Trump’s health questioned despite clean medical report, advisor says he may not finish term

A prominent Republican strategist is voicing serious concerns about President Donald Trump’s mental sharpness, suggesting his cognitive state may prevent him from completing his current term — despite recent medical reports declaring him in excellent health.

In April 2025, President Trump underwent a detailed medical exam involving 14 specialists. The report from Dr. Sean Barbabella concluded Trump had “robust cardiac, pulmonary, neurological and general physical function.” His cholesterol levels had improved, he had lost 25 pounds, and the neurological screening showed no signs of mood disorders or cognitive impairment.

At 78, Trump is the oldest sitting president in U.S. history. His doctors praised his active lifestyle and noted that he neither smokes nor drinks. The only physical concerns noted were minor sun damage and scarring from the July 2024 assassination attempt at a rally in Butler, Pennsylvania.

Political ally turned critic raises red flags

But Rick Wilson, co-founder of the anti-Trump conservative group the Lincoln Project, remains skeptical. In an interview with Times Radio, Wilson said Trump is exhibiting patterns of behavior that suggest possible cognitive decline, such as verbal confusion and disorganized speech.

“He is incoherent,” Wilson said. “The man you’re watching today is not the Trump of 2015 or 2020 — or even 2024.”

Wilson, who has tracked Trump’s political career for years, warned that the president’s current behavior might be early signs of mental deterioration. He called Trump’s ability to serve out the rest of his term “an open question.”

Trump’s 2025 medical report marked a shift from past election cycles, when his health updates were sparse and often overly flattering. This time, the release was more comprehensive — possibly in response to pressure to demonstrate physical and mental readiness after the 2024 election.

Despite the clean bill of health, Trump’s critics point to a lack of cognitive test results released after 2018. While the 2018 screening has been widely circulated by his allies, no newer cognitive evaluations have been shared publicly, even as concerns about aging have grown.

Trump’s campaign spokesperson Steven Cheung defended the president’s health and campaign stamina, noting Trump’s busy travel schedule. He also accused Vice President Kamala Harris — Trump’s 2024 opponent — of being less active on the trail.

Trump has reportedly long feared experiencing the same decline his father, Fred Trump, did late in life due to Alzheimer’s disease. According to journalist Timothy L. O’Brien, who spoke recently on MSNBC, those fears may be influencing Trump’s public behavior and political choices.

O’Brien suggested that Trump’s comments about staying in office beyond a second term reflect more anxiety than ambition, calling them “self-preservation more than strategy.”

Is the public seeing more than the doctors?

The central concern for critics like Wilson isn’t whether Trump can pass a medical screening, but whether those screenings reflect what voters are seeing on stage. Live speeches and interviews, they argue, offer a clearer window into the president’s cognitive state.

“There are professionals watching him now and seeing classic signs of cognitive decline,” Wilson said. “This is something Americans need to pay close attention to — not just what the report says, but what they’re seeing with their own eyes.”

Whether people agree — or whether these concerns will influence Trump’s leadership — remains to be seen.