Concerns about Donald Trump’s health and mental sharpness have resurfaced as he campaigns for a potential second term. Republican strategist Rick Wilson recently warned that Trump appears to be in cognitive decline, frequently losing his train of thought and showing signs of verbal confusion. Wilson argues that these aren’t isolated gaffes but part of a growing pattern of disjointed speech and lapses in focus, suggesting the former president may no longer possess the mental stamina for the presidency.

Trump’s health has drawn attention before, including a mysterious visit to Walter Reed in 2019 and hospitalization for COVID-19 in 2020. However, a recent medical report from April 2025 described him as being in “robust” physical and cognitive health. The report, signed by 14 medical specialists, noted weight loss, improved cholesterol, and no signs of memory or mood issues. Still, Wilson believes a clean bill of health on paper doesn’t reflect Trump’s real-world behavior during public events.

This conversation mirrors ongoing scrutiny of President Joe Biden, who at 81 has faced similar doubts about age and cognitive ability. With both leading candidates already the oldest in U.S. history, the issue of age and fitness has become central to the 2024 election. Some Americans are now questioning whether age or cognitive testing should be required for high office, especially with both Biden and Trump approaching or exceeding 80.

Trump’s team has dismissed Wilson’s comments as politically driven, pointing to his active campaign schedule as proof of vitality. Critics, however, see cause for deeper concern. If Trump were to win and become unable to serve, the 25th Amendment would allow for a transfer of power, but such a scenario would likely be contentious. As the election approaches, one thing is certain: questions about fitness for office won’t be going away—and they may influence the outcome more than ever before.