Is Something Neurologically Wrong With Donald Trump? James Hamblin. The Atlantic, Jan 3 2018

Is Something Neurologically Wrong With Donald Trump? James Hamblin. The Atlantic, Jan 3 2018, https://www.theatlantic.com/health/archive/2018/01/trump-cog-decline/548759/

Excerpts:

The downplaying of a president’s compromised neurologic status would not be without precedent. Franklin Delano Roosevelt famously disguised his paralysis from polio to avoid appearing “weak or helpless.” He staged public appearances to give the impression that he could walk, leaning on aides and concealing a crutch. Instead of a traditional wheelchair, he used an inconspicuous dining chair with wheels attached. According to the FDR Presidential Library, “The Secret Service was assigned to purposely interfere with anyone who tried to snap a photo of FDR in a ‘disabled or weak’ state.”

Documenting the reality of Roosevelt’s health status fell to journalists, who had been reporting on his polio before his first term. A 1931 analysis in Liberty magazine asked “Is Franklin D. Roosevelt Physically Fit to Be President?” and reported on his paralysis: “It is an amazing possibility that the next president of the United States may be a cripple.” Once he was elected, Time described the preparation of the White House: “Because of the president-elect’s lameness, short ramps will replace steps at the side door of the executive offices leading to the White House.”

Today much more can be known about a person’s neurological status, though little of it is as observable as paraplegia. Unfortunately, the public medical record available to assuage global concerns about the current president’s neurologic status is the attestation of Harold Bornstein, America’s most famous Upper Manhattan gastroenterologist, whose initial doctor’s note described the 71-year-old Trump as “the healthiest individual ever elected to the presidency.”

The phrasing was so peculiar for a medical record that some suggested that Trump had written or dictated the letter himself. Indeed, as a key indicator of neurologic status, Trump’s distinctive diction has not gone without scrutiny. Trump was once a more articulate person who sometimes told stories that had beginnings, middles, and ends, whereas he now leaps from thought to thought. He has come to rely on a small stable of adjectives, often involving superlatives. An improbably high proportion of what he describes is either the greatest or the worst he’s ever seen; absolutely terrible or the best; tiny or huge.

The frontal lobes also control speech, and over the years, Donald Trump’s fluency has regressed and his vocabulary contracted. In May of last year, the journalist Sharon Begley at Stat analyzed changes in his speech patterns during interviews over the years. She noted that in the 1980s and 1990s, Trump used phrases like “a certain innate intelligence” and “These are the only casinos in the United States that are so rated.” I would add, “I think Jesse Jackson has done himself very proud.”

[...]

Ben Michaelis, a psychologist who analyzes speech as part of cognitive assessments in court cases, told Begley that although some decline in cognitive functioning would be expected, Trump has exhibited a “clear reduction in linguistic sophistication over time” with “simpler word choices and sentence structure.”