# Age and health concerns about Donald Trump

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At 78 years, 9 months and 4 days old, Donald Trump, the 45th and 47th president of the United States, is the oldest president at his second inauguration in the country's history. He previously became the oldest major-party presidential nominee five weeks after his 78th birthday. Should he serve to the end of his second presidency on January 20, 2029, he will become the oldest person ever to hold the office at 82 years, seven months, and six days old, sparking renewed discussion of his fitness as a president. Since the early days of Trump's 2016 presidential campaign, his physical and mental health have been debated. Trump was 70 years old when he first took office, surpassing Ronald Reagan as the oldest person to assume the presidency. During Trump's presidency, his age, weight, lifestyle, and history of heart disease raised questions about his physical health.
Some psychiatrists and the media have speculated that Trump may have mental health impairments, such as narcissistic personality disorder or dementia, which runs in his family. Such claims have prompted discussion about ethics and applicability of the Goldwater rule, which prohibits mental health professionals from diagnosing public figures without direct examination.
In a 2022 interview, Trump commented that his health may influence his decision to run for the 2024 election. Public opinion polling has indicated a rise in Americans concerned about his fitness for a second term.
Trump has been criticized for his secrecy and lack of transparency around his medical records and health. As of October 12, 2024, Trump had not released his health information since 2015, when he first started running for president, despite promising in August 2024 to release results of a recent examination. Critics noted that his election opponent, Kamala Harris, had released her records and that such disclosures are a common practice among presidential candidates.

## Public opinion

During his 2024 campaign, polls generally showed that a majority of Americans believed that Trump was too old to serve as president. A February 2024 Ipsos poll finding that Joe Biden's age and health were major or moderate concerns for 86% of voters also found that 59% similarly thought Trump was too old to hold the office.
A July 2024 poll, taken shortly after the first presidential debate, found that 60% of voters saw Trump as too old for a second term. This represented a steady and constant increase in voters polled by this pollster sharing this concern, and paralleled the progression of the larger number of voters who had the same concern about Biden. An August 2024 Morning Consult poll found that the number of respondents who thought Trump was too old to run jumped by seven percent, to 51%, from their previous poll once Trump's opponent changed from Joe Biden to Kamala Harris, and the number of respondents who thought Trump was in good health correspondingly fell by six percent. The poll further reported that nearly 80% of respondents "were unsure he'd be up for serving a full second term". A Marquette University poll released the same day reported that 57% of respondents felt that Trump was too old.

### Incidents

A number of incidents have contributed to the trend in public opinion. In a July 4, 2019, speech, Trump said in a gaffe that during the American Revolutionary War, the Continental Army "took over the airports" from the British. In another gaffe in October 2023, Trump referred to Hungarian prime minister Viktor Orbán as "the leader of Turkey", and said that Orbán shares a border with Russia, which neither Turkey nor Hungary does. During the course of the 2024 primary campaign, Trump's gaffes included confusing Nikki Haley for Nancy Pelosi, claiming he is running against Barack Obama, and fearing the nation may enter World War II.
In June 2024, while praising his performance on a cognitive test administered in 2018, Trump "confused the name of his former White House physician" who had administered that test. That same month, he said that his longtime acquaintance Joan Rivers had told him that she had voted for him in the 2016 election, though Rivers had died in September 2014. Following an August 2024 interview, media reports indicated that Trump had acquired a pronounced lisp. Trump released a statement the following day explaining that this was caused by technical issues with the broadcast. In September 2024, Trump said the audience "went crazy" for him at the presidential debate the preceding week, although the debate had no audience.

## Mental health

Since running for president, Trump's mental health and fitness has been a topic of public discussion.

### Allegations of mental illness by medical professionals

The "Duty to Warn" movement was founded by medical professionals concerned about Trump's cognitive health in his first year in office. In 2017, psychologist John Gartner collected more than 41,000 signatures of mental health professionals on a petition, directed to the national opposition leader, Democratic Senator Chuck Schumer. The core of the petition stated: My professional judgement is that Donald Trump manifests a serious mental illness that renders him psychologically incapable of competently discharging the duties of President of the United States. And I respectfully request him [sic] be removed from office, according to article 3 of the 25th Amendment, and so on. Gartner asserted that Trump's mental handicaps are a mix of narcissism, paranoia, sociopathy, and sadism. Mary L. Trump, his niece and a clinical psychologist, wrote a book in 2020 identifying the disorders she believed him to have.

