A significant majority of American adults harbour doubts about Donald Trump’s mental sharpness for the duties of the presidency, according to recent polling. A March 2024 AP-NORC survey found 57% believe he lacks the necessary memory and acuity for the job, a sentiment echoed in other polls. This public scepticism persists despite the former president’s frequent boasts about his cognitive prowess, including claims he aced a “very hard test”.
That test, taken in January 2018, was the Montreal Cognitive Assessment (MoCA), a screening tool for mild impairment. His then White House physician, Ronny Jackson, confirmed Trump achieved a perfect score of 30/30. However, neurologists note such a result from six years ago holds little relevance to a current assessment. Trump has since distorted details of the test, recently claiming it involved identifying a drawing of a “whale”, an element not in the standard MoCA.
Public Perception and Puzzling Incidents
This gap between self-proclaimed ability and public perception is underscored by a series of reported incidents. He allegedly interrupted a cabinet meeting to discuss a conversation with the head of the Sharpie pen company about supplying bespoke pens, a conversation the company said it had no record of. During a press conference with Japanese Prime Minister Sanae Takaichi in March 2026, he made a baffling joke about Pearl Harbor, asking “Why didn’t you tell me about Pearl Harbor?” when questioned about not notifying allies before a strike on Iran, leaving the prime minister visibly alarmed. On another occasion, he referred to the Strait of Hormuz as the “strait of Trump”.
Yet, in a notable shift, a July 2024 Pew Research Center survey indicated 58% of voters now describe Trump as “mentally sharp,” a higher rating than he received in 2020. For context, only 24% described his likely opponent, Joe Biden, the same way. The concern, however, transcends partisan politics and centres on the practical execution of presidential power, particularly in times of crisis.
The Limits of Constitutional Safeguards
This raises a critical question: what constitutional mechanisms exist to check a president’s will if their capacity is in doubt? The frameworks are established, but their practical application is fraught with limitation.
In matters of war, the Constitution grants Congress the sole power to declare war. To curtail executive overreach, the 1973 War Powers Resolution requires a president to notify Congress within 48 hours of committing troops to hostilities and limits such deployments to 60 days without congressional authorisation. Despite this, a significant troop buildup is underway. As of 30 March 2026, thousands of soldiers from the U.S. Army’s 82nd Airborne Division have arrived in the Middle East, with discussions reportedly including potential operations to seize Iran’s Kharg Island or secure the Strait of Hormuz. Some Republican lawmakers, like Representative Nancy Mace, have expressed concern after classified briefings, stating the military objectives presented to Congress differed from those shared with the public.
For a more direct intervention regarding a president’s fitness, the 25th Amendment provides a path. Its Section 3 allows for the voluntary, temporary transfer of power, used by presidents like George W. Bush and Joe Biden for medical procedures. The more consequential, and never-used, Section 4 allows the vice-president and a majority of the cabinet to declare the president unable to discharge their duties. If the president contests this, Congress must decide the issue with a two-thirds vote. The exceedingly high bar for invocation means it is a political nuclear option, reliant on the courage of a president’s own appointees.
The Power of Loyalty and Concealment
In practice, these constitutional safeguards are only as robust as the resolve of a leader’s inner circle, which is often defined by fierce loyalty. History is replete with examples of health realities being shielded from the public. The 2025 book *Original Sin* by journalists Jake Tapper and Alex Thompson, based on over 200 interviews with Democratic insiders, claims Biden’s aides privately discussed the potential need for him to use a wheelchair if re-elected, a concern his physician Dr. Kevin O’Connor had reportedly raised. The Biden administration maintained his stiffened gait was due to spinal wear and tear and was “far from ‘severe'”.
This pattern of concealment is longstanding. The public learned only after his death that President John F. Kennedy was administered a cocktail of amphetamines and steroids during the Cuban Missile Crisis. Similarly, Britons were unaware at the time of Winston Churchill’s heavy drinking, noted by President Franklin D. Roosevelt, or that Harold Wilson likely had the beginnings of dementia during his final days in office.
The motivations for such silence are complex, blending fear of reprisal or panic with a protective, even loving, loyalty forged in political trenches. This creates a dilemma akin to that faced by families with aging relatives: the conflict between the fear of intervening too early and the guilt of acting too late. In the geopolitical sphere, the stakes are magnified to a global scale, with the article noting an estimated 45 million people at risk of acute hunger due to fertiliser shortages stemming from disruption in the Gulf—a direct consequence of presidential decision-making. Ultimately, without a political inner circle willing to invoke them, the constitutional safety mechanisms remain theoretical, leaving the stability of international order resting on a combination of hope, polling, and the volatile reactions of financial markets.
