It was the kind of utterance that makes professional transcribers question their career choice:

“ … there is no collusion between certainly myself and my campaign, but I can always speak for myself — and the Russians, zero.”

When President Trump offered that response to a question at a press conference last week, it was the latest example of his tortured syntax, mid-thought changes of subject, and apparent trouble formulating complete sentences, let alone a coherent paragraph, in unscripted speech.


President Trump denied his campaign colluded with Russia while speaking at a press conference in May 2017. Via YouTube

He was not always so linguistically challenged.

STAT reviewed decades of Trump’s on-air interviews and compared them to Q&A sessions since his inauguration. The differences are striking and unmistakable.


Research has shown that changes in speaking style can result from cognitive decline. STAT therefore asked experts in neurolinguistics and cognitive assessment, as well as psychologists and psychiatrists, to compare Trump’s speech from decades ago to that in 2017; they all agreed there had been a deterioration, and some said it could reflect changes in the health of Trump’s brain.

In interviews Trump gave in the 1980s and 1990s (with Tom Brokaw, David Letterman, Oprah Winfrey, Charlie Rose, and others), he spoke articulately, used sophisticated vocabulary, inserted dependent clauses into his sentences without losing his train of thought, and strung together sentences into a polished paragraph, which — and this is no mean feat — would have scanned just fine in print. This was so even when reporters asked tough questions about, for instance, his divorce, his brush with bankruptcy, and why he doesn’t build housing for working-class Americans.

In an interview from 1987, Donald Trump talks about poverty and homelessness in the US. Via YouTube

Trump fluently peppered his answers with words and phrases such as “subsided,” “inclination,” “discredited,” “sparring session,” and “a certain innate intelligence.” He tossed off well-turned sentences such as, “It could have been a contentious route,” and, “These are the only casinos in the United States that are so rated.” He even offered thoughtful, articulate aphorisms: “If you get into what’s missing, you don’t appreciate what you have,” and, “Adversity is a very funny thing.”

Now, Trump’s vocabulary is simpler. He repeats himself over and over, and lurches from one subject to an unrelated one, as in this answer during an interview with the Associated Press last month:

“People want the border wall. My base definitely wants the border wall, my base really wants it — you’ve been to many of the rallies. OK, the thing they want more than anything is the wall. My base, which is a big base; I think my base is 45 percent. You know, it’s funny. The Democrats, they have a big advantage in the Electoral College. Big, big, big advantage. … The Electoral College is very difficult for a Republican to win, and I will tell you, the people want to see it. They want to see the wall.”

For decades, studies have found that deterioration in the fluency, complexity, and vocabulary level of spontaneous speech can indicate slipping brain function due to normal aging or neurodegenerative disease. STAT and the experts therefore considered only unscripted utterances, not planned speeches and statements, since only the former tap the neural networks that offer a window into brain function.

The experts noted clear changes from Trump’s unscripted answers 30 years ago to those in 2017, in some cases stark enough to raise questions about his brain health. They noted, however, that the same sort of linguistic decline can also reflect stress, frustration, anger, or just plain fatigue.

Ben Michaelis, a psychologist in New York City, performed cognitive assessments at the behest of the New York Supreme Court and criminal courts and taught the technique at a hospital and university. “There are clearly some changes in Trump as a speaker” since the 1980s, said Michaelis, who does not support Trump, including a “clear reduction in linguistic sophistication over time,” with “simpler word choices and sentence structure. … In fairness to Trump, he’s 70, so some decline in his cognitive functioning over time would be expected.”

Some sentences, or partial sentences, would, if written, make a second-grade teacher despair. “We’ll do some questions, unless you have enough questions,” Trump told a February press conference. And last week, he told NBC’s Lester Holt, “When I did this now I said, I probably, maybe will confuse people, maybe I’ll expand that, you know, lengthen the time because it should be over with, in my opinion, should have been over with a long time ago.”

In an interview conducted earlier this month, President Trump explains the timing of James Comey's firing. Via YouTube

Other sentences are missing words. Again, from the AP: “If they don’t treat fairly, I am terminating NAFTA,” and, “I don’t support or unsupport” — leaving out a “me” in the first and an “it” (or more specific noun) in the second. Other sentences simply don’t track: “From the time I took office til now, you know, it’s a very exact thing. It’s not like generalities.”

There are numerous contrasting examples from decades ago, including this — with sophisticated grammar and syntax, and a coherent paragraph-length chain of thought — from a 1992 Charlie Rose interview: “Ross Perot, he made some monumental mistakes. Had he not dropped out of the election, had he not made the gaffes about the watch dogs and the guard dogs, if he didn’t have three or four bad days — and they were real bad days — he could have conceivably won this crazy election.”

The change in linguistic facility could be strategic; maybe Trump thinks his supporters like to hear him speak simply and with more passion than proper syntax. “He may be using it as a strategy to appeal to certain types of people,” said Michaelis. But linguistic decline is also obvious in two interviews with David Letterman, in 1988 and 2013, presumably with much the same kind of audience. In the first, Trump threw around words such as “aesthetically” and “precarious,” and used long, complex sentences. In the second, he used simpler speech patterns, few polysyllabic words, and noticeably more fillers such as “uh” and “I mean.”

