Little Sister Resister: Dementia Don

Me again. Putting on my Speech-Language Pathology hat.

I have been a licensed speech-language pathologist since 1989. Most of those years I have worked with people with neurological disorders. I have helped hundreds, if not thousands, of people with strokes, dementia, ALS, and a host of other neurological problems.

I've been writing on this blog for a long time about the obvious neurological difficulties that this man has had. If you've been with me the whole time, you know I've published extensively about his speech, language and cognition problems. I first talked about his dementia symptoms in April, 2017: A Case for Dementia

I've tagged the relevant posts with Impairments, Speech Disorders, as well as Language, though this last one tags not only disorders of language, but also his rhetoric.

Speech pathology covers, as I like to say, everything that happens from the neck up. Voice, articulation, language (receptive and expressive, written and spoken), hearing and auditory processing, memory and cognition, and one area that I have not talked about up til now with regard to Hamberder Head: swallowing.

Dementia can affect most of those areas. So let's get to it, with new examples of his accelerating difficulties with cognition, communication, and swallowing.

Now we are nine years along, and his dementia is progressing. He's had a few whackadoo speeches lately, chock-full of evidence of dementia. You ready for some lessons in speech-language pathology?

We will examine two of his recent speeches, the one commemorating his one-year anniversary since inauguration v.2, and his hour long speech at the World Economic Forum in Davos, Switzerland. Disclaimer: I didn't watch the entirety of the speeches (🤮) but I skipped along, listening to random bits.

I'll be referring to points in these two speeches, but instead of my embedding them, please open the videos in new windows and zip to the time markers I mention.

The speech commemorating his one-year anniversary of the start of SCROTUS 2.0 on January 20, 2026. (From Forbes)

And his speech at the World Economic Forum in Davos, Switzerland on January 21, 2026. (From The Wall Street Journal)

Speech

He continues to exhibit increasing numbers of instances of distorted speech sounds. The /s/ sound is most noticeable, but you can hear imprecise or distorted phonemes throughout his speech. I showed many instances of his disordered speech in this post, and I won't revisit it in depth again.

I am, however, going to talk about a couple different aspects of his disorder: his voice and his swallowing.

Listen to the end of the Davos speech vs. the beginning. Listen to his voice. By the end, it's a little hoarser, a little more nasal, and a little wetter.

Let me explain.

Swallowing

The term for disordered swallowing is dysphagia. SLPs are experts in swallowing and swallowing disorders. Let's talk about dysphagia!

If you compare the beginning of his Davos speech to the end, you can hear his voice sounding more hoarse and at times, "wet." He also slurps his saliva quite a bit.

David Packman has complied a lot of the instances of his slurping a recent interview with Sean Hannity. Watch:

During the speech on January 20, he also has evidence of a build up of saliva, like at the moment at 4:37, where he suddenly has to swallow the large amount of saliva in his mouth. It's subtle, I know, but it's what my professional eye sees.

Also at 1:16:11, listen to how wet the mouth is on "Christopher Columbus." In my opinion, the distortion is not articulation, but extra saliva in his mouth. (And just after, not a swallowing disorder, but distorted speech: the very imprecise /k/ sound in "social security." The back of the tongue doesn't quite reach the velum there!)

Both of these disordered behaviors – the wet voice and the saliva build up – go toward dementia, but it's the sensorimotor sequelae rather than strictly motor, as in his disordered articulation (though, yes there is a sensory aspect to articulation).

We all swallow hundreds of times a day, without thinking about it. We swallow all day, and we swallow all night. We have a wonderful system of mouth-cleansing where, even when we are not eating, our mouth constantly produces saliva. When the saliva reaches a certain volume in our mouths, it triggers an automatic swallow.

When the brain becomes disordered or damaged, this automatic swallow can be disordered as well. The body might not feel the saliva build up, and the swallow doesn't trigger. The saliva builds until it becomes too much. At that point, the person may slurp it in to control it, or the person may drool.

I can't tell you how many people on my caseload have complained to me, "I produce too much saliva these days!" It's not more saliva; it's fewer instances of swallowing.

That's the sensory part of the disordered swallow. It may or may not have a corollary in swallowing while eating. We do not have many instances of DonOld swallowing functionally with food or liquid. He rarely even drinks water during his speeches anymore. His handlers probably don't allow him to, as it will provide more evidence of his disorder. Remember the awkward two-handed glass hold?

BUT! we can still see what is happening when he does swallow his saliva.

Listen at the end of his Davos speech, above. Play a little of the beginning of his hour-plus-long diatribe, and then scoot the player toward the end. Do you hear differences?

I do!

I can hear a slightly hoarse voice at the end. Understandable, since he has been talking for more than an hour nonstop and without water. But also, I hear a slight "wet" sound to his voice. Listen carefully and you can hear it.

