Is President Trump quite literally losing his mind?

That’s the explosive question that reporter Sharon Begley asked in a recent article published by STAT, a Boston Globe Media-owned website covering health and life sciences. In comparing Trump’s speech patterns today with how he spoke 25 to 30 years ago, Begley and the experts she consulted found a notable slide in his linguistic abilities. Begley wrote:

Research has shown that changes in speaking style can result from cognitive decline. STAT therefore asked experts in neurolinguistics and cognitive assessment, as well as psychologists and psychiatrists, to compare Trump’s speech from decades ago to that in 2017; they all agreed there had been a deterioration, and some said it could reflect changes in the health of Trump’s brain.

The article cites numerous examples, including video clips from 1987 and 1992 in which Trump is seen and heard speaking coherently and using complex sentences in interviews with Larry King and Charlie Rose. Those are accompanied by more recent videos in which, as Begley put it, “he repeats himself over and over, and lurches from one subject to an unrelated one.”

As a journalistic exercise, long-distance diagnosis is out there on the ethical edge. As Begley herself noted in an accompanying piece: “Lots of readers, and some other reporters, think it’s a terrible idea. They argue, rightly, that no one who is not a physician and who has not examined Trump can say anything authoritative about his health, mental or otherwise.”

Which is why it was wise for Begley and her sources to refrain from ascribing a cause to Trump’s inarticulateness. They all pointed out that the changes could be tied to age-related cognitive decline (Trump just turned 71), dementia, stress and exhaustion, or, conversely, a deliberate strategy of simplifying his language in a bid for votes and support.

In a Facebook discussion about the article, Begley said she wonders if Trump’s speech may improve as he gains confidence and becomes more comfortable with the presidency. That seems unlikely given the self-created chaos that has engulfed the Trump White House. Still, Begley is right to focus on objective observations rather than speculating on the underlying cause.

Bill Mitchell, a journalism ethics expert who’s affiliated with the Poynter Institute, praised Begley’s reporting, telling me in an email:

The problem with diagnosis from afar, of course, is that it claims to know something that really cannot be known. I don’t believe any of the clinicians interviewed by Begley fall into that trap. In the context of journalism ethics, reporters have no business presenting opinions as expert when they manifestly are nothing of the sort. Begley avoids that as well. As with most good journalism, Begley’s work here is especially strong in the showing and restrained in the telling.

For an example of why speculating on a president's health can be hazardous, consider the last time that a seemingly addled president was compared to his younger, silver-tongued self. During the presidency of George W. Bush, a video made the rounds depicting him barely able to get a sentence out during a debate with his 2004 Democratic challenger, John Kerry. In contrast, a clip of Bush debating education policy 10 years earlier with Ann Richards, his rival for the Texas governorship, showed him to be confident and in command of the facts and of the English language. Whoever put the video together asserted that Bush’s deterioration could only be explained by “pre-senile dementia.” Yet here we are, 13 years later, and Bush seems none the worse.

Bush, in particular, was a magnet for speculation about his health. A photograph of him taken from the rear while he was debating Kerry showed a bulge underneath his suit jacket, leading to rumors that it was some sort of radio receiver through which his political consultant, Karl Rove, was feeding him lines. That struck me and a lot of other observers as far-fetched. What seemed more likely, I wrote at the time in The Boston Phoenix, was that he might have been wearing a portable defibrillator. After all, he was wearing something during that debate, and he had suffered from a suspicious fainting spell in 2002.

Perhaps the overarching principle is that presidents receive and deserve very little privacy. Their health is a matter of public concern, especially with Trump, who has been as unforthcoming with his medical records as he has been with his tax returns. His changing speech patterns are there to be observed and analyzed. As for what those changes mean — well, only Dr. Bornstein knows for sure.