The Dangerous Decline of Donald Trump

"Trump now has both a dangerous personality disorder and a deteriorating neurological condition. The combination of those disorders... poses a whole other level of threat to the country," says Dr. Vince Greenwood

It's nearly seven years since the now-78-year-old Trump supposedly "aced" his one-and-only confirmed dementia screening test.

That's not much to go on.

And it's hardly reassuring given his frequent tendency to twitch, glitch, meander, wander, snooze and confuse.

Kamala Harris says he's "unhinged and unstable."

And more than 230 doctors and health care providers have joined the VP in calling on Trump to release his medical records.

Never before has an old man's slide into dementia been put on such public display. While being cloaked in such secrecy.

With the election fast-approaching, the questions about Trump's mental decline are more urgent than ever.

So I reached out once more to clinical psychologist Dr. Vince Greenwood, whom I first interviewed about Trump's psychopathy in 2020, with five last-minute questions about Trump's current mental status. Dr. Greenwood is one of the contributors to the new book edited by Bandy X. Lee, "The More Dangerous Case of Donald Trump: 40 Psychiatrists and Mental Health Experts Warn Anew."

Dr. Greenwood also heads DutyToInform.org, writes on Medium, and tweets at @DutyToInform. In addition, he's one of the mental health professionals starring in the new "Trump Is a Danger to the Republic" ad just released by George Conway's Anti-Psychopath PAC.

Here's my new interview:

Five questions for Vince Greenwood, Ph.D.

Q.1: Please tell me about your contributions to the new book "The More Dangerous Case of Donald Trump: 40 Psychiatrists and Mental Health Experts Warn Anew”

This book pulls together the work of mental health professionals who have focused on the psychological roots of Donald Trump’s divisive and deceitful behavior over the last decade. It makes an unimpeachable case that Donald Trump is unfit and unsafe for office. I have two articles in the volume: one that describes his neurological dysfunction and another that spells out our assessment of his Psychopathic Personality Disorder and the danger that condition poses to the country.

We need to emphasize that Trump now has both a dangerous personality disorder and a deteriorating neurological condition. The combination of those disorders is a potentially devastating multiplier force that poses a whole other level of threat to the country.

Q.2 What does your analysis of Trump's cognitive decline tell us about how much or how rapidly he might deteriorate over the next 4 years? What kind of range are we looking at?
 
It is more likely than not that, during the next four years, his current disorder will progress to full-scale dementia with its accompanying loss of functioning in fundamental areas such as dressing, eating, and toileting. The research on the course of individuals with his current level of cognitive decline underscores this prediction. Once you meet the diagnostic criteria for Mild Neurocognitive Disorder (which he appears to have done at least a year ago), the risk of deterioration to full-scale dementia is around 15% per year, thus rising to around 60% over four years.

What does this recent, more rapid decline mean?

First, we should be more declarative about his near-term functioning. It is not possible to predict precisely for any individual the future course of a dementing brain. But this 15% risk, accumulating each year, probably underplays the peril of Mr. Trump’s brain health. He is in a poor prognosis group because of his family history of Alzheimer’s and the fact that these diagnostic signs have escalated in the past year. Sadly for him, his recent noticeable decline certainly raises the concern that he may struggle to maintain the capacity for independent living over the next couple of years.

Second, his documented decline in language functioning strongly suggests deterioration in the other five primary areas of cognitive functioning: memory, attention, executive skills, social cognition, and perceptual-motor skills.

There are worrisome signs with his memory and perceptual-motor skills (how one can navigate the world physically). Everyone can mix up names, but Trump mixes up people — Nikki Haley for Nancy Pelosi and Mayor Willie Brown for a councilman are recent examples. Imagine entrusting the demands of the presidency to a failing memory. Trump’s bent, forward-listing posture, jerking right arm and leg, and arm weakness are also unnerving signs of neurological dysfunction and not just normal aging.

