Donald Trump insists he’s in excellent health—and according to the White House physician, that statement holds up. But behind closed doors, some political insiders aren’t convinced. One prominent Republican strategist is now sounding the alarm, suggesting that Trump might be exhibiting signs of cognitive decline that could prevent him from completing another presidential term.
The speculation reignited following Trump’s highly publicized health exam in April. Dr. Sean Barbabella, the physician leading the evaluation, praised the former president’s overall condition, describing his heart, lungs, neurological system, and general physical health as “robust.” He also noted that Trump’s active lifestyle plays a vital role in maintaining his well-being.
The comprehensive assessment involved input from 14 medical specialists. It included a neurological evaluation to test reflexes, motor coordination, sensory responses, mental clarity, and emotional health, including markers for depression and anxiety.
At 78, Trump remains the oldest person to ever assume the presidency. Notably, he avoids alcohol and tobacco, and his health has improved in some areas. Standing at 6’3″ and weighing just over 220 pounds, Trump has dropped around 25 pounds since his last term. Reports also show a decrease in his cholesterol levels, per the Associated Press.
Aside from some minor sun-related skin damage and scarring on his right ear—a result of the July 2024 assassination attempt in Butler, Pennsylvania—doctors found no cause for concern.
**Doubt from Within the GOP**
Yet Rick Wilson, co-founder of the anti-Trump conservative group The Lincoln Project, isn’t buying it. In a Times Radio interview, Wilson warned the American public to look beyond official statements and observe Trump’s recent behavior for themselves.
“He’s incoherent,” Wilson claimed. “He struggles to express thoughts clearly, frequently goes off-topic, and shows signs of verbal confusion.”
Having monitored Trump’s political career closely since 2015, Wilson argues that the former president is no longer the same figure seen in previous campaigns.
“This is not the Trump of 2015, 2020, or even early 2024,” he said. “There’s been a noticeable decline.”
Wilson openly questioned Trump’s ability to serve another full term, stating, “Whether he can complete four more years is uncertain.”
Despite clean medical evaluations, Wilson cautioned that test results don’t always reflect real-world cognitive decline. “Many health professionals are watching his behavior and identifying patterns typical of early dementia.”
**Age Isn’t Just a Number**
Wilson emphasized that passing a cognitive test doesn’t guarantee immunity from age-related decline. “Age and hidden health issues could still be taking a toll,” he warned.
Although Trump’s April health check may have satisfied some of his critics, skeptics like Wilson believe it left more questions than answers.
Veteran journalist Timothy L. O’Brien, during an appearance on MSNBC’s *The Weekend: Primetime*, echoed those concerns. He revealed that Trump is deeply unsettled by the thought of suffering the same cognitive deterioration that affected his father, Fred Trump, in later life.
O’Brien, who has reported on Trump for decades, also pointed out that the former president’s talk about serving a third term might not be pure political theater.
“He’s either trying to inflate his own image or desperately trying to hold on to power,” said O’Brien. “But I doubt he’ll seriously pursue another term.”
**A Shift in Transparency**
Trump’s April health report marked a departure from his earlier campaign tactics. In 2016 and 2020, health updates were often vague and upbeat, with few specifics. This time, however, the details were more precise—possibly to answer growing calls for transparency.
Throughout the 2024 election season, Trump had promised a full medical disclosure. Instead, he relied heavily on previous notes from physicians like Dr. Ronny Jackson, who treated him after the 2023 assassination attempt.
One such letter, dated November 20, 2023—coinciding with President Biden’s 81st birthday—declared Trump in “excellent” condition as of September. However, it lacked medical data or test results.
Trump’s campaign spokesman Steven Cheung defended the approach, stating that Trump had released ample health information, including assessments from Dr. Jackson. “All reports confirm that he’s perfectly healthy and fit to serve,” Cheung said.
Cheung also criticized then-opponent Kamala Harris, arguing that Trump’s energetic campaign schedule proved his superior stamina and commitment. “He’s been campaigning harder than anyone in political history,” Cheung added.
To strengthen their case, Trump’s team even brought back his 2018 cognitive test results from his first term—documents often used by supporters to validate his mental sharpness.
However, since 2018, no new cognitive assessments have been made public. Dr. Jackson—who worked under both Presidents Obama and Trump—continues to publicly vouch for Trump’s health.
Yet critics say the issue isn’t whether Trump can pass a test—it’s whether those tests reflect the full picture. As Rick Wilson sees it, the true signs of mental decline are unfolding right before the public’s eyes.