Is Donald Trump’s Declining Speech Due to Aging or Dementia?

Trump is increasingly losing his train of thought in the middle of sentences

Last week, Cornell University senior lecturer in psychology, Harry Segal, was quoted in Newsweek saying about Donald Trump, “The complexity of his language has changed. So when he's speaking—what appears to be—coherently, it's almost like he's gumming together phrases that he repeats over and over again. Now, he's always had a tendency to do this, but if you go back, as I have, to looking at interviews in 2016, he was clearly more crisp [and] he was more complex than he is now."

Whereas Biden’s lifelong stutter is widely documented, Trump’s verbal functioning has been deteriorating before our eyes. As Psychologist and Johns Hopkins University Medical School Professor, John Gartner, pointed out, “Biden is aging. Trump is dementing.”

This presents a very important question: Are Trump’s recent speech challenges aberrations that happened to be caught on camera, or are these gaffs indicative of mental decline or even – as Segal and Gartner suggest – dementia?

My expertise in dementia comes from working with many organizations where my role has been to understand the origins of cognitive decline in the patients referred to me. If information on baseline functioning is available, that is key in determining whether there is an ongoing decline in cognitive functioning. Family history of mental and cognitive impairments is also important. I honed my professional skills as a diagnostician in numerous settings including Project Renewal, Project Samaritan, and the Counseling Services Unit of the New York City Fire Department, to name a few.

One useful way to understand whether Trump’s recent, documented speech challenges are symptoms of dementia is to ask whether these examples are due to problems speaking or problems thinking. It’s interesting to note that Joe Biden’s stutter is an example of the first: He simply struggles to form words. However, it does seem as if Donald Trump’s declining speech is of cognitive origin.

We can see this in video of Trump speaking at a rally in North Carolina on March 2, 2024. Not only does Trump slur words, which could be considered a “mechanical” problem, but he frequently loses his train of thought in the middle of sentences. This speech and many others present a similar pattern: Trump starts a sentence, he loses track of where he is, and then either restarts in a completely different direction or keeps speaking in what many have called a “word salad.” These pauses in which Trump loses his train of thought also present opportunities for invention – he forgets where he is going and so leverages topics that are at the top of his mind. That’s how we get this video from a March 2024 rally in Georgia, in which Trump, speaking about immigration, starts a sentence about immigrants supposedly knocking on a front door…and then pivots to immigrants using the kitchen and using the bedroom. He starts on script, loses his train of thought, and says whatever is at the top of his mind.

 I am inclined to dismiss some examples of Trump slurring words, even in extreme cases such as this video, to fatigue and lack of stamina. But losing one’s train of thought in this very specific way is a classic symptom of dementia.

Biden may sound old, but given what we saw in his State of the Union Speech he gave this year, his mind remains intact. On the other hand, while Trump speaks in a forceful tone, his speech is becoming increasingly tangential, devolving into bizarre non sequiturs and increasingly incomprehensible statements and assertions, evidencing a mind in rapid and severe decline. Future posts will expand on and explore additional symptoms of Trump’s dementia. I hope you will subscribe here.