Donald Trump cognition- Wash Rinse Repeat.: Covfefe?

Montreal Cognitive Assessment (MoCA),
the elephant question.

Echo opinion published in the Chicago Tribune newspaper by Jonah Goldberg

Donald Trump’s interview with Chris Wallace, which aired on “Fox News Sunday,” was remarkable in more ways than there is room to recount here.

But let’s start with what should be the lead story: The president of the United States told Wallace that the mental competence test he recently took was “very hard,” specifically the last five questions.
Just to be clear, Trump “passed” the test (Maine Writer, Paaaleeeze! It's not a "test"; rather, it's a cognitive assessment screening tool!)— a fact he’s boasted about on numerous occasions. “I aced it,” he proudly told Fox News’ Sean Hannity, earlier this month. 

Nevertheless, the problem is that none of the questions on the standard Montreal Cognitive Assessment (MoCA) test are supposed to be hard, if you aren’t suffering from dementia of some kind. Crowing that you “aced” the MoCA is like bragging that you passed a sobriety test, while sober.

The last five questions of the 10-minute, nine-task exercise assess things like basic abstract reasoning — e.g., how are a train and a bicycle alike? — and rudimentary memory. The final exercise, presumably hardest, according to Trump, simply asks the patient to provide the date, time and location of the examination.

We should all hope the guy with the nuclear codes can “ace” this test. Some might even say we should have a president who didn’t find it “very hard” to ace it.

Trump’s bragging about his test results may simply be part of his strategy to cast presumptive Democratic nominee Joe Biden as “not all there.” But it’s hard to fathom why the Trump campaign thinks this is a shrewd gambit.

In Sunday’s interview, Wallace asked Trump point-blank, “Is Joe Biden senile?”

“I don’t want to say that,” Trump answered. “I’d say he’s not competent to be president.” (Hello? Vice President Joe Biden was competent to be president according to the US Constitution!) At first, it seemed the president was opting to take the high road. But he then went on to say, “Joe doesn’t know he’s alive, OK? He doesn’t know he’s alive.” And, later on, “He’s shot, he’s mentally shot.”

Perhaps he’s seen data suggesting attacks on Biden’s age don’t play well with senior voters, so the task is to claim Biden is mentally handicapped but not as a result of his age? That’s a level of nuance we’d expect of someone who aced a cognitive evaluation, but not what we’d associate with Trump’s political style.

Regardless, the whole strategy of attacking Biden as mentally incompetent is (wrong minded).... and risky. 

Forget that such tactics were once considered beyond the pale. And put aside the entirely reasonable conclusion that Biden does indeed show his age quite often — and that he’s always had a propensity to say weird things. The Trump campaign is now betting his reelection’s already slim chances on Biden proving Trump’s diagnosis is right.  (But, Donald Trump is completely incompetent to diagnose anything, he has no qualifications to diagnose.)
One of the central tasks of campaigning, and politics generally, is managing expectations. Beating expectations in a primary makes you a winner. Falling short has the opposite effect. For instance, Lyndon Johnson won the 1968 New Hampshire primary by seven points but fell so far below expectations that he withdrew from the race. Trump has benefited from early warnings that the U.S. could see millions of deaths from COVID-19, so the current — and rising — death toll of “only” 143,000 beats expectations.

As of now, all Biden has to do to beat the expectations laid out by Trump is prove he knows he’s alive — a very light lift. In normal times, presidential campaigns work hard to set expectations for the opponent unreasonably high.

Before Trump’s first debate with Hillary Clinton in 2016, for example, then-RNC Chairman Reince Priebus said, “The expectations on Hillary are very, very high. She’s been doing this for 30 years. I think people expect her to know every little detail. She has to perform in a way that is of the highest of expectations. I think in the case of Donald Trump, look, he’s the outsider, he’s a person who’s never run before, let alone be in a presidential debate.”

In other words, if Trump even held his own in the debate, he should be declared the victor? (I don't think so!!!~ ugh!)

Given that Vice President Joe Biden's lead in the polls continues to widen, there’s no rush for him to call off his front-porch-style campaign. But, after months of Trump’s flailing, erratic and increasingly desperate attacks on Biden as a near vegetable, all Biden will have to do is come across as a reassuringly normal, pleasant, albeit gaffe-prone and competent leader. Biden, despite his flaws, seems up to that.

