have that type of personality are also prone to severe hypomanic episodes which escalate in a crisis or when they fixate on something they find exciting. Then they can become even more reckless, impulsive and irritable. Such personalities like Trump show even worse judgment in such moments.
DeVega: Donald Trump’s behavior is wholly predictable. Yet, the mainstream news media, the political class, and the American people as a whole continue to act surprised by his escalating dangerousness, promises of becoming a dictator, violent threats and other pathological behavior. At this point, after at least 8 years of Trump and the MAGA movement and all the horrible things he and they have wrought, one would think the American people and their leaders would be experts on mental pathology.
Gartner: At this point, anybody with an IQ over 90, who isn't brainwashed by Fox News can see that Trump is unwell, dangerously unfit, malignant personality who has reaped massive destruction (have we just forgotten the hundreds of thousands of Covid deaths?) but even "mainstream" news sources have been normalizing Trump's dangerous and aberrant behavior because the corporate owners of the media want the ad money and don’t want to alienate their potential public by telling too much of the truth about the situation. Instead, they waste precious time talking about if President Biden is too old.
DeVega: Given Trump’s personality type and behavior and now his mountain of debts from the civil cases, there must be real anxiety among the United States government and the national security state and allies about the ex-president having access to top secret and other highly classified information. As others have pointed out, Trump could potentially give away the country’s secrets to hostile foreign governments for money.
Gartner: Donald Trump has absolutely no loyalty to the country. In fact, there's a perverse way in which I think he takes pleasure in destroying America. That is a function of his malignant narcissism. I have no doubt Trump would sell America's secrets and likely already has given his psychopathic behavior. Malignant narcissists take joy in destruction. An emotionally and psychologically healthy person can't understand it.
DeVega: Trump is now proclaiming that he is basically the Chosen One, a type of emissary and messiah from “god” and “Jesus Christ." As a clinician who has studied Trump’s behavior, how are you making sense of such claims and what they reveal about his mind?
Gartner: It's the grandiosity; Trump has delusions of grandeur. That fits both the malignant narcissism and the hypomania. It fits both. Trump is practically declaring that he is God. If someone else was doing such a thing they would likely be hospitalized. Trump's sense of reality testing is very fluid. Yes, Trump is performing for his MAGA followers, but I also am convinced that he actually believes that he has some type of God-like powers.
DeVega: What about Trump’s followers who see in him some type of god or superhero?
Gartner: At some level their worship of Trump is cartoonish. They idolize him beyond anything that is reasonable. If you get sucked into a cult, there is this psychology of worshipping the Dear Leader, he or she is omniscient, the Messiah. Some people's personalities are also more vulnerable to joining cults. People who have more primitive personality disorders or other such conditions split the world into idealized figures and devalued figures. Such people also tend to have unstable emotional lives and relationships. On a mass movement scale, Trump is able to mobilize many such people. I would also suggest that many of Trump's most die-hard followers are organized psychologically on this more primitive level. Some have the authoritarian personality described by Adorno after World War II in their attempt to understand who was attracted to the Nazis. Charismatic leaders like Donald Trump excite in their followers a kind of frenzy. But because the MAGA movement, like other fascist and authoritarian movements, is a death cult, what Trump is inciting in them is a kind of a dark frenzy and dangerous excitement. We have seen such energies summoned in some of the worst moments of modern history, most notably in Germany.