Donald Trump took a medical exam yesterday. It probably hasn't escaped your attention, given the coverage the test and subsequent press conference have received. Dr Ronny Jackson said that Trump is "fit for duty" and in excellent health, despite claims in Fire and Fury that the President spends a lot of time in bed eating Big Macs.
Part of the exam that has drawn a lot of attention is his cognitive assessment. Several public figures, including Joe Scarborough and Michael Moore, have gone on record saying Trump is showing early signs of dementia, so the results were eagerly awaited by these critics. His mental health is the subject of a lot of online speculation too, even though he tweeted to confirm that he is, in fact, "a very stable genius".
In his cognitive test, however, he managed to score a perfect 30/30. So what was the test?
The assessment, carried out by his physician, was the Montreal Cognitive Assessment. It is designed to assist medical professionals in detecting cognitive impairment and Alzheimer's disease, and is a standard part of a full medical carried out on people of Trump's age.
The 10-minute test assesses short-term memory, attention, concentration, language, and visuospatial abilities, giving medical practitioners an indication of the subject's cognitive abilities. It isn't designed to diagnose Alzheimer's or impaired cognitive function by itself, but it can lead to further inquiries being carried out, should the subject get a low score.
Here is the test that Trump would have taken.
In one area of the test, the subject is asked to draw a clock face, showing a time specified by the physician. The patient draws the clock, and is awarded one point each for:
- Drawing the clock face as a circle (slight imperfections are allowed)
- Getting the numbers correct and in the correct order
- Getting the time right, with the hour hand being shorter than the minute hand
Alternative trail making
Subjects are asked to draw a trail from A to E. Each letter is matched with a number (A-1, B-2) and the subject must draw their trail in ascending order. The correct order would go 1-A-2-B-3-C-4-D-5-E.
One point is awarded for each successful pairing of a letter to its corresponding number. If a patient makes a mistake that isn't immediately corrected, zero points are awarded.
Patients are shown a cube. They are asked to replicate it, and awarded a point if it matches the drawing on the page.
The patient must be able to correctly identify where they are taking the test, including the city they are in. For Trump that would be the White House in Washinton D.C., but yours is probably less exotic. One point is awarded for identifying your location correctly, no points are awarded if any part is incorrect.
Identify the animals
Patients are asked to identify three animals from line drawings. One point is awarded per animal.
The doctor asks the patient to remember a list of five words. They are then asked to remember a second list of five words. After that, the patient is asked to recite them back to the doctor.
At this stage, no points are given for remembering the words, instead, points are deducted from the total if words are wrong or incomplete.
Later on in the test, however, the doctor asks the patient to recite the list again. Here, a point is awarded for each word.
The patient is given groups of two words and asked to describe the relationship between them. For example:
- Bike and train – both are types of transport
- Orange and banana – both are types of fruit
The patient is given a point for identifying the relationship between the two words.
Vocabulary and fluency
The patient is given a letter. They must list as many words beginning with that letter as possible within a minute. Just like in Scrabble, you aren't allowed to use proper nouns.
One point is awarded for getting more than 11 words within the time limit.
The test is only designed to assist medical professionals in their work, and a low score on the test does not mean that you have Alzheimer's disease. However, it may mean that you are sent for further assessments.
Any score under or around 16 is consistent with someone diagnosed with Alzheimer's disease. Meanwhile, 16-25 indicates that the patient may have a mild cognitive impairment. Above 26 is a normal score for a healthy patient.
Trump was awarded 30 out of 30 – a perfect score. The kind of score you'd expect from a stable genius.