#### Narcissistic personality disorder

An academic consensus across multiple studies has characterized Trump as having "very high extraversion, very low agreeableness, conscientiousness, and emotional stability, and sky-high narcissism".
As early as November 2015, Vanity Fair reported the opinion of a number of mental health experts that Trump had narcissistic personality disorder. Bornstein's letter of December 2015, drafted in response to questions about the health of presidential candidates, did not address Trump's mental health, while saying that Trump would be "the healthiest individual ever elected to the presidency". Bornstein disclosed in 2018 that Trump had dictated this letter over the telephone. He said, "Mr. Trump dictated the letter and I would tell him what he couldn't put in there." In August 2016, Bornstein stated that Trump's "health is excellent, especially his mental health".
In April 2017, forensic psychiatrist Bandy X. Lee hosted a meeting at Yale University medical school regarding the ethics of discussing Trump's mental health. In October 2017, Lee published The Dangerous Case of Donald Trump, containing essays from 27 psychologists, psychiatrists, and mental health professionals on the "clear and present danger" that Trump's mental health poses to the "nation and individual well being". They argued that the president's issues affected the mental health of the United States population, and that he placed the country at grave risk of war because of his pathological traits. They defined Trump's behavior in terms of mental disorder, such as narcissistic personality disorder, 'extreme present hedonism' and bullying. Carlos Lozada, writing for The Washington Post, considered these conclusions "compelling", but also noted that the book contributors were writing from their own political perspective, as other mental health professionals differ. Lee and others contended that Trump's presidency represented an emergency allowing, or even requiring, psychiatrists to take exception from the APA's Goldwater rule, which holds that it is unethical for members of the APA to give a professional opinion about public figures without having examined them in person and without their consent. Proponents of such expression have asserted that there is precedent in allowing psychiatrists to speak out when someone presents a clear and present danger.
In 2017, journalist Bill Moyers interviewed psychiatrist Robert Jay Lifton and said that Trump "makes increasingly bizarre statements that are contradicted by irrefutable evidence to the contrary". Lifton replied, "He doesn't have clear contact with reality, though I'm not sure it qualifies as a bona fide delusion." As an example, Lifton said, when Trump claimed that former president Barack Obama was born in Kenya, "he was manipulating that lie as well as undoubtedly believing it in part."
In 2019, amid continued speculation, the American Psychiatric Association and Alzheimer's Society requested that people should not armchair diagnose Trump, or diagnose him with any disorder without being his doctor, in accordance with the Goldwater rule. A growing number of individuals in academia have continued to call for a relaxation of the Goldwater rule.