Donald Trump shares his take on Ross Perot's 1992 presidential campaign. Via YouTube

The reason linguistic and cognitive decline often go hand in hand, studies show, is that fluency reflects the performance of the brain’s prefrontal cortex, the seat of higher-order cognitive functions such as working memory, judgment, understanding, and planning, as well as the temporal lobe, which searches for and retrieves the right words from memory. Neurologists therefore use tests of verbal fluency, and especially how it has changed over time, to assess cognitive status.

Those tests ask, for instance, how many words beginning with W a patient can list, and how many breeds of dogs he can name, rather than have patients speak spontaneously. The latter “is too hard to score,” said neuropsychologist Sterling Johnson, of the University of Wisconsin, who studies brain function in Alzheimer’s disease. “But everyday speech is definitely a way of measuring cognitive decline. If people are noticing [a change in Trump’s language agility], that’s meaningful.”

Although neither Johnson nor other experts STAT consulted said the apparent loss of linguistic fluency was unambiguous evidence of mental decline, most thought something was going on.

John Montgomery, a psychologist in New York City and adjunct professor at New York University, said “it’s hard to say definitively without rigorous testing” of Trump’s speaking patterns, “but I think it’s pretty safe to say that Trump has had significant cognitive decline over the years.”

No one observing Trump from afar, though, can tell whether that’s “an indication of dementia, of normal cognitive decline that many people experience as they age, or whether it’s due to other factors” such as stress and emotional upheaval, said Montgomery, who is not a Trump supporter.

Even a Trump supporter saw and heard striking differences between interviews from the 1980s and 1990s and those of 2017, however. “I can see what people are responding to,” said Dr. Robert Pyles, a psychiatrist in suburban Boston. He heard “a difference in tone and pace. … What I did not detect was any gaps in mentation or meaning. I don’t see any clear evidence of neurological or cognitive dysfunction.”

Johnson cautioned that language can deteriorate for other reasons. “His language difficulties could be due to the immense pressure he’s under, or to annoyance that things aren’t going right and that there are all these scandals,” he said. “It could also be due to a neurodegenerative disease or the normal cognitive decline that comes with aging.” Trump will be 71 next month.

Northwestern University psychology professor Dan McAdams, a critic of Trump who has inferred his psychological makeup from his public behavior, said any cognitive decline in the president might reflect normal aging and not dementia. “Research shows that virtually nobody is as sharp at age 70 as they were at age 40,” he said. “A wide range of cognitive functions, including verbal fluency, begin to decline long before we hit retirement age. So, no surprise here.”

Researchers have used neurolinguistics analysis of past presidents to detect, retrospectively, early Alzheimer’s disease. In a famous 2015 study, scientists at Arizona State University evaluated how Presidents Ronald Reagan and George H.W. Bush spoke at their news conferences. Reagan’s speech was riddled with indefinite nouns (something, anything), “low imageability” verbs (have, go, get), incomplete sentences, limited vocabulary, simple grammar, and fillers (well, basically, um, ah, so) — all characteristic of cognitive problems. That suggested Reagan’s brain was slipping just a few years into his 1981-1989 tenure; that decline continued. He was diagnosed with Alzheimer’s disease in 1994. Bush showed no linguistic deterioration; he remained mentally sharp throughout his 1989-1993 tenure and beyond.

Sharon Begley answered reader questions about this article on Facebook. Read the conversation here.

  • I not only second A.M. on thanking Mr. Fred Smith, for eloquently summarizing non-challenged American thinking, and expressing dissatisfaction with non quality political vs. Medical and Analytical content commentary.
    “Only in a vacuum would USA elect a wizard, behind White House curtains, no one can’t follow? Then, await in expectancy to find and follow his/her act?”
    Science, Communication and Technology move forward steadily.

    Sleeping more or less it’s not just about a bath of spinal fluid circulating with in one’s brain removing proteins & toxins. It is all about the quality of spinal fluid composition and its external/internal chemical feedback/response to and from every fiber, nerve, neuron and interconnect with in the organic human body.
    Time is a factor but in fact quality of spinal fluid might override at times and take over disregarding time with or without consequences in response.

    Human Genomes complex cellular compositions and environmental agragate impact, on human population would never ever be the same for any two people; thus disease incidence and expectancy shall differ as well.
    It’s a one on one to be clinically medically, psychologically, scientifically, analytically or unfortunately in some circles & cultures group/populations intrusively analyzed.

  • I think I’ve heard Trump say that he sleeps very few hours and considers it an asset. Since the cerebrospinal fluid in the skull washes over brain cells during sleep to remove proteins / toxins accumulated during the day and get the brain ready to perform the next day, I wonder if some of this decline in sentence structure and sophisocation of vocabulary could be related to chronic sleep deprivation over many years? Researchers are starting to see a connection between poor sleep quality and the progression of other age related mental diseases, such as altzheimers. Makes me wonder if what he really needs is some consistent, good sleep to help keep things functioning well. I know it makes a huge difference for me (being someone who has always struggled to remain asleep more than 6 hours), and it’s hard for many of us to acknowledge the importance of a good night’s sleep and make it a priority to figure out what is preventing it. Well, that’s my two cents anyway.

