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.

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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?