### Goldwater rule

In 2016 and 2017, a number of psychiatrists and clinical psychologists faced criticism for violating the Goldwater rule, as they claimed that Donald Trump displayed "an assortment of personality problems, including grandiosity, a lack of empathy, and 'malignant narcissism'", and that he has a "dangerous mental illness", despite having never examined him. In defense of this practice, Bandy X. Lee, a forensic psychiatrist at the Yale School of Medicine, wrote in USA Today, "Diagnostic practices have changed from accepting interviews to observations, so any assertion that a personal interview is mandatory for a valid professional opinion does not hold." Since April 2017, Lee has stated that while she has been an adherent to the Goldwater rule "for over 20 years", the APA was "violating its own rule" by modifying it so that it would not be possible to meet its "affirmative obligation". She formed an organization with several thousand other mental health professionals called the World Mental Health Coalition, "in opposition to the American Psychiatric Association, which, with the Trump presidency, not only failed to meet the psychiatric profession's societal responsibility but inhibited individual professionals from doing so". On December 5, 2019, a group of mental health professionals led by Lee, George Washington University professor John Zinner, and former CIA profiler Jerrold Post publicly urged the House Judiciary Committee to consider Donald Trump's "dangerous" mental state that was ostensibly arising from his "brittle sense of self-worth" as part of the Congressional impeachment ongoing process.
John Gartner, a practicing psychologist and the leader of the group Duty to Warn, stated in April 2017, "We have an ethical responsibility to warn the public about Donald Trump's dangerous mental illness."
The American Psychoanalytic Association (APsaA)—a different organization from the APA—published a letter on June 6, 2017, highlighting differences between the APA and APsaA ethical guidelines and stating, "The American Psychiatric Association's ethical stance on the Goldwater Rule applies to its members only. APsaA does not consider political commentary by its individual members an ethical matter." In July 2017, the website Stat published an article by Sharon Begley, labeled "exclusive" and titled "Psychiatry Group Tells Members They Can Defy 'Goldwater Rule' and Comment on Trump's Mental Health". The article, with a photograph of Barry Goldwater as the headline image, stated, "A leading psychiatry group has told its members they should not feel bound by a longstanding rule against commenting publicly on the mental state of public figures", first sourcing the statement to the July 6 American Psychoanalytic Association (APsaA) letter, but also claiming that it "represents the first significant crack in the profession's decades-old united front aimed at preventing experts from discussing the psychiatric aspects of politicians' behavior". The article then repeatedly referred to the "Goldwater rule", quoted an unnamed source as saying "leadership has been extremely reluctant to make a statement and publicly challenge the American Psychiatric Association", and claimed that an unnamed "official" had said, "Although the American Psychological Association 'prefers' that its members not offer opinions on the psychology of someone they have not examined, it does not have a Goldwater rule and is not considering implementing one." Yahoo News reporter Michael Walsh criticized the Stat article, saying it was "misleading" by stating that the letter "represents the first significant crack": the American Psychiatric Association retains the Goldwater rule, and the APsaA never had the rule and was not changing. Also, although the APsaA has no Goldwater rule for its members and allows its members to give individual opinions about specific political figures, its Executive Councilors unanimously endorsed a policy that "the APsaA as an organization will speak to issues only, not about specific political figures".
In February 2017, psychiatrist Allen Frances wrote a letter to the editor of The New York Times regarding Trump and narcissistic personality disorder, "I wrote the criteria that define this disorder, and Mr. Trump doesn't meet them." According to the American Psychiatric Association, "saying that a person does not have an illness is also a professional opinion."
In September 2017, psychiatrist Jeffrey A. Lieberman published an article extensively speculating on diagnoses for Donald Trump despite claiming to adhere to the Goldwater rule in the beginning paragraph. He arrived at a diagnosis of "incipient dementia" but faced no sanctions.
The APA is accused of conflict of interest, since it receives federal funding, which had been increased after its actions under the Trump administration.

### Responses by political opponents

During the 2016 Republican Party presidential primaries, presidential candidate and primary opponent Jeb Bush speculated in February 2016 that Trump had mental health issues, stating, "I'm not a psychiatrist or a psychologist, but the guy needs therapy."
On April 14, 2017, Representatives Jamie Raskin and Earl Blumenauer introduced the Oversight Commission on Presidential Capacity Act. The bill, if passed, would have allowed Congress, by a concurrent resolution, to require an 11-member commission to conduct an examination of the president and report the findings.
In September 2017, Jeanne Suk Gerson wrote in The New Yorker, "A strange consensus does appear to be forming around Trump's mental state", including Democrats and Republicans who doubt Trump's fitness for office.
   * Donald J. Trump @realDonaldTrump
   North Korean Leader Kim Jong Un just stated that the "Nuclear Button is on his desk at all times". Will someone from his depleted and food starved regime please inform him that I too have a Nuclear Button, but it is a much bigger & more powerful one than his, and my Button works!
In January 2018, after North Korea's leader Kim Jong Un and Trump publicly exchanged claims about their respective "nuclear buttons", Richard Painter, a former adviser to President George W. Bush, deemed Trump "psychologically unfit" and supported transferring his powers to Vice President Pence under the 25th Amendment. In April 2018, Vanity Fair reported that Trump's advisers "worry about his mental health" when he is outside the controls available in the White House environment.

### Trump's responses

In 2018, Trump dismissed then-prevalent questions regarding his mental health, stating that he is a "very stable genius". As evidence of his mental capacities, he pointed to his business success, his victory over Republican competitors, and his election to the presidency against Hillary Clinton. Trump has also pushed back on claims he couldn't remember the name of a fallen soldier while talking to the widow by stating he has "one of the great memories of all time".

