The President in Decline: Trump’s Mind, His Myths, and the Machinery Around Him
He’s 79, impulsive, and increasingly detached from reality — but the people behind him may be the greater danger.
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During his first campaign for president, Donald Trump was a walking word salad — a man who could shock with his lies. Among the whoppers: that Barack Obama was born overseas and that the “real” unemployment rate was 42 percent. But once we accepted that Trump lied freely — more than 30,000 times during his first term — we began to see a method to the madness. Voters liked his brashness and didn’t care about his fabrications. He might have been immoral, but he at least seemed in command of his faculties.
In this, Trump’s second term, it’s time to withdraw that benefit of the doubt. Now 79, he’s on track to become the oldest president in American history. As the previous record-holder, Joe Biden, proved, the White House can obscure a president’s decline for a while — but not forever. In Trump’s case, the evidence is already piling up. In fact, it began surfacing during the last campaign.
Back in January 2024, Nikki Haley, Trump’s main rival for the GOP nomination, noted that he had repeatedly confused her with former Speaker of the House Nancy Pelosi. Then she dared to say what many were thinking:
“The concern I have is — I’m not saying anything derogatory — but when you’re dealing with the pressures of the presidency, we can’t have someone we question as to whether they’re mentally fit to do this. We can’t.”
For a brief period, the press began to examine Trump’s mental condition. Salon quoted one prominent psychologist calling him “dangerously demented.” But when President Biden stumbled through his disastrous June 27, 2024 debate — ninety minutes of hesitation and forgetfulness — Trump seemed, by comparison, coherent. Biden’s visible decline forced him to drop out of the race. Trump later fumbled through his own debate against Kamala Harris but survived to win the election.
Back in the Oval Office, Trump has maintained a breakneck pace that includes late-night social media tirades suggesting a man increasingly unable to control his impulses. In addition to reposting bizarre images of himself, he recently shared a racist depiction of House Minority Leader Hakeem Jeffries and promoted a fake video report about his administration’s supposed construction of “med bed” hospitals. That message reached more than 100 million followers across X (formerly Twitter) and Truth Social.
The “med bed” story is so bizarre it deserves a moment’s explanation. The so-called med beds are a completely fictitious technology — gleaming, sci-fi capsules that supposedly cure every illness, even restoring missing limbs. Conspiracy theorists claim they exist in secret facilities for the global elite. The video Trump shared was a fabricated Fox News segment in which his daughter-in-law, Lara Trump, appears to announce a nationwide rollout of these miracle devices. It even includes a clip of Trump himself promising, “Every American will soon receive their own med bed card.”
To be clear: there are no med beds, no new hospitals, and Lara Trump hasn’t worked at Fox News since 2022. The entire video was generated using AI. And yet, the sitting president of the United States shared it — apparently unable to tell whether he had made such an announcement himself. That is not just careless; it’s alarming.
More recently, Trump lashed out at Time magazine over a cover photo that accompanied a largely flattering article about his role in brokering a preliminary peace deal between Hamas and Israel. “They ‘disappeared’ my hair, and had something floating above my head that looked like a tiny crown,” he posted in the early morning hours. “This is a super bad picture and deserves to be called out. What are they doing, and why?”
The Time article appeared while Trump was in Israel celebrating the initial phase of the peace deal, which ended fighting and exchanged Israeli hostages for Palestinian prisoners. Trump appeared confused about when he was scheduled to address the Knesset, aligning with reports from inside the White House that aides have to help him complete thoughts or stay on topic.
In August, The Guardian reported that during a conversation on immigration with the president of the European Commission, Trump veered off into a rambling digression about windmills “killing the beauty of our scenery” and making whales “loco.” (He’s still haunted by a wind project near his Scottish golf course.) Earlier, he bizarrely claimed to have discussed the Unabomber Ted Kaczynski’s grades with his uncle, who taught at MIT — even though his uncle died eleven years before the Unabomber was identified. Kaczynski, of course, attended Harvard, not MIT.
Then on October 12, Trump claimed that Joe Biden had “seeded” the January 6, 2021, Capitol riot crowd with 274 undercover agents. He wrote, “If this is so, which it is, a lot of very good people will be owed big apologies. What a SCAM – DO SOMETHING!!! President DJT.” What Trump obviously forgot was that he — not Biden — was president that day. He’s the one who whipped the mob into a frenzy, directed them to march to the Capitol, and ignored pleas for help as his supporters broke inside.
January 6 was the defining moment of Trump’s first term. It led to his second impeachment. Returning to power this year, he has embraced a false narrative that recasts the rioters as victims. He pardoned them all, calling the attack “a hoax” and claiming undercover agents were agitators. Now, he seems to genuinely believe those distortions.
In the past, Trump has brushed off questions about his mental condition by citing his annual cognitive exams. (Who could forget his bragging about remembering “person, woman, man, camera, TV”?) He reportedly “aced” the test again in April of this year, then unusually requested another check-up soon after. Again, the result was declared excellent.
That second check-up was likely part politics — See, I’m fine! — and part genuine fear. Trump shows visible signs of age-related circulatory issues known as venous insufficiency, which causes swelling in the ankles and bruising on the hands. For a man who’s long claimed to be immune to aging, the visible evidence must be unsettling.
How do we know he’s worried? Recently, he’s started talking about his own mortality. “I want to try and get to heaven, if possible,” he said. “I’m hearing I’m not doing well. I’m really at the bottom of the totem pole.” On another occasion: “I don’t think there’s anything going to get me in heaven. I really don’t. I think I’m not maybe heaven-bound.” He’s also begun warning that one day he’ll fall down — the same kind of stumble he once mocked Biden for.
These references to heaven and falling suggest an awareness of his own fragility. The physical decline may not be as worrying as the mental one. His father, Fred Trump Sr., displayed clear signs of dementia years before being diagnosed with Alzheimer’s disease — and heredity is a known risk factor. Preventing or slowing such decline requires habits Trump has always resisted: a healthy diet, exercise, and humility.
What does it mean to have a president in visible decline? It means we must watch carefully and hope those around him are competent. In the case of the Israeli–Hamas peace effort, skilled negotiators from the U.S. and abroad did the heavy lifting while Trump played a ceremonial role. A similar pattern is unfolding domestically, where powerful advisers pursue their own agendas. Stephen Miller drives the crackdown on immigrants and the push to use the National Guard. Robert F. Kennedy Jr. is leading the assault on public health. Russell Vought is overseeing the mass firing of thousands of federal workers.
The truth is, what Donald Trump says matters less than what those behind him do. And that may be the most dangerous reality of all.
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