This is his disordered swallow again. Some of the saliva that he is naturally and (mostly) automatically swallowing is hanging around the "wrong place." It is lying on top of his vocal folds, making his voice sound "wet."

Now, this is not a great place for liquids or food to be. Due to a design flaw, our airway and our food-way have a shared tube for part of the way, and a lot has to happen strongly, coordinately, and timely for our food and liquids to go down the right "pipe" and not down into the airway.

When the muscles are weakened or the coordination is off, foodstuffs can head down the "wrong way." When it goes all the way into the airway, this is called aspiration. Usually people will cough with this happens, and clear the material. We've all had that happen. My most embarrassing episode of aspiration was at a dysphagia conference when I aspirated the watermelon served to us at the break. Oh how I coughed!

In dementia patients, or patients with weakness or other neurological or structural disorders, a cough may not be strong enough, or may not occur. If the person's body doesn't sense the material, a cough might not be triggered at all.

In this man's voice, I can hear that a little of his saliva has fallen toward his airway, making his voice sound slightly wet.

I betcha that if we saw him eating or drinking, we would see him coughing, throat-clearing, or having a much more wet voice. All danger signs!

If food or liquid goes all the way past the vocal folds and into the lungs, it can lead to aspiration pneumonia, which is serious and often deadly. This is often the final cause of death among dementia patients.

Tangential to the disordered swallowing, I am also hearing increased instances of a mild nasal emission during his speech. You can especially hear it after a word ending in a nasal sound, of which there are three in English: /n/, /m/, and /ŋ/ (pronounced "ing").

To produce a nasal sound, the velum, or soft palate, must be very quick to relax so that a bit of air can go into the nasal cavity for the sound. Then, the velum returns to its active closed position, keeping the airflow of most speech sounds through the mouth.

You've had the experience when you have a cold and your throat and nasal passages are swollen and you can't get air at all into your nose. This makes your speech sound "de-nasal," where the /n/ sounds like /d/ and the /m/ sounds like /b/.

Or, you are familiar with the opposite. A few dialects in English are extra nasally, think Bobbi Fleckman in "Spinal Tap." It's part of her dialect to let her velum relax a little extra, letting more air go through the nose, making her voice sound nasal.

In the swallowing mechanism, it is important for the velum to move strongly up for two functions: to close off the nasal passage to incoming foodstuffs, and to help create intra-oral pressure for an effective swallow. So the fact that he is hypernasal means that his velum is weak, and this is not a great sign for his swallowing as well.

So. Back to this man's disorders? Listen to a couple spots in the Davos speech. See if you can hear just a little nasal air coming out when it really should have stopped when the previous nasal sound was finished.

Listen at about 1:05:54, after he says, "Come on in." Three nasal sounds in succession, and his velum doesn't tighten in time, letting a little nasal air escape, which is what we call nasal emission.

And at 1:06:09, after "where we've done it is amazing."

and at 1:07:06, after "not pirating."

Even very early in the speech, at 1:05, he has what I think is a little nasal outflow after "investment is soaring" and "incomes are rising."

All these instances are after phrases heavily loaded with nasal sounds.

Here's a speech thing and a slurp. At 57:27, he said, "one sat on the other" and then a slurp.

It is also very wet in his mouth when he slurs through, "it's such a problem. It's just so it will be so sad" during the January 20 speech at 1:08:58.

And again in the same speech at 1:18:22, "It was just an excuse I guess." So wet! Ick!

There may be more, but like I mentioned, I'm not keen on listening to the entirety of the speeches. These are just the ones I picked out by skimming through.

Disordered Language and Cogntion

Language and cognition go together and can influence behavior. Let's take a look at recent examples of these.

His tangents, or his "weave" as he calls it, are evidence of dementia. He strays off topic, he talks a lot, he never circles back to the point of his story. We can characterize all of this as logorrhea (yes, it's a real term), which is, like you've guessed, basically verbal diarrhea. That tracks. It's who he is.

He continues to have paraphasias, which is substituting a word with a similar meaning or a similar sound for the target word. Word-retrieval difficulties are also prevalent. Recent examples are:

He substituted "Iceland" several times when he clearly meant "Greenland" in the Davos speech, at 39:38

Similarly, conflating Denmark and Norway when whining about losing out on the Nobel Peace Prize. Remember the letter that he sent to the prime minister of Norway?

“We appreciate all of the cooperation we’ve been giving,” instead of “given" at 12:46 in the Davos speech
Saying "international murder" instead of "intentional murder" when talking about the mugshots he was presenting. 1:55 in the January 20 speech.

Not being able to come up with the word "Alzheimers" during an interview with New York Magazine.

