Medical expert explains what presidential debate revealed about Trumps cognitive fitness

Mental health experts have been left very worried by Donald Trumps performance in the presidential debate after he displayed a striking cognitive decline, a professor of psychiatry has claimed.

The 78-year-old rambled through his answers and struggled to defend himself as he faced Kamala Harris on Tuesday according to Richard A Friedman of Weill Cornell Medical College.

The former president has frequently boasted of acing mental ability tests and claimed that he is cognitively better now than he was 20 years ago.

But Freidman said that the 90 minutes against Harris left his declining powers harshly exposed.

If a patient presented to me with the verbal incoherence, tangential thinking, and repetitive speech that Trump now regularly demonstrates, I would almost certainly refer them for a rigorous neuropsychiatric evaluation to rule out a cognitive illness, he added.

Donald Trump rambled through his answers and struggled to defend himself as he faced Kamala Harris on Tuesday, according to Richard A Friedman of Weill Cornell Medical College

Harris too demonstrated rigidity and repetition, but her speech remained within the normal realm for politicians according to the professor of psychiatry

The former president saw Joe Biden drop out of the race for the White House after the 81-year-old Democrat fumbled his answers during a car crash performance at their debate in June.

But attention has turned to Trump himself who will be the oldest US president ever elected if he wins in November.

Professor Richard A Friedman 

Although Kamala Harris certainly exhibited some rigidity and repetition, her speech remained within the normal realm for politicians, who have a reputation for harping on their favorite talking points, Friedman wrote in the Atlantic.

By contrast, Donald Trumps expressions of those tendencies were alarming.

He displayed some striking, if familiar, patterns that are commonly seen among people in cognitive decline.

Friedman said he watched the debate in Philadelphia with an eye to the candidates vocabulary, verbal and logical coherence, and ability to adapt to new topics.

Much of the time, following Trumps train of thought was difficult, if not impossible, he wrote.

Evading the question is an age-old debate-winning tactic. But Trumps response seems to go beyond evasion.

It is both tangential, in that it is completely irrelevant to the question, and circumstantial, in that it is rambling and never gets to a point.

The GOP leader has made a virtue of his unconventional speech patterns which he dubs the weave.

Former President Donald Trump stated unequivocally that there will be no third debate, after a new poll showed a majority think he lost Tuesdays contest

You know what the weave is? Ill talk about, like, nine different things that they all come back brilliantly together, he told an audience last month.

And its like, and friends of mine that are, like, English professors, they say Its the most brilliant thing Ive ever seen.

But Freidman said his that his weave on Tuesday was alarmingly incoherent and starting to look less strategic and more uncontrollable.

Harris, for her part, also showed some verbal tics and leaned on tired formulations, he noted. For instance, she invited viewers more than 15 times to understand things.

But Trumps turns of phrase are so disjointed, so unusual, and so frequently uttered that theyre difficult to pass off as normal speech.

Trump expounded at every opportunity on immigration, a weak issue for Harris. But plenty of the former presidents repetitions seemed compulsive, not strategic.

After praising the Hungarian strongman Viktor Orbán, Trump spoke unprompted, at length, and without clarity about gas pipelines in the United States and Europe, an issue unlikely to connect with many voters.

A few minutes later, he brought up the pipelines again. The moderators cut him off for a commercial break.

Harris had worked intensively with her team in the days before the debate on ways of getting under the ex-presidents skin, appearing to rile him with jibes about the size of crowds at his rallies and about having been fired by 81 million people.

But it was his cognitive reactions rather than emotional response which worried the professor.

Even in cases where Trump could have reasonably defended himself, he was unable to articulate basic exculpatory evidence, Friedman claimed.

When Harris raised his infamous very fine people on both sides remark regarding the 2017 white-supremacist march in Charlottesville, Virginia, Trump could have pointed out that even at the time, he had specified, Im not talking about the neo-Nazis and the white nationalists—because they should be condemned totally.

But he did not.

Tuesdays debate was reportedly the first time the two candidates had ever met

Republican Rep Ronny Jackson, a former White House physician, insisted last year that the former president remains incredibly sharp. 

Hes got a better memory than I have, than you have. We all know this, he told Fox Newss Sean Hannity.

But Friedman said the cognitive tests Trump claims to have passed are only designed to detect pronounced cognitive dysfunction.

As such, they are quite easy to pass, he wrote. They ask simple questions such as What is the date? and challenge participants to spell world backwards or write any complete sentence.

Tuesdays presidential debate was, among other things, an excellent real-world test of the candidates cognitive fitness—and any fair-minded mental-health expert would be very worried about Donald Trumps performance.

A condition such as vascular dementia or Alzheimers disease would not be out of the ordinary for a 78-year-old.

Only careful medical examination can establish whether someone indeed has a diagnosable illness—simply observing Trump, or anyone else, from afar is not enough.

For those who do have such diseases or conditions, several treatments and services exist to help them and their loved ones cope with their decline.

But that does not mean any of them would be qualified to serve as commander in chief.