### 2018 cognitive test

In response to speculation about his cognitive abilities, Trump voluntarily took the Montreal Cognitive Assessment (MoCA) as part of his January 2018 health checkup. He reported receiving a score of 30/30, indicating a normal level of cognitive function, though the results have not been released. Critics have contended that the MoCA test is too basic to diagnose the problems asserted. Trump used the phrase "Person, woman, man, camera, TV" several times during a July 2020 Fox News interview with Marc Siegel, a professor of medicine at New York University, while describing part of the 2018 MoCA test and praising his own performance on it. Trump has not publicly revealed the results of any subsequent cognitive tests but, as late as 2024, continued to praise his performance in the 2018 cognitive test. Ziad Nasreddine, the neurologist who created the test, noted that 2018 results would be too outdated to be relevant in 2024.

## Physical health
### Medical reports and records

In December 2015, Trump's personal physician, Harold Bornstein, released a letter of health praising Trump for "extraordinary physical strength and stamina", saying he would be, "the healthiest individual ever elected to the presidency", and said that a recent medical exam yielded "only positive results". Before Bornstein's death in 2021, he told CNN that Trump had dictated the entire letter. The language used was in Trump's style and not that typical of a medical doctor; in particular, the American journalist Kurt Eichenwald noted that positive test results often do not mean a positive (favorable) outcome for the patient. A follow-up medical report by Bornstein claimed Trump's blood pressure, liver and thyroid functions to be in normal ranges, and that he takes a statin. At 6 feet 3 inches (1.90 m) and 236 pounds (107 kg), Trump's body mass index of 29.5 registered as overweight which is on the higher end of overweight BMIs.
In January 2018, Trump was examined by White House physician Ronny Jackson, who stated that he was in excellent health, although his weight and cholesterol level were higher than recommended, and that his cardiac assessment revealed no medical issues. Several independent cardiologists commented that Trump's weight, lifestyle and LDL cholesterol ought to have raised serious concerns about his cardiac health. Trump's 2018 coronary CT calcium scan score indicates he has a form of heart disease called coronary artery disease, which is common for white males at his age.
On May 1, 2018, Bornstein told NBC News that three Trump representatives had "raided" his office on February 3, 2017, taking all of Trump's medical records. He identified two of the men as Trump's longtime bodyguard Keith Schiller and the Trump Organization's chief legal officer Alan Garten. Two days earlier, Bornstein had told a reporter that Trump took a prescription hair growth medicine, Propecia, after which Trump cut ties with him. In February 2019, Trump was examined by White House physician Sean Conley. Conley stated Trump was in "very good health overall", although Trump was now slightly clinically obese, at 243 pounds (110 kg) with a BMI of 30.4. In 2022, MSNBC described Trump as "notoriously secretive about sharing his health records with the public" and "deliberately misleading and even dishonest about his health".
As of 2018, Trump does not drink alcohol; this decision arose in part from watching his older brother Fred Jr. suffer from alcoholism that contributed to his early death in 1981. He also said that he has never smoked cigarettes or consumed drugs, including marijuana.

### 2020 COVID-19 infection

On September 26, 2020, an event was held in the White House Rose Garden announcing Amy Coney Barrett's nomination to the Supreme Court following the death of Ruth Bader Ginsburg. According to a 2021 book by Trump's Chief of Staff Mark Meadows, hours after the ceremony, Trump tested positive for COVID-19, though a subsequent test returned negative. Meadows recalled that Trump looked "a little tired" and was suspected of having a "slight cold".
Trump later traveled in Air Force One to a rally at the Harrisburg International Airport in Pennsylvania, which was attended by thousands. The governor opposed the rally, arguing: that the decision to "bring thousands of people together in a tight space in the midst of a global pandemic caused by an airborne virus is flat out wrong". After Trump's diagnosis was made public, Pennsylvania health officials advised attendees to participate in the state's contact tracing program. In the wake of the rally, the county saw a surge in COVID-19.
After returning from Bedminster, Trump received a positive test result on a rapid test and was waiting to get results of a PCR test when he did a live phone interview on Hannity. Sean Hannity of Fox News brought up Bloomberg's report about Hicks and asked for an update, whereupon Trump publicly mentioned Hicks' diagnosis for the first time, saying, "I just heard about this. She tested positive." Trump stated, "It is very, very hard when you are with people from the military, or from law enforcement, and they come over to you, and they want to hug you, and they want to kiss you because we really have done a good job for them." Without disclosing that he had already tested positive, he announced that he and the first lady were being tested for SARS-CoV-2. He repeated this via Twitter after the interview. Later that night, the result of the PCR test also came in positive. On October 2, 2020, Trump tweeted that he had tested positive for COVID-19, part of a White House outbreak.
Later that day, Trump was hospitalized at Walter Reed National Military Medical Center, reportedly due to fever and labored breathing. He was treated with antiviral and an experimental antibody drug (REGN-COV2) and a steroid. He returned to the White House on October 5, still infectious and unwell. The Washington Post criticized Trump as he continued to downplay the virus during and after his treatment. In 2021, it was revealed that his condition had been far more serious; he had dangerously low blood oxygen levels, a high fever, and lung infiltrates, indicating a severe case.