Here are some expected ramifications of such shifts:

• Attention — tasks take noticeably longer to complete than previously, and work must be double-checked for errors.
• Executive functioning — struggles to understand complex material or concepts, has trouble resuming an interrupted task, and has difficulty organizing, planning, or making decisions.
• Learning and memory — difficulty recalling recent events, relies on reminders and list-making.
• Perceptual-motor skills — may rely more heavily on maps or notes for directions.
• Social cognition — less ability to read social cues, such as facial expressions, decreased empathy, and decreased inhibition.
• Language - more severe mind-wandering, more difficulty expressing oneself in a convincing manner, decreased capacity to understand others' speech.

And we can’t ignore his diagnosed Psychopathic Personality Disorder condition. A dementing brain doesn’t usually alter the traits of the patient. The more common result is that dementia leads the person to be “more so” regarding their cardinal traits. For Trump, given his baseline of psychopathic traits, this would mean a shift from:

• Disinhibited to incontinent
• Disagreeable to antagonistic ("You’re a s*** vice-president")
• Domineering to “I am your vengeance”
• Demanding fealty to locking up “enemies within”
• Arrogance to grandiosity (“I am never wrong”)
• Uncaring to neglectful
• Sense of entitlement to no rules at all applies to him
• Garrulous to can’t get off the stage
• Impulsive to reckless

Q.3 In terms of Trump's Psychopathic Personality Disorder (PPD), how badly might he behave against immigrants and those he calls "enemies of the people"—and others who offend him—now that the Supreme Court's immunity decision has removed his fears of future prosecution for "official acts”?

Let’s start with this. Even though he is lying about it now, while he was president, Trump tried to prosecute Hilary Clinton but was thwarted by the White House counsel and Attorney General who told him it was illegal. He has also pledged to prosecute President Biden and other political enemies if he is re-elected. Now, with no guardrails due to the court’s immunity decision, there is just no limit to how far he could go. There is no limit because of his core trait of remorselessness. It is hard for us to grasp this defining quality of a clinical psychopath. They possess no capacity for shame or guilt that might restrain their vindictive behavior. We must brace ourselves for the norms he may shatter and the harm he may inflict.
 
Q.4 How likely is it that Trump's dementia, combined with his psychopathic nature, will make him more easily manipulated by others than ever, possibly in new and more dangerous ways?

Psychopaths are arrogant and have a ferocious drive to dominate. They manipulate others and are not easily manipulated themselves. He is likely to keep calling the shots even with his diminishing capacities. But in one critical arena, he has always been vulnerable to manipulation. All insider accounts indicate Trump cares little about policy. He certainly never does the homework necessary to understand the thorny, complex issues that face the country. He will go along with proposals that align with his brand of “I am your vengeance” and “I am a martyr who will fight our enemies.” The enemies, of course, are the Democrats and the elitists who defend liberal democracy. Project 2025 prescriptions and policy objectives of hard-right types such as J.D. Vance fit this narrative. Trump will be a pliable vessel for their agenda.

Q.5 Trump recently said that if a vice president “lies or engages in a conspiracy to cover up the incapacity of the president,” they should be removed from office. Can you foresee him behaving in such ways that Vance (and Musk and Thiel) would have the cover they need to use that statement against him as justification to invoke the 25th Amendment and install President JD Vance?

With regard to the next year or two, we are in uncharted territory because of his cognitive decline. I suspect that the more likely scenario would be the family orchestrating his removal after it is clear he has shot past even their threshold of danger to the country. At that point, Trump himself would be pretty oblivious and not experience it as anything like a palace coup. The real danger is what happens between now and then. Most likely, Vance, Michael Flynn, Steve Bannon, and that crowd would be running the country with Trump’s passive assent.

Thanks for reading! While paid subscriptions (billed to TLD Media LLC) and one-time tips are always welcome, all content to this ad-free newsletter is free, so subscribe for $0 and you won’t miss anything. And feel free to share this content knowing there’s never a paywall!