The former president’s repetitive speech is a bad sign.
Tuesday’s 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 Trump’s performance.
Just to be clear: Although I am a psychiatrist, I am not offering any specific medical diagnoses for any public figure. I have never met or examined either candidate. But I watched the debate with particular attention to the candidates’ vocabulary, verbal and logical coherence, and ability to adapt to new topics—all signs of a healthy brain. 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. By contrast, Donald Trump’s expressions of those tendencies were alarming. He displayed some striking, if familiar, patterns that are commonly seen among people in cognitive decline.
Much of the time, following Trump’s train of thought was difficult, if not impossible. In response to a question from the moderator David Muir about whether he regretted anything he’d done during the January 6 insurrection, Trump said:
I have said “blood bash—bath.” It was a different term, and it was a term that related to energy, because they have destroyed our energy business. That was where bloodbath was. Also, on Charlottesville, that story has been, as you would say, debunked. Laura Ingraham, Sean Hannity, Jesse—all of these people, they covered it. If they go an extra sentence, they will see it was perfect. It was debunked in almost every newspaper. But they still bring it up, just like they bring 2025 up.
