You can read the details making the case for the assessment that Trump probably has dementia here, and if you are or were a professional in mental health or medicine if you agree you can sign it here (include your profession and degree).

The petition begins:

We, the undersigned licensed medical and mental health professionals (INCLUDE YOUR ADVANCED DEGREE IN YOUR LAST NAME WITH NO PUNCTUATION) concur: From our years of training and experience, we are convinced that, while a definitive diagnosis would require further testing, Donald Trump is showing unmistakable signs strongly suggesting dementia, based on his public behavior and informant reports that show progressive deterioration in memory, thinking, ability to use language, behavior, and both gross and fine motor skills. 

1) Decline from baseline:

Overall, he shows a shocking decline in verbal fluency from his previous baseline. He was once highly articulate, with a sophisticated vocabulary, and spoke in polished paragraphs. Now, his vocabulary is impoverished, he often has difficulty finishing a thought, sentence or even a word. Typical of dementia patients he perseverates and overuses superlatives and filler words.

People who worked closely with Trump during his administration are reporting a shocking deterioration in just 4 years.

It goes on to describe disturbances in memory, langauge, gait, and behavior, namely impulse control and judgment, which are seen when one has dementia.

The petition concludes:

This represents a unique danger because of Trump’s pre-existing Malignant Narcissistic Personality Disorder. As he continues to deteriorate he will become even more erratic, impulsive, paranoid, and aggressive than he already is. A demented malignant narcissist as president of the United States would have unimaginably catastrophic consequences.

Not only is Trump unfit, but he cognitively incapable of carrying out the duties of president. Under normal circumstances, relatives of such a patient would be seeking consultation with experts, and considering long term care, as he continues to deteriorate.

We feel an ethical obligation to warn the public, and urge the media to cover this national emergency.

I think it is important to take a deep dive into the course of the disease. The Mayo Clinic has an excllent article describing how the disease progresses. Note that patients always deteriorate, i.e., they get worse over time until the final stage when the die from the disease if something else doesn’t kill them first.

Consider, from the artilce:

Alzheimer’s disease tends to develop slowly and gradually worsens over several years. Eventually, Alzheimer’s disease affects most areas of your brain. Memory, thinking, judgment, language, problem-solving, personality and movement can all be affected by the disease.

There are five stages associated with Alzheimer’s disease. They include:

• Preclinical Alzheimer’s disease.
• Mild cognitive impairment due to Alzheimer’s disease.
• Mild dementia due to Alzheimer’s disease.
• Moderate dementia due to Alzheimer’s disease.
• Severe dementia due to Alzheimer’s disease.

Dementia is a term used to describe a group of symptoms that affect intellectual and social abilities enough to interfere with daily function.

The five Alzheimer’s stages can help you understand what might happen. But it’s important to know that these stages are only rough generalizations. The disease is a continuous process. Each person has a different experience with Alzheimer’s and its symptoms.

My impression, like everyone else who is observing Trump’s behavior, is only based on what we see (or read in his Truth Social Posts). We don’t know what he is like when going abiout his normal routine. We don’t know how forgetful he is or how confused he gets. Below is from the Mayo Clinic:

In the mild dementia stage, people may experience:

• Memory loss of recent events. Individuals may have a hard time remembering newly learned information. They may ask the same question over and over.
• Trouble with problem-solving, complex tasks and sound judgments. Planning a family event or balancing a checkbook may become overwhelming. Many people experience lapses in judgment, such as when making financial decisions.
• Changes in personality. People may become subdued or withdrawn, especially in socially challenging situations. They may be irritable or angry when that’s not typical for them. Reduced motivation to complete tasks also is common.
• Trouble organizing and expressing thoughts. At this stage, people may not be able to find the right words to describe objects. They may have trouble clearly expressing ideas.
• Getting lost or misplacing belongings. Individuals have increasing trouble finding their way around, even in familiar places. It’s also common to lose or misplace things, including valuable items.

Moderate dementia due to Alzheimer’s disease

During the moderate dementia stage of Alzheimer’s disease, people grow more confused and forgetful. They begin to need more help with daily activities and self-care.

People with the moderate dementia stage of Alzheimer’s disease may:

• Show increasingly poor judgment and deepening confusion. Individuals lose track of where they are, the day of the week or the season. They may confuse family members or close friends with one another or mistake strangers for family.They may wander, possibly in search of surroundings that feel more familiar. These behaviors make it unsafe to leave them on their own.
• Experience even greater memory loss. People may forget details of their personal history, such as their address, phone number or where they attended school. They repeat favorite stories or make up stories to fill gaps in memory.
• Need help with some daily activities. They may need help choosing proper clothing for the occasion or the weather. People in this stage also may need assistance with bathing, grooming, using the bathroom and other self-care. Some may occasionally lose control of their bladder or bowel movements.
• Undergo significant changes in personality and behavior. It’s not unusual for people in the moderate dementia stage to develop unfounded suspicions. For example, they might become convinced that friends, family or professional caregivers are stealing from them. Or they may accuse a spouse of having an affair. Others may see or hear things that aren’t really there.Individuals often grow restless or agitated, especially late in the day. Some people may have outbursts of aggressive physical behavior.

My impression is that Trump is along the continuum between these two stages:

• Mild cognitive impairment due to Alzheimer’s disease.
• Mild dementia due to Alzheimer’s disease.

John Gartner’s petition makes a case for suspecting this citing examples.

Assume that Trump is somewhere on the progression of this disease, what we can’t know is how quickly he will move to the moderate dementia stage. Some people in this stage need to reside in memory care facilities. He could be in this stage the day he is sworn in as president if he wins the election. Read over what his stage looks like and consider that we could have a president who is totally incapable of governing and who is also a malignant narcissist who then becomes clincally paranoid, and then imagine because of the progression of the dementia, it gets worse.

He’d have surrounded himself with absolute loyalists so to only way to save the country would be to have the Vice President and Cabinet invoke Article 3 of the 25th Ammendment, and then for 2/3rd of both the Senate and House to remove him from offrice installing the Vice President as permanent acting president.

If you thought our country could wake up one morning in the cold sweats with your heart racing from a nightmare, this would be like being caught in a night terror that repeats itself on and endless loop.*

• Read about the difference between nightmares and night terrors.