Age-Related Challenges and Childhood Stutter
President Joe Biden’s cognitive health has been under intense scrutiny, particularly by conservative and far-right media outlets. These narratives often misrepresent normal age-related lapses and overlook Biden’s lifelong challenge with a childhood stutter.
Born in 1942, Biden experiences some normal cognitive changes typical of aging, such as occasional forgetfulness or slight pauses in speech. These are common in individuals of his age and do not indicate severe cognitive impairment. More importantly, Biden’s history with a stutter has influenced his speech patterns, leading to pauses as he carefully constructs his words. His stutter, a challenge since childhood, has been a source of mockery during the Trump era.
Dr. Geraldine Williams, a speech pathologist, emphasizes that Biden’s pauses are strategic, reflecting a coping mechanism for his stutter rather than cognitive decline. "His speech patterns are indicative of someone managing a stutter effectively, not someone suffering from dementia," Dr. Williams explains.
Despite these challenges, Biden’s cognitive health remains robust. His 2023 medical examination described him as "healthy, vigorous, and fit to successfully execute the duties of the presidency." Cognitive assessments by his physician, Dr. Kevin O’Connor, confirm that Biden maintains the mental acuity required for his role.
Dr. Leo Gugerty, Professor Emeritus in Psychology at Clemson University, asserts that Biden exhibits strong cognitive capacities crucial for presidential leadership. "His ability to make deliberate decisions, manage complex issues, and demonstrate extensive knowledge is consistent with someone who has preserved critical cognitive functions," says Dr. Gugerty.
Observations from Experts
Experts in neurology and psychology have noted signs of cognitive decline in Donald Trump, raising concerns about his mental fitness.
Dr. John Gartner, a psychologist and former professor at Johns Hopkins University Medical School, describes Trump as showing "progressive deterioration in memory, thinking, language, behavior, and both gross and fine motor skills." Dr. Gartner's analysis suggests a decline beyond typical age-related changes, pointing to serious cognitive impairments.
Dr. Lance Dodes, a retired professor from Harvard Medical School, adds that Trump’s behavior reflects "gross paranoid psychosis" and "confusion about reality." Dr. Dodes notes that Trump's inability to distinguish between reality and delusion is a hallmark of severe cognitive issues, exacerbated by his narcissistic tendencies.
Physical signs also suggest cognitive decline. Trump’s walk appears wide-based, with a noticeable right leg swing. He seems unnaturally immobile when standing still and struggles with coherent speech, often going off on tangents and repeating phrases.
Dr. Elisabeth Zoffmann suggests Trump might have Behavioral Variant Fronto-Temporal Dementia (FTD). "My clinical experience and these collected observations are congruent with the diagnostic criteria for Behavioral Variant Fronto-Temporal Dementia (FTD)," she notes. Dr. Gartner contrasts Trump’s decline with Biden’s normal aging, stating, "Biden's brain is aging. Trump's brain is dementing."
Cognitive and Psychological Defects
Dr. Suzanne Lachmann observes significant changes in Trump’s speech patterns, noting that he often "forgets how the sentence began and invents something in the middle," resulting in "an incomprehensible word salad." These patterns suggest severe cognitive impairment, contrasting starkly with his earlier ability to communicate more coherently.
In public appearances, Trump has struggled with word retrieval, often defaulting to vague or incorrect terms. His frequent misstatements, such as referring to "wall mongers" instead of "warmongers" and confusing former and current presidents, illustrate his growing cognitive challenges.
Ramin Setoodeh on Trump's Memory Issues
Ramin Setoodeh, co-editor-in-chief at Variety, provides firsthand accounts of Trump’s severe memory issues. Setoodeh, who interacted extensively with Trump, notes that the former president often could not remember basic details or even recall Setoodeh during repeated interactions. "Donald Trump had severe memory issues. As the journalist who spent the most time with him, I have to say, he couldn’t remember things. He couldn’t even remember me," Setoodeh recounts.
Malignant Narcissism and Delusions of Grandeur
Experts consistently point to Trump’s malignant narcissism, characterized by a grandiose self-perception and complete disregard for truth and honesty.
Dr. Lance Dodes describes Trump’s mental state as dominated by "severe narcissistic, antisocial character disorder," manifesting in an inability to tolerate losses and a propensity for destructive behavior when faced with accountability.
Mary Trump, a clinical psychologist, and Donald Trump’s niece, reinforces this view, noting her uncle's "untreated psychiatric disorders," including delusions of grandeur and extreme narcissism. Mary Trump describes him as having been "reasonably adept at getting his point across" in his younger years but now exhibiting clear signs of "mental confusion" and an "inability to communicate effectively."
