Political News

President Clears Cognitive Test and Passes His Annual Physical

Posted January 16, 2018 8:38 p.m. EST
Updated January 16, 2018 8:43 p.m. EST

WASHINGTON — President Donald Trump’s White House physician said Tuesday that the president received a perfect score on a cognitive test designed to screen for neurological impairment, which the military doctor said was evidence that Trump does not suffer from mental issues that prevent him from functioning in office.

“I’ve found no reason whatsoever to think the president has any issues whatsoever with his thought processes,” Dr. Ronny L. Jackson, a rear admiral in the Navy and the White House physician, told reporters Tuesday.

Trump’s first physical examination as president was highly anticipated, in part because of an increasing number of public questions about his sometimes erratic behavior during his first year in office. A book published this month, “Fire and Fury” by Michael Wolff, asserted that even Trump’s own advisers and associates questioned the president’s fitness for office.

Trump, the doctor said, asked for the cognitive test to answer his critics and attempt to quell questions about his mental abilities.

Overall, Jackson said, Trump’s health was “excellent,” with mostly normal results on a battery of tests and examinations. He said Trump, 71, has remarkably good cardiac health, probably because he does not smoke or drink alcohol.

But he did say that Trump’s weight is 239 pounds and that he is too sedentary. His cholesterol is too high, despite taking medicine to lower it, and Jackson said Trump would be increasing the 10-milligram dosage of Crestor to better control it.

At 6 feet 3 inches tall, Trump has a body mass index of 29.9, which is just shy of officially being obese. A New York driver’s license issued in 2012 listed him as 6 feet 2 inches tall, which would put him just into the obese category.

“The president, he and I talked,” Jackson said. “He would like to lose 10 to 15 pounds. We talked about diet and exercise a lot. He’s more enthusiastic about the diet part than the exercise part, but we’re going to do both.”

Jackson said that despite expressions of concern, a cognitive test was not indicated for Trump and he had not planned to conduct one at the Walter Reed National Military Medical Center in Bethesda, Maryland, where the president underwent his annual physical on Friday.

“This has been the narrative for a while. He saw doing the physical as an opportunity to put some of that to rest,” Jackson said during a nearly hourlong question-and-answer session in the White House briefing room. “He actively asked me to include that in it, so we did.”

Jackson said that Trump received a score of 30 out of 30 on the Montreal Cognitive Assessment, a well-known test regularly used at Walter Reed and other hospitals.

The test is described as a “rapid-screening instrument for mild cognitive dysfunction” that focuses on “attention and concentration, executive functions, memory, language” and other mental skills. It asks patients to repeat a list of spoken words, identify pictures of animals like a lion or a camel, draw a cube or draw a clock face set to a particular time.

Jackson said the president did “exceedingly well” on the screening test, adding evidence to the doctor’s own assessment that the president has been “very sharp” during numerous interactions he has had with him during the past year.

Psychiatric experts said the brief, 10- to 15-minute screening test is not comprehensive and might not catch all patients with early stages of dementia. Dr. Bandy Lee, the author of “The Dangerous Case of Donald Trump,” which expresses concern about the president’s mental health, said in a brief interview that the president requires a full, detailed neuropsychiatric evaluation.

However, Jackson said he had observed Trump closely, often several times a day, for the past year, and was satisfied that the Montreal test is “sensitive enough” to have picked up serious cognitive issues if they were present. Asked about a much-discussed episode in which the president seemed to slur his words during a televised speech in December about the Middle East, Jackson said that he and his team of a dozen specialists conducted several tests, including an ultrasound of his carotid arteries, to determine whether there might be a clinical explanation.

Jackson said that the tests all were normal, leading him to believe that the slurred words might have been caused by Sudafed, a medicine for nasal congestion, that he prescribed for the president. He said Trump does not wear dentures “of any kind,” a popular theory on Twitter for the slurred words.

In response to speculation on television and elsewhere that the president has mental health problems, Jackson said, “In my opinion, that’s just tabloid psychiatry.”

The president’s fiercest critics are unlikely to be satisfied by Jackson’s pronouncements, but even top aides to former President Barack Obama were quick to praise Jackson, who also served as the White House physician to Obama.

“Dr. Jackson is a phenomenal doctor and a really great guy,” Dan Pfeiffer, Obama’s senior adviser, posted Tuesday on Twitter. “He and his team took great care of all of us for many years.”

Jackson said several times that he did not hold back any information about the president’s health or the medicines he takes. He said the president had urged him to be forthcoming.

“He said, ‘I want you to get out there, and I want you to talk to them, and I want you to answer every question that they have,'” Jackson said, adding that Trump told Sarah Huckabee Sanders, the White House press secretary, not to pull the doctor off the podium until reporters were finished. Overall, Jackson repeatedly said he was impressed by the president’s health, saying tests revealed no evidence of cancer, lung problems, diabetes or joint problems. Tests of the liver, kidney and thyroid were all normal.

In addition to the cholesterol medicine, Trump takes small doses of aspirin for heart health and a small dose of Propecia, a medicine to treat male-pattern baldness.

Jackson said tests of the president’s heart indicated “excellent” cardiac health, especially for someone of his age. An echocardiogram showed that he had normal function of his main pumping chamber, at 60-65 percent. Trump also performed above average on a treadmill exercise test.

The president’s cholesterol was elevated, at 223, with an LDL measurement of 143 and an HDL level of 67. Jackson said that he hoped the higher dose of Crestor would help Trump lower his LDL to under 120 during the next year.

Dr. Richard A. Chazal, the immediate past president of the American College of Cardiology and the medical director of the Heart and Vascular Institute for Lee Memorial Health System in Fort Myers, Florida, called the report of Trump’s health “very reassuring.”

Based on the information Jackson provided about the president’s cholesterol, Chazal said the decision to increase the statin drug the president is taking is “thoughtful” and “a very reasonable approach.” Speaking of the remainder of the laboratory tests, “all else is very favorable,” Chazal said. In December 2015, Dr. Harold N. Bornstein, Trump’s personal doctor, released a four-paragraph letter saying that, if elected, Trump would be “the healthiest individual ever elected to the presidency.”

Jackson declined to repeat that statement, saying that it was his job to “give you my assessment of President Trump today.

“And I’m not going to make any comparisons with presidents over the last 200 years or anything,” he said.

Jackson said the president sleeps only four to five hours a night, but he said he was not concerned about it. He said he rarely sees the president overly stressed, saying that Trump “has a unique ability to just get up in the morning and just reset. He gets up and he just starts a new day.”

Asked about reports that Trump watches numerous hours of television each day, Jackson said that, as far as he was concerned, “He can watch as much TV as he wants.”

But Jackson repeatedly expressed concern about the president’s sedentary lifestyle, noting that Trump does not have a “dedicated, defined exercise program.”

Still, he said that the president has “a lot of energy and a lot of stamina,” and he said he is asking for a nutritionist to consult with the White House chefs to cut calories and fat in dishes served to the president. But he said the president remains healthy.

“It’s called genetics,” Jackson said. “I told the president if he had eaten healthier over the last 25 years, he might live to be 200.”