Three Physicians Agree Donald Trump Shows Signs of Cognitive Decline: As physicians and retired national security leaders, we are trained to assess symptoms, diagnose conditions, and consider the broader implications of a person's health. In this context, the individual in question is Donald Trump, a 78-year-old man seeking a second term as president—the oldest presidential candidate in history. We are neither motivated by political partisanship nor personal bias; our concern lies solely in the facts. We acknowledge that forming medical opinions about individuals we have not examined is inherently unreliable, violates medical ethics, and falls outside the bounds of clinical practice. Therefore, we are not making a diagnosis.

The combination of Trump's advanced age and potential signs of cognitive decline (most recently a ten-minute public diatribe about Arnold Palmer, culminating in an assessment of the late golfer's genitalia) raises serious questions about his fitness to lead the country for four more years, especially in a world fraught with instability. Fitness for duty means that an individual can reasonably perform the duties of their office without posing a danger to themselves or others. Donald Trump's past and recent behaviors have raised concerns about his suitability for such a demanding role.

The United States is currently navigating a volatile geopolitical landscape marked by Russia's unprovoked war in Ukraine, multiple conflicts in the Middle East, competition with China, and the ever-present threat of terrorism. These challenges demand a leader who is sharp, focused, and mentally equipped to handle the pressures of global diplomacy. However, Donald Trump's advancing age and behaviors suggest he may lack these strengths. His decision-making is often influenced by a disregard for expertise, an overreliance on his "gut feelings," susceptibility to manipulation through praise or criticism, personal gain or loss, and a long history of recklessness and impulsivity. 

Aging is inevitable. By the time most people reach their late 70s, they experience some cognitive decline. These changes are not inherently disqualifying for most professions, but the presidency of the United States is not like most professions. It is one of the most mentally and physically demanding roles in the world.

Some observers have noted that in recent years that Trump's speeches have become more meandering, with frequent digressions, loss of focus, and peculiar phrasing. Slurred speech, lost train of thought, and incoherent ramblings are often considered signs of cognitive decline. While these observations are concerning, we must be cautious in interpreting them without a formal medical evaluation.

We are concerned that such behaviors are indicative of cognitive impairment. It is well-documented that decision-making and complex information processing can become more challenging with advanced age. We note that these troubling signs have become much more apparent since his last term in office.

In our practice, we advise further evaluation and caution when we observe such signs in our elderly patients. It would be irresponsible to ignore the potential risks of cognitive decline in someone seeking the highest office in the nation.

The president must make life-altering decisions, often under immense pressure and without the luxury of time. From managing crises to negotiating with foreign leaders, the job requires an individual to process enormous amounts of information and quickly evaluate the best course of action.

Donald Trump has often demonstrated an impulsive and erratic decision-making style. Examples include withdrawing U.S. troops from Syria without consulting military leaders and engaging in unconventional nuclear diplomacy with North Korea. These tendencies are concerning on their own, but when considered alongside potential signs of cognitive decline, they could pose a significant risk.

The geopolitical landscape has only grown more dangerous since Trump left office in 2021. Putin threatens European stability, China's ambitions for Taiwan have grown more aggressive, and Iran's nuclear program continues to raise alarms amid its conflict with Israel. These are not conflicts that can be managed with charisma or bombast; they require deep strategic thinking, careful diplomacy, and mental sharpness.

The fact that Trump has not fully released his medical records further complicates the issue. As physicians, we understand that an accurate assessment of someone's health cannot be made without comprehensive, up-to-date information. While we can make observations based on public appearances and communications, we lack the necessary information about his health that could affect his ability to serve. The American public deserves to know whether their president is physically and mentally capable of fulfilling the duties of the office.

As physicians, we are deeply concerned that Donald Trump, showing potential signs of cognitive decline, may not be able to perform the duties of the presidency for a full term. We believe he should release his medical records, as Vice President Harris has done, to provide transparency about his health. The presidency demands a leader who is mentally sharp, physically fit, and open about their health status. To date, Donald Trump has not demonstrated these qualities.

Americans deserve better.

About the Authors: 

Dr. Stephen Xenakis is a retired brigadier general and Army medical corps officer with 28 years of active service. He has been a senior adviser to the Department of Defense on neurobehavioral conditions and medical management.

Dr. Mitchell L. Cohen retired from CDC in 2010 as an Assistant Surgeon General, U.S. Public Health Service, after more than 33 years of experience in public health practice and leadership, clinical medicine, and epidemiologic and laboratory research.

Dr. Michael Baker is a retired general and trauma surgeon who served his country in uniform for 30 years.

The views expressed in this opinion piece are the Author's own.