I

t 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.

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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.

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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.

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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.

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  • My first reaction to this article is pretty positive. I believed for some time that Psychology/Mental Health information can offer some powerful and positive information. Overall the article was fairly responsible and the proposition that it may be stress etc. is as likely as his age or that he may have some cognitive problems. Of course, any of these, does not really lessen the danger to the public that he represents. Although it was not the focus of this article, I am waiting for someone to look how his Narcissism controls his decisions and also how the general public misunderstand this. One point of interest is how some, despite no evidence for it, look at his ‘stupidity’ as somehow calculated. Wonderful example of projection.

    • I don’t think it’s projection, I think it’s utter disbelief. How can a person rise to the top while being stupid? It makes no sense, so he must be playing dumb. It sort of throws the theory of natural selection out the window; nature will weed out the weak and stupid – but here we are, with a fat, stupid, slothful glutton as the most powerful person on earth. It defies belief, it’s staggering to think how this situation came about. The only reasonable, logical explanation must be he’s playing dumb.

    • Actually what the comment below is describing and the process revealed, is exactly what projection is. By stating disbelief there is an admission to not knowing what the facts are and in an absence of the facts, we then project, from our own beliefs, what must be going on. This is where a good use of Occum’s razor is appropriate. Since Trump acts stupid, looks stupid and makes stupid comments, it is most likely that he is just actually stupid. To presume that he is anything else, especially clever, calculating or benign is a projection of our own belief about the situation, and really tells us more about ourselves than what is really going on.

    • I think the Narcissism issue prevails among politicians from both sides of the aisle. This article was fairly cogent, but I want to add something that is rarely mentioned in the media—the absolutely horrible candidate the Democrats pushed through to the general election. During the Primaries, I remember Republican candidates saying, “I would vote for the worst Republican over Hillary Clinton.” Many people voted with that belief.

  • Trump is now a politician, which means that he is communicating directly with the electorate (simple people…the Common Clay Of The New West…you know…morons). He communicates effectively precisely because he is not speaking articulately. Most Americans do not watch Masterpiece Theater. They watch pro wrasslin’ and game shows. No one succeeds in American politics by orating like Sir Laurence Olivier – you keep it lowbrow or you lose. Trump has a multitude of failings, but mental incompetence is not one of them. In fact, the attempt to dislodge him is so bombastically ham-handed that it calls into question the intelligence of the Democrats.

    • This is exactly the reason why Hillary lost; liberal smugness. I live and breathe it everyday in NYC. Maybe after losing in 2018, you “morons” can blame it on the Vikings.

    • simple people…the Common Clay Of The New West…you know…morons

      is a quote from the movie Blazing Saddles; please read the rest of the comment, Julian, before getting upset.

    • Here’s another quote from Blazing Saddles that’s relevant to this whole Trump farce; “Where the white women at?”

  • It should be noted that Trump did not got thru the routine health evaluation that previous candidates or newly elected Presidents used to – a complete exam at Walter Reed AFB Hospital.

    My father had dementia effecting the same parts of the brain and exhibited behaviors that obervers of Trump would recognize. He was verbally hyper-sexual and behaved inappropriately often but was very charming to somebody who had a sense of humor. He exhibited a general lack of comportment. Having been out-going all his life and very bright, it was a long time before his family realized he was ‘not himself’. A very astute comment made by neurologist that tested him was, ” A CPA all his life, he is no longer able to provide advise to business owners or individuals – but he thinks he can.”

  • So I guess the question is, if he is suffering from mental decline, at what point (by whom and how!) is he declared unfit to be president and is forced to step down? This could be a big issue with ramifications for all future presidents. Having my aunt just pass away a month ago from dementia and having a father who probably won’t last much longer because of something similar, this is an issue that hits pretty close to home.

    • As with the owner of the California basketball team, with a the results of a neuro-psych exam and a brain scan showing abnormalities or changes in the brain, his wife or another person with a medical proxy or legal rights can have him declared incompetent.

  • An alternative and simpler (and non-negative) explanation is that he is being VERY careful about what he says, since the MSM is obsessed with finding a word of phrase to slam him with 24/7.

    • careful? those incoherent ramblings are being careful? he has got that wrong then.

    • If you want to be careful about what you say, the first thing you should do is just say nothing at all. Impulsivity goes up with dementia, especially Lewy body dementia.

    • This article dovetails well with the theory that Trump suffers from the long term effects of the STD, syphilus. Consider: New York experieneced a spike in syphilis in the 1980’s when Trump was – by his own admission – very sexually active. The symptoms are not always physically apparent, but if it goes undiagnosed the disease eventually, over decades, can move to the cortex and erode speech. It also causes fits of uncontrollable rage – which Trump insiders say is a daily occurrence in the WH.

      https://newrepublic.com/article/140702/medical-theory-donald-trumps-bizarre-behavior

  • Sharon, congratulations on the enthusiastic response to your piece, especially from those who believe that an MRI of Trump’s frontal cortex would show that it consists of only two neurons, widely separated, and connected by a spirochete.

  • This is a layperson’s observation: I would expect some decline in speech skills with age, but not to the extent we see in Trump. I am about the same age as he and, of course, so are my friends. There have been minor declines in language skills in some, but not approaching the decline that can be noted in Trump’s interviews.

    • Of course Trump has VD because Ted Cruz said so. Meanwhile Lincoln contracted an STI as a younhlg man, which obviously disqualified him from the presidency.

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