There is a test called the Montreal Cognitive Assessment. It was invented in 1996 by a Canadian neurologist called Ziad Nasreddine, who is Canadian, which is a country underneath Greenland where the people are polite as a defense mechanism.
The test is one page long. It takes ten minutes. You draw a clock. You copy a picture of a cube. You look at some drawings of animals and say what they are. Then somebody says five words at you, and five minutes later they ask you to say them back.
It is not an intelligence test. Doctors give it to people to find out whether they have dementia. It is designed to be easy, because the entire point of it is that failing it means something is wrong. It is the medical equivalent of asking someone to walk in a straight line. Nobody has ever walked in a straight line and gone home and told their wife about it.
Donald Trump took this test in 2018 and got thirty out of thirty, which is what you get if nothing is the matter with you.
He has been talking about it ever since.
The five words
The first time most people heard about it was July 2020, when the President went on television to explain to a doctor how well he had done on a test that the doctor already understood.
He said the last questions were the hard ones. He said one was a memory question. He said it goes like this: person, woman, man, camera, TV. And then they ask you to say it again, and you say it, and then fifteen or twenty minutes later they ask you again, and you say it again, and the doctors say that’s amazing, how did you do that.
I want to be fair to him here. Five words is more than four words. If they had asked him for six words we might be having a different conversation.
But there are some problems with this, and the first one is that the man who invented the test says the words are always unrelated to each other on purpose, because relating them makes them easier to remember, which is the opposite of what you want in a test about remembering. Person and woman and man are three words for a person. Camera and TV are both a box that does pictures.
So either the President was given a special easy version of the test, or he has spent six years reciting five words that were never said to him. Both of these are worse than the other one.
The second problem is the fifteen or twenty minutes. The actual test says five minutes. He has therefore misremembered, in a story about his memory, the amount of time he was asked to remember something for.
The third problem is that he said if you get them in order you get extra points, which sounds like the sort of thing a man says when he is about to tell you he got extra points, and which is not a thing the test does.
The animals
This is where it becomes properly astonishing, and I say astonishing in the way that a car accident is astonishing rather than a sunset.
In January 2024, in New Hampshire, the President described the animal bit. He said they show you the first one, like a giraffe, a tiger, or a whale, and they say which one is the whale.
The Washington Post called Ziad Nasreddine, the man who made the test, and asked him about the whale. He said, and I am quoting a neurologist here so pay attention, that he did not think they had a version with a whale.
There are three versions of the test in circulation. The animals are a lion, a camel, and a rhinoceros. There has never been a whale. There has never been a whale because a whale is a difficult thing to draw in a small square and because the whole point of the animals is that one is easy, like a lion, and the others are harder to say, like rhinoceros. A whale is neither. A whale is just a big fish that isn’t one.
In October 2025 he told it again and the animals were a tiger, an elephant, and a giraffe.
In May of this year he told it again on an airplane and the animals were a lion, a bear, an alligator, and a squirrel, and the question was which one is the squirrel.
I have watched this clip several times. A man who is the President of the United States told a group of journalists, with pride, that he had been shown four animals and had successfully identified the squirrel.
The lion is on the test. The bear is not. The alligator is not. The squirrel is not.
He has now described this test at least four times over six years and produced a giraffe, a tiger, a whale, an elephant, a bear, an alligator, and a squirrel. That is seven animals. One of them, the lion, appears on the test, and he mentioned it last, in 2026, after eight years.
If you gave a man a memory test and he told you about it seven different ways with a different animal each time, you would not conclude that his memory was excellent. You would conclude something else, and then you would probably want to talk to his family about it.
The last five questions
In the summer of 2020 he was interviewed by Chris Wallace, who used to be on Fox News before Fox News decided it did not want the sort of person who asks things.
The President told him the first few questions were easy but he bet Wallace could not answer the last five, because they get very hard.
The last five questions of the Montreal Cognitive Assessment ask you what the date is. They ask you what month it is. What year it is. What day of the week it is. What city you are in.
He looked at a journalist, on television, and bet him he did not know what year it was.
Wallace, to his enormous credit, said that he had taken it and it was not hard, and described the bit where they show you a picture of an elephant and ask what it is. And the President said yes, that’s the first question. Which means for one shining moment they were both discussing a test only one of them had described accurately, and it was not the man who had taken it.
