He points to the increasingly visible signs: verbal stumbles that go beyond ordinary gaffes, moments of confusion that can’t be brushed off as simple fatigue, physical stiffness and hesitations that raise concern among observers, and rambling monologues that drift without coherence. In Gartner’s assessment, as memory weakens and executive function frays, the underlying traits—impulsiveness, vindictiveness, the urge to dominate—don’t fade. They intensify. A personality built on denying weakness becomes more erratic when weakness starts breaking through. A worldview shaped around identifying enemies becomes even more hostile when the ability to regulate emotions erodes.

For millions who have watched aging relatives slip into cognitive decline, the pattern feels unsettlingly familiar. The difference is scale. Instead of unfolding quietly inside a household, it plays out on the global stage, amplified by cameras, headlines, and political consequence. Gartner emphasizes that he cannot diagnose without direct medical evaluation, nor can anyone interpret MRI visits without access to official medical findings. Still, he insists the broader pattern of conduct raises enough red flags that the public should not dismiss the warnings outright.

What concerns him most is not any single moment, but the accumulation: the repeated name mix-ups, the confusion about timelines, the abrupt shifts in mood, the looping speech patterns, the fixation on old grievances as if they happened yesterday, the moments of apparent physical imbalance, the inability to track questions, and the bursts of anger that seem disproportionate even by Trump’s historical standards. Gartner describes it as a feedback loop—cognitive decline amplifying the darkest edges of the personality, and those traits in turn worsening the instability produced by decline.

He argues that if this trajectory is even partially accurate, the real question is no longer just what is happening to Trump himself, but what might happen to the country still orbiting around him. A political movement built on absolute loyalty is now anchored to a man whose behavior appears increasingly unpredictable. The pressure, the scrutiny, the expectations—none of it softens with time. And the more strained he becomes, Gartner warns, the greater the risk that decision-making becomes erratic, reactive, or driven by grievance instead of reason.

The psychologist points to patterns observed in other political figures across history—leaders whose cognitive decline collided with authoritarian impulses, accelerating instability in the systems around them. He stresses that personality disorders do not disappear with age; they can sharpen as coping mechanisms weaken. A person who has always relied on bluster to mask insecurity may cling to it harder when clarity slips. A person who interprets setbacks as betrayal may react more aggressively when memory lapses make the world feel unpredictable. A person who refuses accountability may become even more resistant when confronted with limitations he can neither accept nor understand.

Observers within Trump’s inner orbit, past and present, have quietly mentioned changes as well—moments of confusion backstage, difficulty remembering briefings, visible frustration when details escape him. Public appearances show flashes of the old sharpness, followed by stretches of wandering statements and misplaced references. Supporters often dismiss these moments as harmless or exaggerated by critics, but Gartner warns that minimizing them only increases the stakes.

He highlights the psychological strain of someone who has built his identity on dominance facing the erosion of faculties he cannot control. Decline doesn’t just challenge the brain; it challenges the ego. When a person accustomed to command starts to feel mentally unsteady, the emotional fallout can be volatile. Fear becomes anger. Confusion becomes suspicion. Vulnerability becomes denial.

And while political allies may try to shield him, the demands of public life don’t allow space to hide deterioration for long. Cameras capture everything. Microphones amplify every slip. Crowds scrutinize every gesture. The stress compounds, speeding what experts say is often a downward spiral.

Gartner notes that families dealing with dementia in private often describe a similar progression: years of subtle signs dismissed or downplayed, followed by sharper shifts that force acknowledgment. Loved ones struggle between loyalty and reality, wanting to protect the person while grappling with what they’re witnessing. Multiply that dynamic across a political landscape and the stakes become harder to ignore.

What troubles Gartner most is the potential for misjudgment. Dementia doesn’t simply slow thinking; it can distort it. It blurs boundaries between real and imagined threats. It fuels frustration, especially in someone unaccustomed to feeling powerless. Combined with a personality already inclined toward grievance, it creates what Gartner sees as a highly combustible mix.

He warns that the public must pay attention not because of partisanship, but because the consequences of decline in someone with enormous influence ripple outward. Decisions made in confusion can be mistaken for strategy. Outbursts driven by fear can be interpreted as conviction. Erratic behavior can be normalized because it arrives in small steps, not dramatic leaps.

The question then becomes not whether decline exists, but how people around the individual respond—whether they enable, ignore, or confront what they see. History shows that when decline intersects with power, silence often carries the highest cost.

Gartner stresses again that he can’t diagnose from afar, but he refuses to look at the constellation of signs and pretend they’re meaningless. He insists that even if only some of the concerns are valid, the public deserves clarity, transparency, and vigilance. Because when a nation’s political stability is tied so tightly to one person’s state of mind, decline—real or perceived—has consequences far beyond the individual.

For millions watching, the warning lands with the blunt weight of recognition. The behaviors may be debated, but the pattern feels familiar. And familiar, Gartner reminds, does not mean harmless.