Trump keeps boasting about passing a cognitive test — but it doesn’t mean what he thinks it does.

As President Trump and his team began attacking former vice president Joe Biden's mental and physical fitness this summer, Trump began pondering his own cognitive abilities.

As part of his annual physical two years earlier, the president had taken the Montreal Cognitive Assessment — a 10-minute test designed to detect mild cognitive impairment such as the onset of dementia — and he believed he could weaponize his performance against Biden, the presumptive Democratic presidential nominee.

During a private campaign meeting in the Cabinet Room in early June, Trump brought up the test unprompted. In an extended riff, he talked about how well he had done — boasting that he'd been able to remember five different words, in order — and suggested challenging Biden to take the assessment, saying he was certain the former vice president would not fare as well.

Since then, the president has been speaking about the test publicly, telling Fox News's Sean Hannity in a July 9 phone interview that he'd "aced it," and again on Sunday, when he told the network's Chris Wallace that he doubts Biden could answer all of the questions. On Wednesday evening, in another Fox News interview, Trump couldn't resist revisiting what he said was the hardest part of the test — repeating the five words, in order.

Trump said he was first asked to repeat a set of words — "person," "woman," "man," "camera," "TV," he said, offering a hypothetical example — and then, later in the assessment after some time had elapsed, he was again asked whether he remembered those same words, in order.

"And they say… 'Go back to that question, and repeat them. Can you do it?' " Trump said, mimicking the doctors administering the exam. "And you go, 'Person, woman, man, camera, TV.' They say, 'That's amazing. How did you do that?' I do it because I have, like, a good memory, because I'm cognitively there."

But medical and public health experts stress that the cognitive exam is not what Trump seems to think it is — an indicator of IQ or a cudgel to be wielded against a political opponent like a debate challenge.

Experts say the president's fixation on the Montreal Cognitive Assessment — or MoCA, as it is sometimes called — is particularly puzzling because the test is normally administered only if someone is concerned that they or their loved ones may be experiencing dementia or other cognitive decline. Getting a perfect score — as Trump has repeatedly claimed he did — merely signifies that the test-taker probably does not have a cognitive impairment as measured by the exam.

"It's not meant to measure IQ or intellectual skill in anyway," said Ziad Nasreddine, the neurologist who created the test. "If someone performs well, what it means is they can be ruled out for cognitive impairment that comes with diseases like Alzheimer's, stroke or multiple sclerosis. That's it."

Nasreddine continued: "The reason most people take the test is they or others start noticing mental decline. They forgot where they parked the car, can't remember what groceries to buy by the time they get to the store. They keep forgetting to take their medication."

The MoCA is often administered at memory clinics or by primary care physicians or geriatricians. Trump's was administered at Walter Reed National Military Medical Center in early 2018 by Navy Rear Adm. Ronny L. Jackson, then the White House's top physician, who is now a Republican candidate for Congress in Texas.

At a news conference that year discussing Trump's physical, Jackson described Trump as "mentally very, very sharp" and "very intact" and said he would not have given Trump the cognitive assessment but that the president himself requested it. At the time, Trump was reeling from the fallout of Michael Wolff's book, "Fire and Fury" — a best-selling account of life inside the White House that depicted a maelstrom of chaos and incompetence — and was eager to demonstrate that he was, as he had claimed on Twitter, "a very stable genius."

Washington Post. By Ashley Parker and William Wan. July 22, 2020


July 23, 2020

Voices4America Post Script. Hey, Trump's test is what they administer if they are wondering- can your grandfather still drive or live alone? Someone in the White House was worrying. This man has his hands on the nuclear codes! 103 days until Nov. 3rd. #TrumpUnfit #VoteTrumpOut #Biden2020

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