Donald Trump’s doctor, Dr Ronny Jackson, told the world on Tuesday that the president “has absolutely no cognitive or mental problems.”
He came to that conclusion, he said, after meeting regularly with Trump and starting with the president’s perfect score of 30 out of 30 on Montreal’s cognitive assessment done during his physical exam on Friday.
The Montreal Cognitive Assessment, or MoCa, is a tool designed to identify symptoms of dementia that accompany a neurodegenerative disease such as Alzheimer’s disease or Parkinson’s disease. According to Jackson, Trump ordered a cognitive test during his annual physical exam and is the first president to have one.
To people of good mind, some of the questions may seem too simple or silly. It asks, for example, the patient to identify the names of some animals, and to correctly indicate their date and their location. He has basic tasks like counting down to seven and drawing a clock that shows 10:11 am These are some of the basic mental processes that people with dementia tragically escape. (See all the test here).
It is a very useful tool for quickly assessing symptoms of dementia or for assessing cognitive functioning after stroke. A 2007 to study in the Canadian Journal of Psychiatry found that the Montreal Cognitive Assessment correctly detected 94 percent of patients with mild cognitive impairment, outperforming another cognitive resources test. It has been found to be useful in identify symptoms in patients with Parkinson’s disease and in those who have had a stroke.
So that’s what the test does. Just as important is what it doesn’t assess. It does not assess personality or judgment, like the Canadian Press reports. It is not designed to tell us if someone is fit to be President of the United States.
It is also not the only, nor necessarily the best way to assess cognitive decline. Other tests recommended by the Alzheimer Association take into account information from family members who can report if the person’s cognitive ability has deteriorated over time. “There is not a single cognitive assessment tool that is considered the gold standard”, the Alzheimer Association reports in its guidelines for physicians. The Alzheimer’s Association highlights three most suitable tests for rapid assessment (find out more about these here), and MoCa is not one of them (some limitations being that it takes more than five minutes to administer, and it’s a relatively new tool to the field.)
The MoCa is easy to ridicule, as are many on the left. It’s also weird to brag (see Donald Trump Jr’s tweet below.)
Following #winner. 30 out of 30. I look before @ScottAdamsSays take, but mine is that the left has to stop hitching their wagon to the bytes of BS sounds they want to be true so they don’t get stopped so loud all the time. They continue to lose any credibility they left behind! https://t.co/d9L8EB1HXd
– Donald Trump Jr. (@DonaldJTrumpJr) January 16, 2018
But all the information is useful. And this is also the result of this test, to a small extent.
Journalists and mental health professionals have publicly argued that the apparent deterioration of Trump’s vocabulary over the past decades is a sign of cognitive decline. It is important to know that Trump does not have such obvious signs of dementia to register for this test.
At the press conference where Jackson explained the results, CNN’s Sanjay Gupta (a doctor) pointed out that the test cannot always find the early stages of dementia, such as changes in personality or mood.
As Richard Friedman, professor of clinical psychiatry and director of the clinical psychopharmacology at Weill Cornell Medical College, the a argued in the Washington Post, we don’t need a test to judge Trump’s suitability for the job: “The most accurate measure of a person’s fitness, whether mental or physical, is the function observable in the real world – not the results of an expert opinion. The point is, Americans already have all the data they need to judge Trump’s fitness. “