Trump keeps losing his train of thought. Cognitive experts have theories
about why

Olivia Goldhill

By Olivia Goldhill Aug. 7, 2024
Reprints

A screen shows former president Donald Trump's mouth as he speaks �
politics coverage from STAT
JIM WATSON/AFP via Getty Images

In a speech earlier this year, former President Trump was mocking President
Biden�s ability to walk through sand when he suddenly switched to talking
about the old Hollywood icon Cary Grant.

�Somebody said he [Biden] looks great in a bathing suit, right? When he was
in the sand and he was having a hard time lifting his feet through the
sand, because you know, sand is heavy. They figure three solid ounces per
foot. But sand is a little heavy. And he�s sitting in a bathing suit. Look,
at 81, do you remember Cary Grant? How good was Cary Grant, right? I don�t
think Cary Grant � he was good. I don�t know what happened to movie stars
today,� he said at a March rally in Georgia. Trump went on to talk about
contemporary actors, Michael Jackson, and border policies before returning
to the theme of how Biden looks on the beach.

This shifting from topic to topic, with few connections � a pattern of
speech called tangentiality � is one of several disjointed and occasionally
incoherent verbal habits that seem to have increased in Trump�s speech in
recent years, according to interviews with experts in memory, psychology,
and linguistics.

Back in 2017, Trump�s first year in the White House, a STAT analysis showed
Trump�s speaking style had deteriorated since the 1980s. Seven years on,
now that Trump has the GOP presidential nomination, STAT has repeated the
analysis. The experts noted a further reduction in Trump�s linguistic
complexity and, while none said they could give a diagnosis without an
examination, some said certain shifts in his speaking style are potential
indications of cognitive decline.

Both Trump�s and Biden�s cognitive abilities have received extensive public
scrutiny in an election initially involving two men of retirement age,
though concerns about Biden�s mental competence have faded since he
announced he wouldn�t be seeking re-election.

Trump has often said that he�s taken and passed an unspecified cognitive
test. Last week, speaking to the National Association of Black Journalists,
he said, �I want anybody running for president to take an aptitude test, to
take a cognitive test. I think it�s a great idea. And I took two of them,
and I aced them.� The Trump campaign did not respond to a request for
comment on this story.
Related: Physicians weigh in on potential impact of Trump�s ear wound:
�It�s a matter of inches�

Questions about Trump�s memory are typically raised when he makes a glaring
verbal slip, such as mistaking names. Among the most publicized examples in
recent months were when the 78-year-old confused former president Obama and
Biden, and spoke about Nikki Haley when he meant to refer to Nancy Pelosi.
Yet for all the attention they drew, experts in aging and cognition said
those errors were relatively insignificant.

�Everyone to some degree has some level of mixing up of names,� said Ben
Michaelis, a clinical psychologist who has carried out cognitive
assessments for the New York Supreme Court. �It�s a bit of a red herring.�
Zenzi Griffin, a psychology professor at the University of Texas at Austin
agreed, noting the phonetic similarities between �Nikki Haley� and �Nancy
Pelosi� (both names start with �N� and both their first and last names end
with an �ee� sound.) �That level of similarity really makes it an easy
error to make,� she said.

Other verbal shifts are more telling. At STAT�s request, four experts
reviewed four clips of Trump�s speeches in recent months, and compared them
to speeches from 2017. Several noticed Trump�s 2024 speeches included more
short sentences, confused word order, and repetition, alongside extended
digressions such as Trump�s comments on Biden and Cary Grant, or in another
speech, comments on banking abruptly giving way to Trump lamenting the cost
of electric cars.

These could be attributed to a variety of possible causes, they said, some
benign and others more worrisome. They include mood changes, a desire to
appeal to certain audiences, natural aging, or the beginnings of a
cognitive condition like Alzheimer�s disease.
A selection of clips from Donald Trump�s 2024 campaign appearances that
experts reviewed at STAT�s request.
STAT, source clips: YouTube

One other academic, James Pennebaker, a social psychologist at the
University of Texas at Austin, performed a more formal analysis for STAT
based on complete transcripts of 35 Trump interviews from 2015 through this
year. Rather than reviewing specific clips, he used statistical software to
track word use in detail, highlighting changes in Trump�s speaking style.
Although Pennebaker said he�d want to analyze more texts before submitting
his findings to an academic journal, he concluded that the texts showed
significant changes in Trump�s linguistic tendencies.

Since the end of Trump�s presidency in 2021, Pennebaker�s analysis showed a
steep increase in �all-or-nothing thinking,� as indicated by a roughly 60%
increase in use of absolute terms like �always,� �never,� and �completely.�
This habit, Pennebaker said, can be a sign of depression, which also fits
with other changes in Trump�s word choices: His dialogue now has far fewer
positive words than previously, and includes more references to negative
emotions, especially since his return to civilian life.