  • It’s disappointing to read stat news articles with political propaganda. Leave that to the political sites. Please adhere to real medical topics and analysis. This news site cheapens itself when straying away from real medical topics into politics.

  • He’s the oldest person ever to be elected President and the drug he takes for hair loss, Propecia, is associated with early dementia.

    So none of this should come as a surprise.

  • Trump is in his 70s when you get that old you do start to fall apart, even with that said, he is much better than Hillary, or Obama was!

    • You seem rather linguistically challenged yourself. When you say he’s better, what do you mean he’s better at? He can’t be a better president because Hillary wasn’t president. This is why simple-minded people like mr. Trump: they don’t have to think.

      Now it is true that mr. Trump is a better liar than mr. Obama. He is also better at insulting than Obama. But as far as leading the country, no. His approval rating is currently 32%. That is the lowest level of any sitting president, ever. And it is rightfully deserved. But simple-minded people will follow him all the way down to zero.

  • His co-author of ‘The Art of the Deal’ weighed in yesterday about this very thing. He puts it down to Trump’s being profoundly mentally ill, and describes it as merely a progression of the path he was on mentally, decades ago. Another psychiatrist was on record yesterday, saying it was stress-induced psychosis, with flares at the obvious times. Hopefully, if he is to be hauled away in a strait-jacket, it will be very soon.

  • I have been amazed at the speech and behavior ways that Trump has like my Mother. She was diagnosed with Dementia almost 4 years ago. She has days that are really good, and days that are not so good. She has developed anger control issues, always has to be the one who is right, she remembers many things much differently than the way they really happened, or recalls facts different than the way someone told them to her. She is going to have that last word, no matter how long the challenge, and will have a come-back at you. She’s extremely defensive when she perceives she might be being criticized. And this has always been a very humble and kind Lady, never got angry about anything, never raised her voice beyor She gets disoriented every once in a while, even in her house she has lived in for 56 years. Yet she gave correct answers on 15, out of 18 questions on a memory test given to her by her Doctor, in June 2017. Most people who aren’t around her much don’t even realize that she has Dementia. After I watched Mr Trump in the campaign Debates last year, I know he has Dementia, I’ve been around it every day

  • It sounds more like his speech has had to conform to self censorship when previously he had no trouble with lying, more offensive language, and always saying exactly what he wanted. It’s like he’s about to lie and realizes that could be legally more trouble than it used to be and quickly adjusts mid-sentence; or he’s about to say something “truly awful” and manages to noticeably change gears to just “mildly offensive” in a speech instead.

  • It sounds like his speech has changed to conform to the 160 character thought bytes that the rest of the people in the USA best understand.? So, is that his fault for changing his speech patterns to what people expect and see as they tweet all day? It did help him get elected to President of the United States so maybe Donald Trump’s change of speech patterns is not due to decreased mental capacity but a change to communicate better with the citizens in the manner they can most easily understand. Seems like you are blaming Trump, in some part, for our twitter-based society. In all of these comment sections it seems you can get the most approval if you smear Trump, with the approval increasing the worse the smear. Even the original article has parts of truth about IQ followed by unfounded statements about Trump in order to imply he has seriously diminished mental capacity. Shame on any news organizations that reprint this rubish.

    • This is a man who is incapable of controlling himself enough to refrain from tweeting, insulting world leaders, attacking his own administration, or aligning with Nazis. You think he has the self-control to reorient his entire speech pattern for more effective communication? Riiiiight.

    • Has he adapted to a Twitter based society or has Twitter come along at just the right time to meet his increasing need for an outlet that also supports his decreasing abilities?

    • Fred, thanks so much for your thoughtful reply. Our President has no problem communicating that’s for sure He may be blunt, but he gets his point across loud and clear. Personally, I would rather see someone in action and doing a great job rather than someone sugar coating how wonderful everything is while doing quite the oppostie. We dealt with that for 8 years with Obama. Trump has done more for this country his first year than Obama did the entire time he was in office.

  • See this all before. Pill induced drug anxiety. He’ll need some time at the Betty ford clinic getting cleaned up. Our president is a pharma monster.

    • LMAO! Could be true. Would be lotsa fun to know what meds he’s on, and for what, who prescribed them, and for how long.
      Benzodiozapines may be the most commonly prescribed class of drugs in America, for anxiety, depression, long term use can cause permanent brain damage, brain atrophy, loss of brain mass, the brain shrinks. Can also cause confusion, incoherence, short and long term memory loss, short term use relieves anxiety but long term use can aggravate anxiety. Very addictive, very hard to kick, but legal if prescribed by an MD.

    • I saw similar linguistic patterns with my mother who was diagnosed with dementia. I believe Trump is suffering from the similar patterns. He will have his good days and his bad linguistically.

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