Three of them, apparently
In May 2026 he opened with the line that no president has ever taken a cognitive test except him, and that he has taken three of them.
I have thought about this sentence for some time.
The first half is not true, because presidents get physicals and physicals include this sort of thing, and also because there is no register of presidential cognitive tests, so what he means is that no president has ever gone on television afterwards to talk about it, which is true, and which is the point, and which he has now told us three times.
The second half is the part that stays with you. He has taken it three times. This is a test that screens for cognitive decline. Nobody takes it three times because they enjoyed it. It is not a fairground ride. Taking it three times is not a boast. It is a medical history.
He said it as a flex. It is on tape. He said the number three out loud the way you would say the number of countries you have visited.
What this is actually about
Here is the thing I keep coming back to, and then I will stop.
The hair, the face color, and the shape are all choices, made daily, at length, to his specification, and calling them accidents let him off a hook he built himself. Only the smell is unprovable, and the paragraph now says that unprovability is exactly why it caught on, because unprovable is another word for endless.
The stronger distinction turned out not to be provable versus guessed. It’s that all of that is still only what he looks like, which is the weakest available charge, since plenty of ridiculous-looking people have been perfectly competent. The cognitive test is different because he built it out of words, into a microphone, on purpose, for six years, unprompted.
This is different, because he did it to himself, on purpose, on camera, repeatedly, over six years, without anybody asking him to.
Nobody made him bring up the dementia test. Nobody put the whale in his mouth. There is no version of events in which a hostile journalist tricked him into announcing that he had correctly identified a squirrel. He walked out to the press with that, willingly, as his best material.
And the thing he was trying to prove, every single time, was that his memory works. That is the whole reason he tells it. It is a story specifically about the reliability of his recall, deployed to establish that his recall is reliable, and he has never once told it the same way twice.
The doctors said that’s amazing, how did you do that.
Well. Quite.
I’m a retired, 30-yr career Canadian Family Doctor, worked also in hospitals my whole career, worked also P.T. in my hospitals’ Emerg. Dept.’s 1990-2004, and delivered babies (over 1000, by 2018). Keeping up-to-date, meant knowing how to find blank copies of the MoCA, I knew it well. I’ve been trying to say, the President is not saying the truth about this test (and, I knew immediately when he said “Man, woman, person, camera, TV”). Also, he clearly does not understand the PURPOSE of the test, and talks about it like it’s an IQ test. Thanks for so clearly explaining how wrong he is. Note that this is the man who is re-setting U.S. Economic Policy, and U.S. Immigration Policy, with every wave of his hand; the same man who misunderstands the purpose of a “Screening Test for Cognitive Impairment”.
My dear old mom is 94, with very advanced dementia now: About 3-or-so years ago, a Nurse in a Geriatric-Specialist’s office, gave her a form of this test. One question, is either a serial-subtraction test, or asked as “Spell WORLD, backwards”. And my mom could actually spell “D-L-R-O-W”. BUT, she did not know the City (same one she’d lived in since 1970), the Day, whether it was morning or afternoon, or what Season it was. Later, however, in front of the doctor, she calmly argued that she probably could re-start her past 25-year career as a Travel Consultant, if only she just “brushed up on the modern procedures”. “Travel”, hmm!, which no doubt relies heavily on you knowing the date, the season, and “what city you are in”.
This is not her fault; this is “a symptom” of Advanced Dementia, of no longer understanding what you’ve lost, what you no longer know, and of “being unaware” of the extent of your own disability. It’s called “Anosognosia”, or sometimes called just “Lack of Insight”. Your President has this. God help the USA.
I’ve read, on various social media sites, that he (trump) is being treated with Alzheimer’s disease infusions either once monthly or twice monthly. Infusions are typically an hour or so in an upper extremity. Cognitive tests such as the MoCA are given routinely. MRIs to determine whether plaques in brain have reduced, are also performed. The hand bruising, the frequent trips to Walter Reed, along with some pretty obvious behavior and speech patterns and a parent who died with the disease speak for themselves. The Republican Party, billionaires and trillionaires, as well as foreign actors hit the jackpot with their hand puppet.