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The test "was designed as a rapid screening tool for mild cognitive dysfunction — a loss of memory and clear thinking ability that sometimes precedes dementia."
Trump, who had said in a Fox News interview on July 9 that he had taken the cognitive test "very recently" at Walter Reed, said two weeks later in his famous "Person, Woman, Man, Camera, TV" interview on Fox on July 22 that during his most recent trip to a hospital "a little less than a year ago," he specifically asked if there was "some kind of a cognitive test that I could take".
The memorization portion of the test account for five points, but without more information, we have only Trump's word to go by as to whether he did better or worse than the average person without cognitive impairment.
Jackson (after nine-month gap that included a short stint as Trump's nominee for Director of Health and Human Services that fell apart because of various scandals that emerged about Jackson's time in the White House that ultimately led to his demotion from the rank of rear admiral to captain) did move to the newly created role of Chief Medical Advisor to the President (a now vacant position in which Dr. Anthony Fauci served for two years starting in January 2021), but that came to an end in December 2019.
(It's probably notable that Conley, in November 2019, wrote in a memo that what seemed like a sudden, unexpected trip by Trump to Walter Reed three days earlier was actually just part of Trump's regular preventive care and included just an hour of "examinations, labs, and discussions" followed by a tour to visit wounded military personnel.
Setting aside the fact that even that revisionist story has some holes, what is clear is that Conley's accounts of Trump's health cannot be fully trusted.)
source: The inside scope: How ego led Trump to hide a colonoscopy - POLITICO In other words: Trump doesn't describe the test accurately, he isn't clear about when he took it, and come on: it's just really weird for any adult, much less the President of the United States, to be boasting about passing a test normally given only to people who are suspected of suffering from cognitive decline.
My suggestion is that one sentence be added to this article's "Leadership Style" section (which is pretty good) along these lines: "In January 2018, Dr. Ronny Jackson, the Physician to the President, reported that, in a first for a sitting president, Trump had taken and passed the Montreal Cognitive Assessment, despite Jackson seeing no reason to administer the test, which is normally given only to patients who show signs of mental impairment; in July 2020, Trump boasted about his achievement on the test, which he said was "not that easy," adding that he had taken it either 'very recently' or 'a little less than a year ago,' in order to silence people who questioned his acuity."