diagnosing dementia?

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The Atlantic's James Hamblin wonders about Trump's cognitive decline, noting that "Trump's grandiosity and impulsivity has made him a constant subject of speculation among those concerned with his mental health:"

But after more than a year of talking to doctors and researchers about whether and how the cognitive sciences could offer a lens to explain Trump's behavior, I've come to believe there should be a role for professional evaluation beyond speculating from afar.

"Viewers of Trump's recent speeches have begun noticing minor abnormalities in his movements," writes Hamblin, and a prominent neurosurgeon commented on what are "clearly some abnormalities of his speech." He continues:

Though these moments could be inconsequential, they call attention to the alarming absence of a system to evaluate elected officials' fitness for office--to reassure concerned citizens that the "leader of the free world" is not cognitively impaired, and on a path of continuous decline. [...]

Unfortunately, the public medical record available to assuage global concerns about the current president's neurologic status is the attestation of Harold Bornstein, America's most famous Upper Manhattan gastroenterologist, whose initial doctor's note described the 71-year-old Trump as "the healthiest individual ever elected to the presidency."

The phrasing was so peculiar for a medical record that some suggested that Trump had written or dictated the letter himself.

Hamblin also observes that "over the years, Donald Trump's [verbal] fluency has regressed and his vocabulary contracted:"

Ben Michaelis, a psychologist who analyzes speech as part of cognitive assessments in court cases [said that] Trump has exhibited a "clear reduction in linguistic sophistication over time" with "simpler word choices and sentence structure."

"Though it is not possible to diagnose a person with dementia based on speech patterns alone," Hamblin points out, "these are the sorts of changes that appear in early stages of Alzheimer's:"

Trump has likened himself to Ronald Reagan, and the changes in Trump's speech evoke those seen in the late president. Reagan announced his Alzheimer's diagnosis in 1994, but there was evidence of linguistic change over the course of his presidency that experts have argued was indicative of early decline. [...]

After more than a year of considering Trump's behavior through the lens of the cognitive sciences, I don't think that labeling him with a mental illness from afar is wise. A diagnosis like narcissistic personality disorder is too easily played off as a value judgment by an administration that is pushing the narrative that scientists are enemies of the state. Labeling is also counterproductive to the field in that it presents risks to all the people who deal with the stigma of psychiatric diagnoses. To attribute Trump's behavior to mental illness risks devaluing mental illness.

"The idea that the president should not be diagnosed from afar," Hamblin concludes, "only underscores the point that the president needs to be evaluated up close."

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This page contains a single entry by cognitivedissident published on January 6, 2018 4:34 PM.

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