President Donald Trump has repeatedly highlighted his performance on cognitive screening exams in recent months, presenting what he calls "perfect" scores as proof of mental sharpness. But for some medical professionals, the very frequency of those tests - and the president's fixation on them - has prompted renewed scrutiny rather than reassurance.
The White House said in April that Trump, 79, was in "excellent health" following his annual physical examination, conducted at Walter Reed National Military Medical Center. The report confirmed that Trump scored 30 out of 30 on a cognitive assessment. Still, critics argue that repeated testing itself raises clinical questions, particularly as Trump enters the first year of his second term after his January 2025 inauguration.
Dr. John Gartner, a clinical psychologist and former professor at Johns Hopkins University, has argued that repeated administration of the Montreal Cognitive Assessment - commonly known as the MoCA - is not routine for healthy patients. "If you're giving it to him three times, that means you're not assessing dementia. That means you're monitoring dementia," Gartner told The Daily Beast.
Trump has publicly discussed the test on several occasions, including aboard Air Force One, portraying it as unusually difficult. "The first couple of questions are easy: a tiger, an elephant, a giraffe, you know," Trump said. "But when you get up to about five or six and then when you get up to 10 and 20 and 25, they couldn't come close to answering any of those questions."
During an October appearance, Trump challenged political opponents - including Alexandria Ocasio-Cortez and Jasmine Crockett - to take the same exam, describing it as "very hard" and "really aptitude tests." Medical professionals note that the MoCA is designed as a brief screening tool, not an intelligence measure, typically administered once unless impairment is suspected.
Gartner has also suggested that repeated cognitive testing is sometimes paired with regular brain imaging. He alleged that in clinical settings, reassessments often serve to "check again, see how bad he's doing now," a process commonly used for patients with known impairment or post-stroke complications.
Beyond testing frequency, Gartner argues that Trump's public speech patterns merit attention. "We have to judge people against their own baseline," he said. "If somebody doubles their rate of speed, that's a mental status change of some kind." Gartner has pointed to what he described as "phonemic paraphasias" and increasingly tangential speech as indicators worth evaluating.
The administration has not released underlying cognitive data beyond the headline score, and White House officials have declined to address questions about how often the tests have been administered. Medical experts note that a single high score does not rule out early-stage cognitive decline, making longitudinal trends more clinically relevant than isolated results.