Increased all-or-nothing thinking can also be linked to cognitive ability,
and such a sharp increase is associated with cognitive decline, said
Pennebaker. �Another person who�s all-or�nothing thinking has gone up is
Biden,� he added.
Related: Trump wasn�t always so linguistically challenged. What could
explain the change?

Another clear trend from his analysis showed that, since 2020, Trump has
increasingly spoken about the past, with around a 44% increase in past-
focused sentences, and is spending very little time talking about the
future. This is particularly striking, said Pennebaker, given that
presidential candidates are typically forward-looking and making promises
about what they will deliver. It�s something that Vice President Kamala
Harris picked up on in her first campaign speech, in which she criticized
Trump�s vision as being �focused on the past.�

Even as Trump speaks with more derailments, Pennebaker found that he�s
relied on unusually simple words and sentence structures since before he
was elected president. A linguistic metric of analytic thinking shows that
Trump�s levels of complexity have always been unmistakably low, said
Pennebaker. Whereas most presidential candidates are in the 60 to 70 range,
Trump�s speeches range from 10 to 24. �I can�t tell you how staggering this
is,� said Pennebaker. �He does not think in a complex way at all.�

Michaelis, who also reviewed Trump�s speaking style for STAT in 2017 and
showed how it had become significantly less sophisticated over the decades,
said the most important change in the past seven years is Trump�s
increasing digressions and speeches that don�t stay on topic, which he
explained can be an indication of diminished cognitive ability.
�Tangentiality certainly amped up and it�s difficult to follow him,�
Michaelis said. �You�d expect some cognitive diminishment of course, he�s
78 years old � if he was your grandfather you wouldn�t expect anything
different. He just happens to be running for president.�

Although Michaelis said he couldn�t offer a formal diagnosis, he said
Trump�s speaking style was cause for concern. �There�s reasonable evidence
suggestive of forms of dementia,� he said. �The reduction in complexity of
sentences and vocabulary does lead you to a certain picture of cognitive
diminishment.�

Trump�s habit of speaking off-topic is likely related to the frontal lobe,
the part of the brain involved in executive function such as planning and
problem-solving, said Andrew Budson, a neurology professor at Boston
University and author of �Seven Steps to Managing Your Aging Memory.� This
is the area of the brain and aspect of thinking that is most often affected
by aging, which makes it difficult to remain focused on one topic, and
leads to jumping around in conversation. Such a habit could also reflect
ADHD or poor sleep, he said, though it can also be a sign of impending
Alzheimer�s.

�There are absolutely changes that are occurring, without any doubt,� he
said. Previously, Trump was more focused on topics and could articulately
describe events. �Now, it�s much more about evoking different things, using
general terms and saying the same thing again and again, then jumping to
something else, then jumping back to it,� he added.

This repetitive speaking style could indicate decreased efficiency in the
frontal lobe, said Budson, though this could also happen with normal aging
rather than a pathological condition. He added that the changes in Trump�s
speaking style since 2017 could also reflect a political strategy and
desire to connect with a certain audience, or else an increasingly relaxed
manner around crowds Trump feels comfortable with.

In addition to shorter sentences, Michaelis noticed Trump using words in
the wrong order or inventing words, which adds to confusion in
understanding him, and can be signs of cognitive problems that come either
with natural aging or conditions such as Alzheimer�s. He pointed to this
passage from a campaign event in January:

�We�re also going to place strong protections to stop banks and regulators
from trying to debank you from your political beliefs,� Trump said in the
New Hampshire speech. �What they do, they want to debank you. And we are
going to debank, think of this. They want to take away your rights. They
want to take away your country, the things you�re doing. All electric cars.
Give me a break. If you want an electric car, good. But they don�t go far.
They�re very expensive.�

�I�m not clear what de-banking means,� said Mark Liberman, a linguistics
professor at the University of Pennsylvania, who noticed that Trump also
seems to be speaking more slowly now than compared to seven years ago.

Determining a definitive cause for Trump�s shifts in language would require
in-person tests and interviews, Lieberman said. And analysis is further
complicated by Trump�s long-standard unusual communication manner: �You�ve
got to keep talking. Never stop. Make up names for your opponent, make fun
of your opponent, promise all kinds of things,� said Liberman, who compared
Trump�s style to wrestling promo talk.

https://www.statnews.com/2024/08/07/trump-mental-health-linguistic-
analysis-suggests-potential-cognitive-decline-experts-say/