Can we tell by a candidate’s language?
Key points

• The arguments about “age” and “competency” are usually flawed.
• Speaking problems rarely signal cognitive problems.
• Strange sentence structures may signal dementia.
• The inability to complete a thought may signal dementia.

As the presidential race heats up, everyone with strong beliefs has an opinion about the opposing candidate’s mental acuity, gleefully waiting for the Ahah! moment that bolsters their opinion that “the old man is nuts.”

Two problems with this. The first is that Mr. Trump and President Biden are both old. Some would say, really old. The second is that speculation on their thinking ability is based more on ideology than facts.

We can’t do anything to clear up misconceptions about the first in time for the election—as a society, we will still stigmatize age. But we can do something about the second by looking at three areas that can tell us if what we are hearing is stuttering, a senior moment, or dementia.

Forget their speech when following a teleprompter. Anyone who can read at a sixth‐grade level can appear to be mentally adequate as the monitor’s lines scroll by. But listen to what and how they communicate spontaneously or when answering questions. When you hear something “odd,” determine if it is a sign of stuttering, a senior moment, or a dementia warning light.

Stuttering

Stuttering is the disruption of the flow of speech characterized by hesitations, repeats of sounds, or blocks. Problems with how words are said are not related to their meaning or a person’s cognitive ability.

Speech is not the same as language. Speech is how you say words, and language is the meaning of the words you use. Stutterers who successfully control their disorder—recognized as a neurological motor problem—often develop many strategies for fluency either on their own or with the help of speech-language therapists.

If you saw the movie The King’s Speech, you’ll recall many techniques the King’s therapist taught him to control his stuttering, ranging from stretching out sounds to tapping his fingers. When these techniques cease to be useful, they may remain and disrupt speech, sometimes making conversation difficult to follow.

President Biden has been a stutterer his entire life. There is no history of Mr. Trump being diagnosed with stuttering. Therefore, any stuttering behaviors can only be attributed to President Biden, none of which are related to cognition.

Senior Moments

Although “senior moments” are described as humorous lapses of memory or brief errors, they really are information processing errors that may or may not involve memory.

Single or infrequent senior moments rarely signal dementia. When Mr. Trump says “Obama” rather than “Biden,” does he really believe he’s running against Obama in 2024? Probably not. When President Biden can’t find a simple word to complete a sentence, is it due to a brain riddled with plaque or merely a momentary lapse of short‐term memory? Most likely, it is short‐term memory.

Older people, including the President, Mr. Trump, and millions over 50 (myself included), have senior moments. We have all forgotten the name of a granddaughter, misused a common word, made a bizarre connection between events, or forgotten how to exit a favorite shopping mall.

Disconcerting or embarrassing, senior moments—except for outright disorientation—do not, by themselves, signal dementia. However, other factors (such as frequency, severity, or context) may suggest the beginning of dementia.

Dementia

The National Institute of Health defines dementia as the loss of cognitive functioning—thinking, remembering, and reasoning—to such an extent that it interferes with daily life.

One‐third of us, according to the NIH, will exhibit some signs or forms of dementia by the time we reach 85. They cite six signs:

1. memory loss

2. difficulty concentrating

3. finding it hard to carry out familiar daily tasks

4. struggling to follow a conversation or find the right word

5. being confused about time and place

6. mood changes

These six indicators share many similarities with what we identify as senior moments. However, as with senior moments, the context in which they occur, their frequency, and how bizarre the mistake is all matter.

Within the structure and content of sentences, early dementia may be indicated when a person can’t finish a sentence, repeatedly misuses grammar, or combines multiple thoughts into a single disjointed sentence. If this occurs only once or a few times, a non‐cognitive explanation (like preoccupation with a major issue) might suffice. However, repeated occurrences may signal early dementia, regardless of the candidate’s age.

The Takeaway

It’s easy to label someone we disagree with as “demented.” Anyone with an adult child has unfortunately experienced this. Disagreement becomes more rationally grounded when we acknowledge that it may be ideologically based—not signs of impaired cognitive ability. Call ideological disagreements what they are: differences of opinion. However, when signs of dementia are incontrovertible, don’t be afraid to call them what they are: markers for governing disqualification.

References

1. Goldberg, S.A. Preventing Senior Moments: How to Stay Alert Into Your 90s and Beyond (Lantham, MD: Rowman & Littlefield, 2023)
2. Culatta, R. and Goldberg, S.A. Stuttering Therapy: An Integrated Approach to Theory and Practice (Needham Heights, MA: Allyn & Bacon, 1995)

This article originally appeared on psychologytoday.com.