Like Father, Like Son. The Troubling Problem of Dementia in Trump’s White House
For many years prior to his death in 1999, Fred Trump, Donald Trump’s father, suffered from Alzheimer’s disease. Even though he suffered from this deadly form of dementia, Fred Trump clung to his position as chairman of the board of Trump Management until he died at the age of 93, according to his obituary in the New York Times. While people who have a family history of dementia are at increased risk, the biggest risk factor for dementia is age. Trump, who will be 73 years old on June 14, 2019, was the oldest person ever elected as President to a first term. The second oldest was Ronald Reagan, who was diminished by Alzheimer’s disease while he served as President. According to a study published in the journal Neuroepidemiology, about one in seven Americans over age seventy has dementia. Just as he followed his father’s footsteps into the real estate business, Trump also is following his father into the inescapable labyrinth of dementia. Just as his father would not let go of his position at the top of Trump Management even when he was dying from dementia, Trump will never stop clinging to his position as President of the United States no matter how mentally debilitated he is.
The U.S. Centers for Disease Control define dementia as “ a decline in mental ability severe enough to interfere with daily life.” It can be divided into three stages: preclinical, Mild Cognitive Impairment (MCI), and advanced. In the preclinical stage, significant symptoms are not yet obvious. According to the National Institutes on Aging, Mild Cognitive Impairment includes “symptoms of memory and/or other thinking problems that are greater than normal for a person’s age and education, but that do not interfere with his or her independence.” In advanced dementia, symptoms of memory loss, word finding difficulty and other diminished brain function are so serious that individuals have difficulty living independently. As a result of the slow progression of their disease and death from other maladies, many people with Mild Cognitive Impairment never reach the advanced stage of dementia.
Trump can be diagnosed with Mild Cognitive Impairment because he is constantly in the public eye such that anyone who knows what to look for can see the signs and symptoms of Trump’s disease. He has many symptoms of Mild Cognitive Impairment, including poor memory, word finding difficulty, slurred speech, linguistic decline, irritability, depression, mental confusion, lack of restraint, inexplicable lying, poor occupational performance, impaired judgment and paranoia.
In a speech announcing his decision to move the U.S. embassy from Tel Aviv to Jerusalem in December of 2017, for example, Trump severely slurred his words. While a White House spokesperson claimed his slurring was due to dry mouth, the severity of the slurring was inconsistent with this explanation and was more likely caused a Transient Ischemic Attack (TIA). In another speech this April to the Republican Jewish Coalition, Trump again slurred his words at one section, although less severely than he did in the 2017 episode. Trump has made numerous other rambling and incoherent speeches throughout his candidacy and presidency, including a famously incoherent speech declaring that there was a national emergency at the Mexican border. Experts in linguistics and psychology, who have compared Trump’s recorded statements in the 1990’s with more recent statements, have documented his marked linguistic decline. Trouble with word finding, including the confusion of names, is a signature form of linguistic decline typically found in the middle stage of dementia. Trump referred to Apple CEO Tim Cook as “Tim Apple” at a White House event in March. TIAs, as well as many small strokes, are caused by reduced blood flow to the brain, and are associated with the second most common cause of dementia — vascular dementia. This form of dementia often co-exists with other types of dementia, including Alzheimer’s, Lewy body dementia and Parkinson’s disease. Trump very likely suffers from mid-stage vascular dementia, and possibly also suffers from the early effects of Alzheimer’s. While Trump currently remains capable of speaking at great length, he unfortunately suffers from substantial neurocognitive decline that is certain to get worse.
We cannot predict precisely how Trump’s cognitive decline will interact with his well documented personality disorders. Based on many of Trump’s own statements as well as dozens of accusations of criminal activity, many psychological and psychiatric experts have concluded that Trump suffers from malignant narcissism and antisocial personality disorder. Disinhibition and agitation-paranoia are two common effects of dementia that can worsen behavior associated with antisocial personality disorder. If Trump’s dementia significantly damages his pre-frontal cortex, his impaired capacity to inhibit antisocial impulses may well be further diminished. Trump’s dementia also puts him at substantially increased risk of delusional thinking and aggressively agitated behavior. A delusion has been defined as “an unshakable theory or belief in something false and impossible, despite evidence to the contrary.” Trump’s asserted belief in the birther theory, his claims that climate change is a hoax and false claims that his father was born in Germany could all be delusions, or they could be lies related to his cognitive impairment and personality disorders. While we cannot predict with precision how Trump will act, we can say with certainty that any decisions he makes will be products of his impaired brain and his disordered personality. The physical and psychological chaos between Trump’s ears are mirrored by chaos in the White House. We are in a period of extreme danger because of this.
J. Whitfield Larrabee is the founder and executive director of the Resistance Committee Action Fund. Mr. Larrabee is also an influential lawyer. He has initiated dozens of criminal, ethics, civil rights and election law cases against powerful people in government and politics. These include cases against Donald Trump, The Trump Organization, The Donald Trump Foundation, Eric Trump, The Eric Trump Foundation, Paul Manafort, Attorney General Jeff Sessions, former White House Chief of Staff Reince Priebus, EPA Administrator Scott Pruitt, Florida Attorney General Pam Bondi, Representative Dana Rohrabacher, Representative Ed Royce, Senator Jim Risch, Judge Roy Moore & Justice Brett Kavanaugh. Follow him on twitter @jwlarrabee