A prominent psychiatrist is raising red flags about former President Donald Trump’s debate performance, urging him to seek a neurological evaluation after observing behavior that could signal cognitive decline. Prof. Richard A. Friedman, director of the psychopharmacology clinic at Weill Cornell Medical College, highlighted several “alarming” patterns in Trump’s rhetoric during the recent presidential debate, prompting concerns that the former president may be experiencing early signs of dementia or other cognitive issues.
Friedman’s concerns stemmed primarily from Trump’s repetitive speech patterns and tendency toward circumstantial and tangential responses. According to the psychiatrist, these habits are commonly associated with individuals experiencing cognitive impairment, such as short-term memory loss or diminished executive functioning. While political figures often use rhetorical devices to reinforce their messaging, Friedman suggested that Trump’s repetition and inability to stick to a coherent narrative may indicate more serious underlying issues.
The psychiatrist was careful to clarify that he has not personally examined Trump and is not offering an official diagnosis. However, Friedman’s observations, published in The Atlantic, focused on specific moments during the debate in which Trump’s answers veered off-topic, a behavior that could indicate difficulty in organizing thoughts—an early symptom of cognitive disorders such as Alzheimer’s disease or vascular dementia.
One of the key examples Friedman referenced was Trump’s response to a question about the January 6 Capitol riots. The former president’s answer, which included references to energy policy, media personalities, and Charlottesville, was disconnected from the original topic. This kind of circumstantial speech, according to Friedman, is often observed in individuals experiencing cognitive decline, where the ability to maintain logical and linear thought processes becomes impaired.
In addition to these disjointed responses, Friedman pointed out Trump’s repetitive rhetoric as a potential sign of short-term memory issues. He noted that individuals facing cognitive challenges often revert to familiar topics and phrases, as they struggle to generate new, spontaneous thoughts. This repetitive behavior, known as perseveration, is commonly seen in neurodegenerative conditions.
Though Friedman stopped short of diagnosing Trump, he emphasized the importance of a neurological evaluation given the former president’s age—78 years old—and the demands of the presidency. In his analysis, he pointed out that conditions such as Alzheimer’s and vascular dementia are not uncommon in individuals of Trump’s age and may impair their ability to perform complex tasks, such as serving as commander-in-chief.
The psychiatrist argued that Trump’s behavior should not be dismissed as mere political tactics or eccentricities. Instead, he urged the former president to undergo a comprehensive neuropsychiatric evaluation to rule out any serious cognitive conditions. For someone in Trump’s position, Friedman noted, short-term memory and clear, logical thinking are critical skills.
While Trump has repeatedly insisted that he is in good health and has shown no signs of slowing down, the concerns raised by Friedman add to the growing debate about the role of age and mental fitness in presidential candidates. As the 2024 election approaches, discussions about cognitive health are likely to remain in the spotlight, with Trump’s performance being closely scrutinized.
Whether Trump chooses to address these concerns publicly or seeks medical advice remains to be seen, but the psychiatrist’s warnings may resonate with voters questioning the cognitive readiness of the candidates vying for the highest office in the country.


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