On April 30, 2026, Senators Sheldon Whitehouse and Jack Reed of Rhode Island placed a formal statement into the Congressional Record signed by 36 physicians—including neurologists, psychiatrists, and cognitive disorder specialists from Harvard, Tufts, Columbia, and George Washington University. The doctors warned that President Trump is experiencing a 'rapidly worsening, reality-untethered, increasingly dangerous decline' and declared him 'mentally unfit' for office. They cited his 'grandiose and delusional beliefs,' 'reckless threats of violence,' 'compulsive, manic-like late-night communications,' and 'fixation on perceived enemies.' Given his access to nuclear codes, they argued that invoking the 25th Amendment is a matter of 'greatest urgency.'
Yet the political will to act appears weaker than ever. Unlike during Trump's first term, when the possibility of using the Constitution's 25th Amendment was at least openly debated, no one in his inner circle is willing to challenge him now. This silence makes it all the more necessary to examine the mounting evidence that the oldest-ever elected president is physically and mentally deteriorating.
What the 25th Amendment Allows
Ratified in 1967 after President Kennedy's assassination, the 25th Amendment created procedures for presidential succession in case of incapacity. Its Section 4 allows the vice president and a majority of the Cabinet—or another body designated by Congress—to declare the president unable to discharge his duties. This would require Trump's own appointees to make that call, with Vice President JD Vance taking over as acting president. During Joe Biden's presidency, debate over fitness was intense from both sides; voters should demand the same scrutiny now.
Warning Signs Before 2024
Concerns about Trump's fitness predate the 2024 election. Speech and language pathologist Michael de Riesthal noted that during Trump's 2017 speech in Jerusalem, there was 'definitely some imprecise progressive change in articulatory precision and slowing of his speech that is not typical in normal speech.' The White House dismissed it as a dry throat. After Trump's June 2020 West Point commencement address, questions arose about unsteadiness and trouble enunciating. In the final days of the 2024 campaign, Trump repeatedly jumped from teleprompter remarks to nonsensical tangents. Former Republican presidential candidate Nikki Haley questioned his mental capacity after he confused her with Nancy Pelosi and falsely claimed she was responsible for Capitol security on January 6, 2021.
Accelerating Decline
Now, as Trump approaches his 80th birthday, the situation has worsened. After his first physical in April 2025, the White House physician released results within 48 hours. But for his May 2026 visit, the administration initially stayed silent, then issued a memo from Dr. Sean Barbabella declaring Trump in 'excellent health' while recommending weight loss and exercise after he gained 14 pounds in the past year. Barbabella is downplaying unmistakable signs: Trump's latest Walter Reed visit was his third in 13 months. He has dark, unexplained bruising on both hands and has been diagnosed with chronic venous insufficiency. His habit of using two hands to drink from a glass has become a documented pattern.
Cognitive issues are equally alarming. Before his August 2025 Alaska summit with Vladimir Putin, Trump told reporters, 'I'm going to see Putin. I'm going to Russia on Friday,' though he later corrected himself on Truth Social. At the January 2026 World Economic Forum in Davos, he repeatedly confused Greenland and Iceland. In May, for reportedly the eighth time, he wrongly blamed President Obama for the deaths of 13 U.S. servicemembers during the Afghanistan evacuation—deaths that occurred under Biden. He has also called Hungarian Prime Minister Viktor Orban 'the leader of Turkey.'
Carolyn Aldwin of Oregon State University, a researcher on aging, told Slate that Trump was a much better speaker in the 1990s. Now, she said, he 'has really severe language problems. He can't complete sentences. He wanders off topic. He gets very confused. How severe those are can only be established by testing.'
Trump's apparent naps during high-level meetings have become legendary—reportedly 13 instances, including at a December 2025 Cabinet meeting while Secretary of State Marco Rubio spoke; during remarks at February's inaugural 'Board of Peace' meeting on Gaza negotiations; at an April Oval Office meeting; and during a Memorial Day ceremony at Arlington National Cemetery while Defense Secretary Pete Hegseth spoke. Critics have begun calling him 'Sleepy Don,' a pointed echo of his old 'Sleepy Joe' label for Biden. A February 2026 Reuters-Ipsos poll found that a majority of Americans, including 30 percent of Republicans, say Trump has become erratic with age.
The political calculus makes invoking the 25th Amendment virtually impossible, but the medical and behavioral evidence continues to accumulate, raising urgent questions about the president's fitness to lead.
