In psychiatry, the tendency to conspicuously and rigidly repeat a thought beyond the point of relevance, called “perseverance,” is known to be correlated with a variety of clinical disorders, including those involving a loss of cognitive reserve. People tend to stick to familiar topics over and over when they experience an impairment in cognitive functioning—for instance, in short-term memory. Short-term memory is essentially your mental sketch pad: how many different thoughts you can juggle in your mind, keep track of, and use at the same time. Given the complexity of being president, short-term memory is a vital skill.
If a patient presented to me with the verbal incoherence, tangential thinking, and repetitive speech that Trump now regularly demonstrates, I would almost certainly refer them for a rigorous neuropsychiatric evaluation to rule out a cognitive illness. A condition such as vascular dementia or Alzheimer’s disease would not be out of the ordinary for a 78-year-old. Only careful medical examination can establish whether someone indeed has a diagnosable illness—simply observing Trump, or anyone else, from afar is not enough. For those who do have such diseases or conditions, several treatments and services exist to help them and their loved ones cope with their decline. But that does not mean any of them would be qualified to serve as commander in chief.
Richard A. Friedman, a psychiatrist, in The Atlantic.
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