Forensic psychiatrist on physical signs of Trump's mental decline: "Changes
in movement and gait"
"His walk appears wide-based," Dr. Elisabeth Zoffmann notes of Trump. "He has
developed a swing of his right leg."
By Chauncey DeVega

Donald Trump�s obvious public challenges with speech, language, and thinking
are continuing to get worse. At a recent rally in Ohio, the former president
continued to act like a broken computer, going off on odd tangents, rambling,
muddling his speech, and saying, �Joe Biden won against Barack Hussein Obama,
has anyone ever heard of him? Every swing state, Biden beat Obama but in
every other state, he got killed.�

This is not an example of one so-called gaffe or misstatement but rather part
of a much larger pattern where Donald Trump confuses people and time. Experts
have empirically shown such behavior likely indicates some type of brain
disease. Dr. John Gartner, a prominent psychologist and contributor to the
bestselling book "The Dangerous Case of Donald Trump: 27 Psychiatrists and
Mental Health Experts Assess a President," has repeatedly warned in a series
of conversations about Trump�s apparent challenges in cognition and
communication that something seems to be very wrong with the ex-president:

Not enough people are sounding the alarm, that based on his behavior, and
in my opinion, Donald Trump is dangerously demented. In fact, we are seeing
the opposite among too many in the news media, the political leaders and
among the public. There is also this focus on Biden's gaffes or other things
that are well within the normal limits of aging. By comparison, Trump appears
to be showing gross signs of dementia. This is a tale of two brains. Biden's
brain is aging. Trump's brain is dementing.

Dr. Gartner�s attempts to sound the alarm about Trump�s behavior have been
joined by the hundreds of medical professionals who have signed his
Change.org petition, �We diagnose Trump with probable dementia: A petition
for licensed professionals only.�

To deny the obvious about Donald Trump�s evidently diseased mind is to deny
reality and to ignore the real possibility that a man who is already morally
and ethically corrupt and now appears to be experiencing problems with his
thinking could be back in the White House with the awesome responsibility and
power of the presidency � including the sole authority to order the use of
America�s nuclear weapons. Trump�s mind and overall behavior and character
are not just a national emergency but a global crisis as well.

Related
Who brought the crime, the drugs and the rape? It was him

Because of a commitment to horserace journalism, fake objectivity and
balance, self-interest and fear, the mainstream American news media �
especially the elite agenda-setting news media � has largely ignored Donald
Trump�s obvious struggles with communication and cognition. The Washington
Post�s Jennifer Rubin is a notable exception.

"His walk appears wide-based and he has developed a swing of his right leg.
He appears glued to the floor when he �dances� for his audience. If caught on
camera standing still, he appears unnaturally immobile."

In an attempt to better understand what we are witnessing with Donald Trump�s
behavior, I recently spoke with Dr. Elisabeth Zoffmann, a forensic
psychiatrist and an Associate Clinical Professor of Forensic and General
Psychiatry at the University of British Columbia. Dr. Zoffmann shares her
evidence-based preliminary conclusion that Donald Trump is displaying a range
of behaviors that suggest cognitive challenges if not impairment. The former
president appears to be suffering from Behavioral Variant Fronto-Temporal
Dementia, Dr. Zoffmann concludes, and needs to be evaluated by neurologists
who specialize in the condition.

This interview has been edited for length and clarity:

What do you see when you look at Donald Trump through a clinical lens?