Cruel Sadism and Lack of Empathy
Trump’s behavior has also been characterized by a lack of empathy and a penchant for cruelty. Dr. Justin Frank, a psychiatrist, describes Trump as a "cruel sadist" who takes pleasure in inflicting pain on others. His policies and public statements often reflect a disregard for the suffering of others, consistent with traits of malignant narcissism.
Donald Trump’s behavior has often been characterized as erratic and unconventional, raising questions about his fitness for leadership. Numerous anecdotes from his presidency illustrate a pattern of aberrant behavior that departs from expected presidential norms.
Ranting About Wind Turbines: In a bizarre speech, Trump ranted about wind turbines causing cancer, a claim without any scientific basis. His obsession with wind turbines' supposed dangers became a frequent, unfounded talking point.
The Sharpie Incident: During Hurricane Dorian, Trump displayed a map altered with a Sharpie to falsely extend the hurricane's projected path into Alabama, contradicting official forecasts. This incident, dubbed "Sharpiegate," epitomized his disregard for factual information.
Covfefe Tweet: Trump’s infamous tweet, "Despite the constant negative press covfefe" left many confused, as the term "covfefe" had no meaning. The tweet remained up for hours, and the White House never clarified its intent, leaving it as a symbol of his erratic communication style.
Injecting Disinfectant: During a press briefing, Trump suggested injecting disinfectant as a potential COVID-19 treatment. This dangerous and scientifically unfounded advice led to public health warnings and ridicule from the medical community.
These anecdotes reflect a pattern of unpredictable and often irrational behavior, undermining confidence in Trump’s capacity for rational decision-making.
Trump’s boastfulness about his MoCA score perfectly illustrates his lack of depth in understanding cognitive assessments. Regularly bragging about his performance on the Montreal Cognitive Assessment (MoCA), Trump seemed to think it was equivalent to an IQ test or the SATs, viewing it as evidence of intellectual giftedness. This delusion reflects a fundamental misunderstanding of the MoCA’s purpose. Its tasks—like distinguishing animals or recalling words—assess basic cognitive functions necessary for daily life, not the profound intellectual depth required for the presidency.
Trump reportedly boasted about his MoCA score during White House meetings. An anonymous attendee recalled his overemphasis, noting, “I just remember when I walked out, saying to a coworker, ‘That was nuts,’” in reference to Trump's lengthy discussion of the test during a crucial campaign meeting.
The Montreal Cognitive Assessment (MoCA), developed by Dr. Ziad Nasreddine in 1996, is a tool designed to screen for mild cognitive impairment (MCI). It evaluates memory, attention, language, visuospatial skills, executive functions, and orientation, aiming to detect early signs of cognitive decline. Dr. Nasreddine explains, "The MoCA’s elements are selected with an intent to assess multiple cognitive domains that relate to human memory and brain function." Scored on a 30-point scale, with 26 or above considered normal, it is a preliminary screening tool, not a comprehensive measure of intelligence or capability for complex tasks.
Dr. Jonathan Reiner criticized Trump’s claims, stating, “It’s a very, very low bar for somebody who carries the nuclear launch codes in their pocket to pass and certainly nothing to brag about.” The MoCA does not assess the high-level cognitive functions required for nuanced decision-making or executive responsibilities. It is designed to identify potential cognitive impairments, not to measure intelligence or suitability for leadership.
The MoCA’s simplicity allows it to screen effectively for cognitive issues but does not gauge the sophisticated abilities required for national governance or crisis management. Trump’s misuse of the MoCA as a measure of intellectual aptitude highlights his misapprehensions and demonstrates his lack of readiness to tackle the multifaceted challenges of the presidency.
Claims equating the cognitive health of former President Donald Trump and President Joe Biden lack a factual basis and serve to obscure significant differences. Cognitive health assessments and observable behavior point to a clear distinction. Trump’s erratic behavior, frequent lapses in speech, and questionable decision-making have raised concerns about his cognitive decline. Specific incidents, such as his difficulty with common words, repeated falsehoods, and erratic public conduct, underscore this decline.
In contrast, despite being older, President Biden has shown no similar cognitive decline.
His administration's management of complex policy issues and his public speeches indicate intact cognitive function. Leading medical experts, including Dr. Sanjay Gupta, have noted that while Biden's age naturally raises questions, there is no substantial evidence of cognitive impairment.
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