## 2024 election

The shift in Trump's speeches by 2024 towards shorter sentences, more tangents, more repetition, more all-or-nothing thinking and more confusion of words and phrases could indicate cognitive decline. Basil Smikle of Columbia University argued in January 2024 that one reason Trump has not seen as much of the age criticism as Biden is that his rallies seem loud and vibrant, whereas Biden has a more old-school approach to politics.
An article in The Conversation by finance professor Brandon Cline showed that around half of the 1500 largest public companies in the U.S. force their CEOs to retire when they turn 65 or so because of declining performance, with nearly 70% of S&P 500 companies having mandatory retirement ages for their boards in the mid-70s. Cline noted that a similar rule would have made both Trump and Biden ineligible to run in 2024 and argues that the evidence supporting a mandatory retirement age is strong. He cited studies showing that CEOs over 65 hired and fired fewer people, made fewer deals, were less active overall and that age-related changes impair judgement.
As of October 12, 2024, Trump has declined to release health information going back to 2015 when he first started running for president, despite a promise he made in August 2024 to release records from a recent examination. Releasing detailed medical reports is typical of presidential candidates. Kamala Harris released her detailed medical report on October 12, 2024.
The New York Times published an analysis of Trump's speeches on October 6, 2024, writing, "with the passage of time, the 78-year-old former president's speeches have grown darker, harsher, longer, angrier, less focused, more profane and increasingly fixated on the past, according to a review of his public appearances over the years." The paper commented that Trump has lately seemed "confused, forgetful, incoherent or disconnected from reality" but that it does not get covered much because it is so common. It highlighted an average rally length of 82 minutes compared with 45 minutes in 2016, and a 13% increase in use of all-or-nothing terms like "always" and "never". It also found 32% more negative words than positive words compared with 21% in 2016, and a 69% increase in swear words. It cited that experts considered this increase in tangential speech and behavioral disinhibition potential results of advancing age and cognitive decline. The paper also found that Trump has appeared tired at times and has maintained a far less active campaign schedule this time around, holding only 61 rallies so far in 2024, compared with 283 through all of 2016. The authors also highlight how he is more easily distracted and not open to correction.
In January 2024, Dr. Jay Olshansky gave Donald Trump less than a 75% chance of living through a second term based on publicly available information about his health.

### 2024 assassination attempt

On July 13, 2024, Trump survived an assassination attempt while addressing a campaign rally near Butler, Pennsylvania. Trump was shot at by Thomas Matthew Crooks, a 20-year-old man from Bethel Park, Pennsylvania, who fired eight rounds with an AR-15–style rifle from the roof of a building located approximately 400 feet (120 meters) from the stage.
According to the FBI, Trump was hit by a bullet or shrapnel, and injured in his upper right ear. He raised a hand to his ear before dropping down on his podium behind the lectern for cover. Secret Service agents lunged toward Trump and shielded him. After the assailant was declared "down", agents helped Trump get up. Blood was visible on his ear and face. He asked the Secret Service agents to let him get his shoes. According to Trump, the agents "hit me so hard that my shoes fell off, and my shoes are tight". None of the medical records, as of October 12, 2024, from the wounds have been released.
Psychologist Simon McCarthy-Jones of Trinity College Dublin said in The Conversation in July 2024 that "the potential effect of these events on his mental health – whether negligible, negative or positive – cannot be ignored", and that Trump being an extrovert might improve his ability to deal with the psychological impact of the event, while "other personality traits, including low agreeableness, low conscientiousness and low emotional stability, also attributed to Trump, are associated with greater levels of PTSD", as are "high levels of narcissism", which can also "cause people to react to even limited threats with aggression". In August 2024, Vanity Fair reported that Trump was in fact "experiencing trauma from his near-death experience", with a campaign insider reportedly claiming that Trump was "watching that seven-second clip of how close he was to getting shot right in the head – over and over and over again", saying that Trump "may actually legit have PTSD".