If the Wallace interview is any indication, it’s Trump who struggles to meet that remarkably low bar.

Jonah Goldberg is an editor-at-large of National Review Online and a visiting fellow at the American Enterprise Institute.

And the Guardian newspaper wrote this:  

The test is called the Montreal Cognitive Assessment (MoCA), and was created by the neurologist Dr Ziad Nasreddine in 1996. Talking to MarketWatch on Monday, Nasreddine stressed that the test “is supposed to be easy for someone who has no cognitive impairment”, saying that “this is not an IQ test or the level of how a person is extremely skilled or not. The test is supposed to help physicians detect early signs of Alzheimer’s.”

There are a few different versions of the test with small variations (such as the words to remember or animals to name), but the questions are generally the same. We can’t tell for sure which version Trump took, but as he said he did it recently, I’ve taken the latest MoCA test from their website.

Trump is right about the start of the test being easy. But when it comes to the last five questions, his claim that they’re “very hard” is unsettling (although not surprising) in what it reveals about his relationship with reality.

But before we dive into that, here’s what the test involves:

The first few questions are indeed “easy” – although it goes without saying that anyone experiencing cognitive problems is supposed to find it hard, and the point of the test is to help diagnose their condition.

First, you have to draw a line between numbers and their equivalent letters (1 to A, A to 2, 2 to B and so on). Then you have to draw a cube, and a clock at 10 past 11. Call it what you will – millennial-itis, lockdown brain – but this was actually a slight challenge as I can’t remember the last time I looked at a clock that wasn’t on my phone or laptop. So yes, it took me a second to remember that the minutes are all multiples of five – for 10 past the big hand points to two. But I figured it out in the end, and that’s all that matters.

The ‘elephant’ question

If you’re lucky enough to not have any cognitive impairment, this part is also easy. There are three drawings – a lion, rhino and camel. As mentioned, there are a few versions of the test with very minor differences – for example, the test Fox News showed during the interview had an elephant on it, but the latest test has a rhino instead. This has led some of Trump’s critics to baselessly claim that he can’t tell the difference between the two.

Repeat after me – and do some maths

Both of these sections are very simple, and involve repeating a series of numbers forwards and backwards, and remembering a string of five random words. The final part, which Chris Wallace mentioned, asks you to count back from 100 in multiples of seven (100, 93, 86). Like the clock, this took me slightly longer than I would have liked – but nowhere does it say this is a timed test. I did it in the end, slowly but surely.

The difficulties begin

This is where things get a little concerning.

If you remember, Trump bet Wallace that he “couldn’t even answer the last five questions” of the test. But for a mentally healthy person, the last five questions should be as simple as the rest.

The fifth-to-last question on the test asks you to repeat a sentence out loud, before naming as many words as you can starting with F. In the following “abstraction” section, you have to spot the similarity between different objects such as trains and bicycles (modes of transport), or a watch and a ruler (measuring devices).

Next, you have to recall the random words that were included in the earlier memory section. This may be the part that’s easiest to trip over.

And finally, for the orientation part of the test, you have to … say what the date is.

For Trump to claim these are hard is worrying because for any cognitively healthy person, they shouldn’t be. But before we start any armchair diagnosis, you have to weigh up two probabilities against each other. Is it really likely that he found the last five questions hard? Or is it more likely that he’s misrepresenting about how hard they were, in order to look “smarter” than Joe Biden?

In the same interview, Trump got his team to pass him a chart that he said showed the US had “one of the lowest mortality rates in the world”, when it didn’t do anything of the sort. This is shocking, but not surprising – Trump has now made more than 20,000 false or misleading claims since he took office.

So it seems more likely that Trump’s difficulties at the end of the test tell us nothing that we don’t know already. His prolific lying and self-aggrandisement, two things we have empirical evidence for, should be what worries us. For, similar to his “stable genius” claims, you’ve got to ask yourself: how many smart people brag about their supposed intellect so much, and in such a misguided way?

• This article was amended on 24 July 2020. To ensure that the memory section of the MoCA test remains valid for future participants, two images which revealed the answers to that section have been removed. (Maine Writer: The purpose of the cognitive evaluation tool is to assess memory capacity regardless if the image presented to the test taker is an elephant, a giraffe or a rhinoceros.)

America faces an epic choice ...