Those concerns gained renewed attention following Trump’s recent interview with TIME. The interview showed “moments of confusion, incoherence, and paranoia that look like windows into Trump’s mental state,” a politics writer for Slate summarized. “Suffice it to say that if any other president—or person—spoke the way Trump does, you’d probably worry about their psychological and perhaps medical well-being.”

Critics have long questioned Trump’s mental and cognitive health, though his Administration has repeatedly argued that the President remains fit to carry out presidential duties, citing regular checkups.

Lawyer George Conway, a Republican-turned-Democrat and a vocal Trump critic who has called for his removal from office since 2019, posted on X: “You can reasonably dispute the meaning of a lot Trump says because he’s so incoherent and inarticulate. But what you can’t reasonably dispute is that he is a sadistic and delusional narcissistic sociopath, at once both psychopathic and psychotic, who is lacking in morality, conscience, empathy, remorse, and impulse control, and whose only concern if a city (in any country, including ours) were to be wiped off the face of the Earth, would be how it affects him.”