The Trump family already knows how to manage cognitive decline. They’ve done it before.
If you think Donald Trump has dementia, you’re probably right.
The Trump family has been here before. They know exactly what cognitive decline looks like. And they know exactly what to do about it.
Fred Trump Sr. spent the last eight years of his life showing up to an office where the paperwork was blank, the phone was disconnected, and the staff was in on the con. His children created an elaborate theatrical production – a Potemkin office – so the old man could shuffle papers and feel important while they quietly drained his billion-dollar real estate empire into their own pockets.
Every morning, Fred Sr. got dressed in his three-piece suit. His chauffeur drove him to Brooklyn. He sat at the same desk he’d occupied for fifty years. He signed documents. He picked up the phone. He thought he was running the company.
But the documents were meaningless. The phone only connected to a secretary in the lobby who was paid to play along. The whole thing was a stage set designed to manage an elderly man with Alzheimer’s who was too proud to admit he couldn’t do the job anymore.
I’m sure that’s not relevant to anything happening right now.
Here’s what we know from court records and family testimony: Fred Trump was diagnosed with “mild senile dementia” in October 1991. By 1992, doctors reported he couldn’t remember his own birthday, didn’t know his age, and scored below the 15th percentile for cognitive function in his age group. After a thirty-minute delay, his ability to recall anything he’d just been told was – and I’m quoting the medical report here – “nil.”
His grandson Fred III wrote that the old man would get out of his limousine at traffic lights and just start walking away. He’d scream at his wife over nothing. He once came downstairs wearing three ties. At Donald’s 1993 wedding, Fred Sr. had to be reminded why he was there – despite being designated the best man.
And through all of it, they kept bringing him to the office. Kept him in the routine. Because familiarity kept him calm. Agitation and outbursts were the alternative.
Here’s where it gets darker.
While Fred Sr. was signing blank papers and thinking he was still the boss, Donald was busy getting his father’s lawyer and accountant to draft a codicil that would have given him complete control of the estate. According to Mary Trump – Fred’s granddaughter – the plan was to slide it in front of the old man “as if it had been Fred’s idea all along.”
But Fred had a lucid day. He knew something was wrong. He called his daughter Maryanne, who showed it to her lawyer husband. His response, according to secretly recorded conversations Mary later released: “Holy shit. It was basically taking the whole estate and giving it to Donald.”
The codicil didn’t get signed. But within a few years, with Robert Trump holding power of attorney, the siblings transferred the vast majority of their father’s empire to themselves anyway. When Fred Sr. died in 1999, he had less than $2 million in the bank. Five years later, his kids sold the company for $700 million.
So the Trump children have experience with this.
They know how to manage a cognitively declining patriarch. They know how to keep him comfortable and feeling important. They know how to maintain the illusion of control while the real decisions happen elsewhere. They know how to extract value from a situation while protecting the principal from anything that might upset him.
Fast forward to January 2026.
Donald Trump is 79 years old – the oldest person ever inaugurated as president. His father was diagnosed with dementia at 86. His aunt Maryanne had dementia. His cousin John Walters had dementia. “It runs in the family,” Fred III told interviewers. “If anyone wants to believe that dementia did not run in the Trump family, it’s just not true.”
In December, Trump fell asleep on camera during his own Cabinet meeting. Not once. Not twice. The Washington Post counted nine separate instances where his eyes closed for extended periods over a 75-minute stretch – nearly six minutes total of the president appearing to doze while Marco Rubio spoke directly next to him. His head dropped. He snapped back awake. This was on live television.
A New York Times investigation found Trump has cut his official appearances by 39 percent compared to his first term. His public events now typically start after noon instead of 10:30 a.m. He’s reportedly asking staff to put “fewer, more important meetings” on his schedule. He posted in December that it’s “seditious, perhaps even treasonous” for anyone to discuss his health.
And here’s the thing that should make everyone’s hair stand up: Trump keeps bragging about “acing” cognitive tests. Three of them now. Dr. John Gartner, a psychologist who’s been tracking this, put it simply: “You could maybe justify giving someone the MoCA once, just on their age. If you’re giving it to him three times, that means you’re not assessing dementia. That means you’re monitoring dementia.”
Mary Trump, the clinical psychologist niece, says she sees the same “deer in the headlights” look in her uncle that she saw in her grandfather during his decline. Fred III says he watches his uncle’s deterioration “in parallel with the way my grandfather’s decline was.”
And who’s surrounding him? JD Vance. Stephen Miller. Marco Rubio. A rotating cast of ideologues and opportunists who figured out what the Trump children figured out thirty years ago: you can get a lot done when the guy at the top thinks he’s still in charge.
The paperwork Fred Sr. signed was blank. The phone went nowhere. But he felt like he was running things.
Trump’s schedule is lighter. His meetings are shorter. His public appearances start later. The executive orders keep flowing – 228 of them and counting – written by people who aren’t Trump. And somehow, mysteriously, the people around him keep getting exactly what they want.
Half of Americans now say they believe the president is suffering cognitive decline. But the White House won’t answer basic questions about when his cognitive tests were taken. Press Secretary Karoline Leavitt promised details “at a later date.” That date hasn’t come.
The Trump family built a Potemkin office for Fred Sr. because they understood something fundamental: you can control an empire if you can control what the man at the top sees, hears, and believes.
The only difference now is the office is oval, the paperwork isn’t blank, and the stakes are global.
SOURCES
https://www.thenewworld.co.uk/nicky-woolf-when-fred-trump-lost-his-mind
https://en.wikipedia.org/wiki/Fred_Trump
https://www.washingtonpost.com/graphics/2020/politics/donald-trump-father-will
https://www.washingtonpost.com/politics/2025/12/02/donald-trump-drowsy-cabinet-meeting
https://www.thedailybeast.com/research-exposes-how-trump-79-has-drastically-reduced-schedule
https://www.thedailybeast.com/why-ailing-trump-is-paranoid-about-mental-decline
https://en.wikipedia.org/wiki/Age_and_health_concerns_about_Donald_Trump
https://www.thedailybeast.com/trump-79-has-dementia-just-like-his-dad-trumps-niece/