Trump health fears prove every ageing world leader must take this 1 test, expert says

Donald Trump's health was in the spotlight as he arrived in the UK for his lavish State Visit, with a leading neuropsychologist highlighting potential signs of cognitive decline. Dr Narinder Kapur, a former President of the British Neuropsychological Society, pointed to certain public behaviours which he believes may warrant closer attention, hours before the US President, travelling on Air Force One with First Lady Melania, touched down at London Stansted.

He has also called for mandatory, comprehensive cognitive testing for all leaders over 70, arguing that current brief assessments are wholly inadequate. At 79, Mr Trump’s public appearances have prompted Dr Kapur to suggest that observers keep an eye on patterns that could indicate cognitive challenges, particularly given the high-stakes nature of his role. His itinerary during the three-day visit includes meetings with King Charles III, a working lunch with Prime Minister Keir Starmer, and a state banquet at Windsor Castle, complete with ceremonial pomp and the traditional display of British pageantry.

Dr Kapur explained: "During such high-profile events, even subtle cognitive difficulties can become apparent.

"Paying attention to speech patterns, memory recall, and overall coherence during public appearances could provide further insights into his cognitive health."

The issue of ageing leaders’ mental fitness has attracted increasing attention in recent years, particularly during the debates over President Joe Biden’s cognitive sharpness.

Dr Kapur said: "Yes, concerns about Joe Biden's mental sharpness were probably justified, and were probably more of a concern than those for Donald Trump," referencing a presidential debate in which Mr Biden exhibited clear cognitive difficulties, after which he confirmed he would not run for a second term.

He added that while both leaders are in their late 70s, there are differences in how these signs manifest publicly, and the implications for governance remain significant.

Dr Kapur argues that the current system of brief cognitive tests is inadequate for assessing the mental fitness of leaders over 70. He explained: "The cognitive assessment that Donald Trump had in his last medical examination was just a five-minute test… What is required is a detailed neuropsychological assessment lasting three to four hours."

He proposes a more rigorous evaluation, carried out by a senior neuropsychologist, a senior neurologist, and a senior psychiatrist, supplemented with an MRI scan to detect underlying issues that may not be obvious through behaviour alone.

Implementing mandatory cognitive testing for world leaders, however, faces substantial political and practical hurdles, not least of which being Mr Trump's likely resistence to the idea.

Dr Kapur added: "Achieving such a standard would require international consensus and a rethinking of what is expected in terms of leadership capability. Without this, these checks are unlikely to become standard practice."

While Dr Kapur stresses that these are observations rather than formal diagnoses, he believes they are worth noting, particularly for those in positions of global authority. He explained: "One naturally cannot make any firm diagnosis just based on public observations, but repeated patterns in speech and behaviour can raise legitimate questions that warrant careful attention."

He identified several public behaviours in Mr Trump that he believes may indicate cognitive anomalies.

He explained: "These include word substitutions, such as referring to Russia when he meant Alaska during a meeting with President Putin; statements that are factually incorrect or exaggerated; sudden changes in conversation topics; forgetting events or mixing up details; and use of language uncharacteristic for a head of state, including swearing."

As Mr Trump carries out his diplomatic activities during the state visit, Dr Kapur’s observations underline the importance of recognising and discussing cognitive health in leadership.

He said: "While public behaviours alone cannot provide a diagnosis, they may offer valuable insight into the mental fitness of those in high office. Continued discussion and careful observation remain essential in the age of ageing leaders, particularly when the decisions made affect millions around the world."

Public Behaviours to Watch

Dr Kapur identifies five types of behaviours in Trump’s public record that he says may be indicative of cognitive anomalies:

• Word Substitutions: “Before the Alaska meeting with Putin he said he was going to Russia to see him, when he meant Alaska,” Dr. Kapur notes
• Factual Inaccuracies and Exaggerations: Instances where statements are clearly incorrect or overblown
• Topic Switching: Sudden changes in conversation topics without clear transitions
• Memory Errors: Forgetting events or mixing up details of occurrences
• Inappropriate Language: Use of words or expressions that would be unusual for a Head of State, including swearing