Taking Donald Trump’s evident cognitive deterioration seriously

This is a followup to Scott’s post about the NYT publishing a story this morning that suggests in the most mealy-mouthed and hedged way possible that just maybe somebody might have some questions about whether there might be something problematic about Donald Trump’s mental state, related to his age. This by the way is a lot older than the age of any other previous president other than Sleepy Joe Biden, who had approximately 10,000 stories of this type written about him, approximately none of which were as diffident as this one.

Despite the extreme gentleness of the story — which in fact is more in the way of a whitewash than an actual investigation — it has already elicited a furious response from Trump:

I’ve been looking into this issue for the past several weeks, and I’m just going to throw out some preliminary observations:

(1) Donald Trump is getting tested regularly — at least twice this year that we know of — for early stage dementia. This is a matter of public record. Here is the only mention of such testing in the Times’s story:

With no official template for releasing health information, physicians sometimes rely on summaries of medical tests without going into detail. A physician for Mr. Biden, who faced persistent questions about his health, wrote last year that he had taken an “extremely detailed” neurological exam, but did not say whether the examination contained common tests for assessing cognitive decline or detecting signs of dementia that are often recommended for older adults.

Again, that TRUMP, not Joe Biden, who — breaking news here — isn’t actually president any more, has been given such a test at least twice this year is a matter of public record! And this is not mentioned or even alluded to in this hard-hitting piece of investigative journalism.

(2) That Trump got an MRI last month — something revealed by him rather than his doctors — is extremely suggestive. An MRI is of course not part of a routine physical. Why was he given one?

Hey let’s do a little “wild speculation,” which is how the Times describes any inquiry whatsoever into the possibility that Trump’s mental state is pathologically deteriorating, as opposed to merely declining as a function of simple aging:

The U.S. Food and Drug Administration (FDA) is recommending an additional, earlier magnetic resonance imaging (MRI) monitoring prior to the 3^rd infusion for patients with Alzheimer’s disease taking Leqembi (lecanemab). The earlier monitoring can identify individuals with amyloid-related imaging abnormalities with edema (ARIA-E), which is characterized by brain swelling or fluid buildup. ARIA-E is usually asymptomatic, although serious and life-threatening events, including seizure and status epilepticus, can occur and there have been deaths.

The Alzheimer’s disease community has been aware of ARIA-E associated with Leqembi, and current prescribing information recommends MRI imaging before the 5^th, 7^th, and 14^th infusions. However, after an in-depth analysis of this safety issue, the Agency has determined that an additional monitoring MRI prior to the 3^rd infusion can potentially help identify ARIA-E events earlier.

ARIA-E can progress after initial detection on MRI. Identifying patients with ARIA-E can lead health care professionals, patients, and their families to delay or discontinue Leqembi treatment to potentially mitigate these serious and, in some cases, fatal events.

(3) Speaking of regular infusions, how are these administered? The most common way is via an IV in the hand — the sort of thing that would produce a purplish bruise after every administration.

(4) This video is 26 minutes long, but I strongly recommend it — as well as the 14 others in the series — to anyone who has any interest in this one would think rather important topic:

I will be interviewing Dr. Gartner next week, and I suspect he will have some interesting thoughts on the Times’s story, among many other things.