health & medical

Grimly plausible question of the day: is the President showing early signs of dementia?

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May I be wrong.

May I be so wrong.

Having been through this with many beloved relatives including multiple grandparents, it’s not something I wish on anybody, no matter what I may think of them personally. No one deserves to lose their identity—no one’s loved ones should be forced to witness them going through this loss.

That noted, reading Donald Trump’s interview in TIME, it’s hard not to think that something’s… off.

Understand: Trump is at risk. An estimated one in ten Americans over 65 has Alzheimer’s dementia. Trump is the oldest person ever to reach the presidency—he turns 71 on June 14. Beyond this, Trump’s own father had Alzheimer’s.

The Mayo Clinic has listed the signs of dementia. They include:
• Difficulty communicating or finding words
• Difficulty reasoning or problem-solving
• Confusion and disorientation
• Anxiety
• Inappropriate behavior
• Paranoia
• Agitation

At the risk of being blunt: does this sound like anyone we know?

The previous oldest man to enter the White House, Ronald Reagan, suffered from Alzheimer’s. He may have been showing signs of it while still in office. (His own children debate whether this is the case.) The reporter Leslie Stahl noted an episode when Reagan “didn’t seem to know who I was.”

Stahl also reported that Reagan grew sharper as the meeting progressed. And it should be observed that, again speaking from experience, it’s not as if people one day are perfectly lucid and the next unrecognizable. No, at first there are occasional moments when things are just… off.

Then there are more moments.

Then the moments are more common than the times they’re themselves.

And then one day they’re just gone, though their body may stick around for years to come.

I’ll explain why the TIME interview is particularly troubling to me. Having conducted quite a few interviews over the years, I can say that all of us seem a bit deranged when our remarks are transcribed on to the page—so many false starts to sentences; so many “um”s and “you know”s; frankly, it’s amazing we express ourselves at all.

Trump’s interview, however, does a few things most interviews just don’t.

In my experience, people beginning to show signs of dementia do three things:
1. They get stuck in “ruts.” By this I mean, the conversation continually circles back on itself. There are things they want to discuss and they repeat them again and again. At first it seems to be for emphasis, but eventually it can feel as if they forgot that they’ve already made the points, which is why they continue to make them.
2. They get unexpectedly emotional. There are bursts of what Mayo termed “anxiety” and “agitation.” These tend to pass equally abruptly.
3. They occasionally stop making sense. Understand: This isn’t total incoherence. This isn’t even primary incoherence. These are only moments that make you go, “Huh, I’m not sure I quite got that.”

Now read Trump’s remarks. In particular, focus on two phrases: “Devin Nunes news conference” and “Brexit.”

I’ll give you a moment.

(Moment passes…)

Beyond his age and family history, Trump is particularly at risk for dementia because of his diet: fast foods simply aren’t brain food. (Ironically though, Trump’s KFC heavy eating habits might benefit him in another way: studies have shown obesity may decrease the risk of dementia.)

Trump has been deeply reluctant to release his full medical history, though in fairness he’s secretive about many things. Still, his personal physician has hardly been reassuring. Dr. Harold Bornstein has said of his famous patient:

“If something happens to him, then it happens to him. It’s like all the rest of us, no? That’s why we have a vice president and a speaker of the House and a whole line of people. They can just keep dying.”

Again, I might be totally wrong about all this (I damn sure hope I am). But when Trump repeats stories he saw on TV and can’t quite recall all the details even though he’s very confident about them, perhaps it’s not the work of a calculating politician determined to change the topic.

Maybe it’s a warning that an old man is beginning to suffer from the ailment that afflicted his father. (And, at the risk of being even more morbid, will eventually affect many of the people reading this right now, not to mention—in light of my own family history—very possibly me as well.)

Maybe our President is a person who will soon need a lot of medical care and general support and—this is something I never thought I’d say about Donald Trump—love.

And if it seems like rough sailing for America today, just wait until tomorrow.

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