The Independent described it this way:

During a lengthy interview about his health with New York Magazine, Trump, 79, struggled to remember the term while speaking about his father, Fred Trump, who died in 1999 at 93. Trump told the outlet his father had a “heart that couldn’t be stopped” and almost no health problems — except for one.

“At a certain age, about 86, 87, he started getting, what do they call it?” Trump asked, pointing to his forehead and looking toward White House Press Secretary Karoline Leavitt.
“Alzheimer’s,” Leavitt replied.
“Like an Alzheimer’s thing. Well, I don’t have it,” Trump added.

How meta!

His perseveration continues. He returns to the same ideas over and over (his cognitive tests, the 2020 election, Biden and Obama, sometimes mixing them up, the crap about water pressure), as well as the same phrasing, such as "like the world has never seen," "tremendous," "beautiful," "hottest country."

Disordered Cognition

You've been seeing an increase in the number of instances of really wacky, nonsensical stuff that this man has been coming up with. Here are just a few of the newest ones.

We see confabulation, we see "empty" speech – frequently using indeterminate words like "thing" or "whachimacalit" – or word-finding difficulties or paraphasias (substituting a related word or a similar-sounding word).

We also see nonsense. At 1:05:25 in the Davos speech, talking about California Gov. Gavin Newsom. He seems to have forgotten that he is supposed to hate Gavin, and also seems to have forgotten that he is currently president.

He says, "I know Gavin was here. I used to get along so great with Gavin when I was president. Gavin's a good guy."

Remember, all of this is superimposed over a lifelong personality disorder, malignant narcissism. Sometimes it's hard to tease out the cognitive difficulties from the apathy, logorrhea, hostility, and lack of empathy that come with narcissism. If you ever go back and listen to speeches from 20 years ago, and compare, though, you can see his language and speech are much worse now.

Disordered Behavior

There are a lot of recent instances of disinhibition, a hallmark of dementia. He impulsively acts, often inappropriately.

Not sure if this episode was planned. He had a stack of photos of criminal immigrants during his inauguration anniversary speech. I don't know what his handlers intended he do with them, or if he had printed them off himself. In any case, it was weird when he flipped through the photos, holding some of them up to the audience briefly, muttering as he went. It went on for about 10 minutes, but here is one minute of it.

Trump is just standing before reporters in the White House briefing room leafing through mugshots and riffing pic.twitter.com/Duv5oTGudC
— Aaron Rupar (@atrupar) January 20, 2026

During a meeting with top oil company executives, he suddenly got up to look at the hole in the ground that is to be his ballroom. Awkward chuckles from some of them at the meeting. So bizarre.

At the same meeting, Little Marco slipped him a private note. He took it and read it out loud, which he was not meant to do. Check out Marco's face. Some of the executives jumped in to cover, as Dear Leader was completely clueless.

Here was apparently a fart. Listen close at the very beginning of the clip. I am not sure if this is real, but if someone mocked this up, they could've done a louder shart.

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Disinhibition exemplified, at the end of this clip from the January 20 speech. And what the hell was all that about the binder clip? Did it really warrant 30 seconds of chatter? Also notice the paranoia as he tries to blame someone in the room for his flubbing a binder clip and almost catching his own finger. I haven't talked about it, but paranoia is another hallmark of dementia (as well as a hallmark of malignant narcissism, of course).

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This weird disinhibited imitation of Joe Biden (and a little projection/every accusation is an admission at the end).

This horrible imitation of a transgender weightlifter. What a terrible person.

*****None of this is normal, folks!*****

Then there is this weird policy thing about whole milk. It's not 47's disordered brain that came up with the milk thing, it's the worm-eaten brain of RFK. They have been talking about it as if whole milk is this newly discovered substance. That's beside the cognitive point, but there was this weird brain glitch:

And as he slurred his way through prepared comments, of course he had to riff, and his addled mind came up with this about whole milk. It's at timestamp 0:35.

Here's The Late Show's take on the whole milk thing.

Another moment of disinhibition. He was heckled during a visit to the Ford Plant in Michigan. Someone yelled out, "Pedophile protector!"

Who reacted? Why, the only pedophile protector in the room, of course.

He got mighty upset, and as befitting not a president of the United States but a disinhibited, demented pedophile protector, he said (or mouthed) "Fuck you," and he flipped the bird. See video here from TMZ. I am unable to embed it.

This photo. This is every dementia patient I've known, wandering the halls at the skilled nursing facility.

Other Stuff

He has been exhibiting difficulties walking, which I won't address here, but we know that this is also a sign of diminishing brain function.

His hand bruising continues, and it has appeared on the left hand. It's not from a misplaced high-five, nor from hitting a table, nor from shaking hands. He is getting IV medications of some sort. If you look closely, you can see the vein track.

I betcha it's diuretics to take off extra fluid, given his congestive-heart-failure-looking cankles.