My observations are garnered from viewing the phenomenon of Mr. Trump for the
past decade. Also, observations from viewing old videotape interviews and
coverage of Mr. Trump as a younger man form part of my impression that Mr.
Trump might benefit from a thorough evaluation by a neuropsychiatrist with
expertise in neurodegenerative disorders. My observations are as follows:

Changes in speech patterns with many fewer and simpler words (decline in
vocabulary) with fewer adjectives and adverbs.
A decline in cognitive focus on speech subjects with incomplete sentences
and an inability to focus on a topic long enough to complete a sentence when
not reading from a teleprompter.
Difficulty pronouncing words, word substitution and nonsense words �
known as paraphasia
Tangential thinking where the topic switches mid-sentence to some
unrelated topic.
Frequent repetition of words and phrases as if his mind is stuck in a
loop.
Disinhibition and an inability to control verbal outbursts.
Socially inappropriate behavior � mocking a man with muscular dystrophy,
disrespecting fallen soldiers as losers.
Lack of self-awareness in that he apparently cannot see how inappropriate
his behavior has become and use his judgment to stop himself.
Changes in movement and gait. His walk appears wide-based and he has
developed a swing of his right leg. He appears glued to the floor when he
�dances� for his audience. If caught on camera standing still, he appears
unnaturally immobile.
The changes in judgment and impulse control have uncovered and perhaps
worsened underlying personality traits that others have characterized as
narcissistic and antisocial. The changes have led some experts to suggest a
diagnosis of �malignant narcissism."

Mr. Trump has stated that he passed a cognitive that he described in terms
that suggested either the Mini-Mental Status Exam (MMSE) or the Montreal
Cognitive Assessment (MOCA) scale. These are both simple screening tests for
suspicions of Alzheimer�s Disease.

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My clinical experience and these collected observations are congruent with
the diagnostic criteria for Behavioral Variant Fronto-Temporal Dementia
(FTD). People presenting with such a cluster of observations should undergo
expert assessment. This diagnosis is often largely based on external
observations and collateral reporting from others close to the person. Early
in the disease, the individual may be aware of changes, but as frontal lobe
deterioration progresses the capacity for self-awareness diminishes. Unlike
Alzheimer�s Disease, people with FTD have intact short-term memory and can
easily score full points on screening tests like the MMSE and MOCA.

Is a person with FTD inherently dangerous?

No.

When social awareness is deteriorating the sufferers may become irritable
with caregivers. In Mr. Trump�s case, the overall picture is consistent with
Behavioral Variable Fronto-Temporal Dementia (with the caveats mentioned
about needing a thorough evaluation including an MRI brain scan.) The
associated disinhibition exposes unfortunate aspects of his personality and
worldview where he repeatedly dehumanizes anyone he sees as �the other." His
repeated statements dehumanizing migrants and exaggerating their numbers and
suggesting they are all killers is a good example. This meme has caught on
with his supporters and in situations of mass-thinking they may pose a danger
to migrants seeking refuge.

"My clinical experience and these collected observations are congruent with
the diagnostic criteria for Behavioral Variant Fronto-Temporal Dementia
(FTD)."

Mr. Trump�s memes seem to resonate with a stratum of American society that
feels disaffected and maligned in a rapidly changing world. Being blinded to
new information and new ways of experiencing scientific discovery poses a
risk for those people � for example, anti-vaccine people frequently dying of
COVID-19 when they could have vaccines.

People often conflate dementia and Alzheimer�s. Can you please clarify?

Dementia is a catch-all term for a number of recognized neurodegenerative
disorders: Alzheimer�s Disease, Lewy Body Disease, Multi-infarct Dementia,
Pick�s Disease, Parkinson�s Disease, Primary Progressive Aphasia variant
Fronto-temporal Dementia and Behavioral Variant Fronto-temporal Dementia.

In reading and hearing the comments of other observers and experts I am
reminded of the fable of Five Blind Men trying to describe an elephant. One
has the tail, others have the trunk, tusk, legs, and ears and all give a
version of what they have observed. One cannot get a complete picture of the
elephant without combining all of the observations. In the various interviews
and comments from other experts, I recognize all the criteria I set out from
my observations of Mr. Trump. I think we get a clearer picture if we combine
all these observations.

When you were first approached about making a public statement about Trump's
apparent neurological challenges you were reluctant to speak �on the record.�
What changed your mind?