Concerns about Donald Trump’s mental and physical fitness to serve as Commander in Chief have circulated for years, particularly among his critics. While Trump and his allies have repeatedly questioned President Biden’s mental fitness, often since Trump’s first term, the pattern can feel less like analysis and more like projection—what’s happening in Trumpland being cast onto others. One pattern I can’t unsee is that when Trump or his allies point the finger at someone else, it often reads like a confession—his own vulnerabilities projected outward, likely rooted in deep‑seated insecurity.
On New Year’s Day, The Wall Street Journal published an article titled “As Signs of Aging Emerge, Trump Responds With Defiance,” detailing Trump’s own comments about his health, habits, and visible signs of aging. Some of the questions about his health are addressed there, though not in a way that supports his preferred narrative of “perfect” health. After the piece ran, Trump lashed out on Truth Social, attacking coverage of his age and health—hardly a reassuring response.
What we do know about Donald Trump’s health comes from what has been reported by the White House, his physicians, and his own interviews. Recent coverage notes his visible hand bruising, that he was diagnosed with chronic veinous insufficiency, he has had multiple cognitive assessments–which Trump claims he aced, and he recently underwent advanced imaging.
The article didn’t really ease any of my concerns about Trump’s fitness to hold office, and in many ways, makes me a bit more concerned. When Trump embraces shaky health narratives—whether about himself or others—it raises the question of whether he’s misled, misleading, or simply uninterested in the difference. Whether he truly believes he has a clean bill of health or not, his attitude about his health is troubling.
Trump dismisses exercise as boring—“To walk on a treadmill or run on a treadmill for hours and hours like some people do, that’s not for me,” he tells The Journal. His long‑documented preference for fast food, combined with his reported weight placing him in the medically obese range, are all factors that, according to cardiology guidelines, increase the risk of heart disease. That context makes his heavy reliance on aspirin more notable.
In the WSJ interview, Trump reveals that he takes 325 mg of aspirin every day—about four times the common 81 mg “low‑dose” regimen often used for cardiac prevention—despite his doctors recommending he switch to a lower dose. He says he has been taking it for years because he’s “a little superstitious,” explaining, “They say aspirin is good for thinning out the blood, and I don’t want thick blood pouring through my heart. I want nice, thin blood pouring through my heart. Does that make sense?” To answer his question, not really–You don’t want thick blood, but if a person’s blood is too thin, that leads to a higher risk of bleeding, especially internal bleeding, though it does make the easy bruising on his hands more believable.
He also casually describes his hand starting to bleed when Attorney General Pam Bondi gave him a high‑five while wearing a ring at the 2024 Republican National Convention. The WSJ reports that witnesses were “alarmed” by the amount of blood and that aides say similar cuts have occurred multiple times. Trump downplays it as a “slight little cut,” but minor nicks that bleed enough to alarm staff are consistent with the increased bruising and bleeding risk he himself links to his aspirin use.
The article also discusses his sleepless nights, which are unfortunately very obvious by his 3 a.m. posts on his social media. Trump admits to texting and calling aids at 2 a.m. or later. Trump says he has “never been a bigger sleeper.” It has also been said that he keeps his advisors awake on Air Force One trips. to the point that they developed a rotation so someone is always awake for Trump to talk to while the others sleep—something he reportedly teases them for. Sleeping is a human necessity, Mr. President. In typical Trump fashion, he objects to media’s accusations of him nodding off in public events and important meetings, saying, “I’ll just close (my eyes). It’s very relaxing to (me),” and blaming unflattering shots on being caught mid‑blink. The footage, however, tells a less flattering story.
In his interview Trump leans on “very good genetics” and insists that genetics are very important. That sent me digging into his family history. Trump’s niece, Mary Trump–a clinical psychologist with a PhD–has been outspoken about how “Trump’s alarming decline” makes his position of power “dangerous.” She argues that as Trump ages he is becoming more insecure, and the more insecure he becomes, his behavior becomes more extreme in an effort to maintain power and influence.
Mary has a unique vantage point: Donald Trump’s father, Fred Trump, Sr., is her grandfather. She has described her grandfather as a “high-functioning sociopath,” though she has been a little more kind in how she describes her uncle and has framed Donald’s personality as a product of growing up in the toxic, hyper‑competitive environment Fred created, where winning at all costs—including lying and cheating—was rewarded. In her public commentary and writing, she has referred to Donald Trump as a compulsive liar, a label that aligns with his long‑documented pattern of false and misleading statements.
In a Daily Beast podcast interview, Mary Trump says, “There are times I look at him and I see my grandfather. I see that same look of confusion. I see that he does not always seem to be oriented to time and place. His short‑term memory seems to be deteriorating.” Fred Trump Sr. died at 93 with a diagnosis of dementia, and Mary has described watching his decline begin with “small lapses” that escalated into more obvious memory failures.factually.co Her perspective is shaped both by that personal experience and by her clinical training in recognizing cognitive impairment.
While anything that doesn’t come directly from his doctors or from Trump himself remains speculative, the combination of his family history of dementia, Mary Trump’s observations about his confusion and orientation, and his own accounts of erratic sleep and late‑night posting understandably fuel public concern about his cognitive health. Trump was raised to hide weakness, and former administration officials have acknowledged efforts to conceal aspects of his health from the public—for example, downplaying the severity of his COVID infection during his first term. Trump insists he is in “perfect” health, but his behaviors, his visible signs of aging, and the contradictions between his rhetoric and the reporting tell a more complicated story.
*None of this is a diagnosis; it’s a reading of publicly available reporting and commentary.*
