We, the undersigned licensed medical and mental health professionals (INCLUDE YOUR ADVANCED DEGREE IN YOUR LAST NAME WITH NO PUNCTUATION) concur: From our years of training and experience, we are convinced that, while a definitive diagnosis would require further testing, Donald Trump is showing unmistakable signs strongly suggesting dementia, based on his public behavior and informant reports that show progressive deterioration in memory, thinking, ability to use language, behavior, and both gross and fine motor skills. 

 

1) Decline from baseline:

Overall, he shows a shocking decline in verbal fluency from his previous baseline. He was once highly articulate, with a sophisticated vocabulary, and spoke in polished paragraphs. Now, his vocabulary is impoverished, he often has difficulty finishing a thought, sentence or even a word. Typical of dementia patients he perseverates and overuses superlatives and filler words.

People who worked closely with Trump during his administration are reporting a shocking deterioration in just 4 years.

2) Memory:

Forgetting names and dates is normal for people who are aging (like Joe Biden). But the Dementia Care Society says "confusing people and generations" is a sign of advanced dementia. Recently, Trump confused Nikki Haley and Nancy Pelosi. 8 times he said he was running against Obama. He didn't look like he was joking. An example of confusing generations: Trump said his father was born in Germany, when that was his grandfather. Michael Wolff wrote Trump not infrequently failed to recognize old friends.

3) Language

Trump shows formal signs of disordered speech we typically see only in organically impaired patients. Trump is verbalizing an increasing number of  "phonemic paraphasias. Using non-words in place of real words that may include a fragment of the actual word. For example saying "mishuz" instead of missile, or "Chrishus" insead of Christmas. Sometimes he just uses sounds that don't resemble words at all. 

Trump evidences ‘semantic aphasia’ where he uses words in the wrong way. For example, "the oranges of the investigation."

Trump evidences "tangential thinking" where he drifts from one unrelated thought to another, and sometimes tries to confabulate them into a story. But the narrative is literally incoherent. With increasing frequency he degenerates into literal incoherence, where no one can tell what he was trying to say.

4) Motor:

Trump shows evidence of a "wide based gait" commonly found among patients with dementia. He swings his right leg in a semi-circle as if it were a dead weight. He also show deterioration in fine motor coordination, for example having difficulty drinking a bottle of water.

5) Behavior:

He is showing marked deterioration in impulse control and judgement.

This represents a unique danger because of Trump's pre-existing Malignant Narcissistic Personality Disorder. As he continues to deteriorate he will become even more erratic, impulsive, paranoid, and aggressive than he already is. A demented malignant narcissist as president of the United States would have unimaginably catastrophic consequences.

Not only is Trump unfit, but he cognitively incapable of carrying out the duties of president. Under normal circumstances, relatives of such a patient would be seeking consultation with experts, and considering long term care, as he continues to deteriorate.

We feel an ethical obligation to warn the public, and urge the media to cover this national emergency.

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