I do not wish Trump ill. While he hasn’t shown a shred of compassion for anyone other than himself, this doesn’t justify any of us lacking compassion for him.

It’s also in the interest of the US and the world that he be physically and mentally able to discharge the duties of his office.

So we have reason to be concerned about Trump’s visit to Walter Reed national military medical center last week for what the White House described as a “routine annual dental and medical assessment”. (A memo from Trump’s physician released over the weekend by the White House said Trump “remains in excellent health”.)

Trump turns 80 next month. I feel entitled to comment on the practical meaning of this milestone because I’ll also turn 80 next month (he was born 10 days before me).

Let’s just say that reaching it doesn’t mean altogether good things, unless you consider the alternative.

Even in a healthy person, small things begin to break down as one approaches 80. Everything takes just a bit more time and effort. Joints ache. Energy isn’t quite as abundant.

The 80-year-old mind isn’t as quick. The frontal lobe’s capacity to remember names goes to shit. (Yesterday, I could barely remember the name of a garage mechanic whom I’ve known for nearly half a century.)

Taken separately, such minor frailties typically mount to no more than a personal frustration. In a president of the United States, they can pose a major challenge to the nation and world.

Trump frequently proclaims he’s in excellent health. “Just finished my 6 month physical at Walter Reed Military Medical Center. Everything checked out PERFECTLY,” he wrote on Truth Social early Tuesday afternoon. “Thank you to the great Doctors and Staff! Heading back to the White House.”

But even “PERFECTLY” is a relative concept for someone ending his eighth decade and beginning his ninth, who’s the oldest person to assume the presidency and the second-oldest to hold the office. (Joe Biden was 82 when he left in 2025.)

Presidents aren’t legally required to release their medical records but, given the effluvium of lies in which Trump permanently floats, we’d be excused if we didn’t entirely trust this “PERFECTLY” report.

Plus, there are his bruised hands, swollen ankles, bouts of drowsiness, exceedingly long blinks during official meetings (some call them “naps”) and erratic – if not off-the-charts weird – behavior.

Add in the frequency of his health “checkups”.

Tuesday’s visit to Walter Reed was Trump’s third in-person doctor’s visit in a little more than a year. His first physical of this term of office was in mid-April last year. He returned in early October for a “semiannual physical”. In early January, he had what was described as a brief dental appointment. Earlier this month, another dental appointment. Followed by his return to Walter Reed on Tuesday for his third physical in 13 months.

Consider also the shifting explanations. In July, navy Capt Sean Barbabella, Trump’s physician, explained that the bruises on Trump’s right hand were “consistent with minor soft tissue irritation from frequent handshaking”. The explanation seemed plausible until the bruises spread to his left hand.

There’s also the changing story about Trump’s scans. In December, he told reporters that he’d had an MRI in October, but wasn’t sure what part of his body was scanned. “It wasn’t the brain,” he said, defensively, “because I took a cognitive test and I aced it.” Barbabella then issued a memo explaining it had been a scan of his heart and abdomen, and that in both cases the imaging was “perfectly normal”.

In January, Trump altered his story to say it was a CT scan rather than an MRI. Why? Trump being Trump, presumably he doesn’t want anyone to know anything about his health that might reveal something he fears enemies and critics might see as a weakness.

“In retrospect, it’s too bad I took [the scan] because it gave them a little ammunition,” Trump said. “I would have been a lot better off if [I] didn’t, because the fact that I took it said: ‘Oh gee, is something wrong?’ Well, nothing’s wrong.”

What’s he afraid of? Probably that the American public will catch on to his diminishing capacities.

Three years ago, according to a Washington Post/ABC News/Ipsos poll, only 28% of the public thought Trump insufficiently healthy to hold the nation’s highest office. This month, the same poll found that 55% of the public thought his health insufficient for him to serve effectively.

Behind the public’s mounting worries is a growing sense that Trump isn’t mentally all there.

Physical and mental health aren’t easily separated, especially as one reaches 80. I often can’t remember where I put my wallet and keys or why I’ve entered a room. I also have less patience than I used to have. (I’m less tolerant of long lines, automated phone menus and Republicans.)

But if Trump can’t remember where he put, say, a top-secret memo or why he entered the Situation Room, or if he expresses bizarre impatience, it’s a potential risk to the nation and world.

“Open the Fuckin’ Strait, you crazy bastards, or you’ll be living in Hell,” Trump exploded on Easter morning, adding an Islamic prayer to the end of the post.

The following Tuesday, he threatened that unless Iran struck a deal in 12 hours, its whole civilization would die.

When Iran shot down two US airmen, aides who were getting minute-by-minute updates reportedly kept Trump out of the Situation Room because they believed his impatience wouldn’t be helpful, a senior administration official said.

Then came Trump’s rant against the pope.

Pope Leo is WEAK on Crime, and terrible for Foreign Policy. … I like his brother Louis much better than I like him, because Louis is all MAGA. He gets it, and Leo doesn’t! … Leo should get his act together as Pope, use Common Sense, stop catering to the Radical Left, and focus on being a Great Pope, not a Politician. It’s hurting him very badly and, more importantly, it’s hurting the Catholic Church!

During a subsequent Q&A with reporters, Trump doubled down: “I don’t think he’s doing a very good job. He likes crime, I guess. … I am not a fan of Pope Leo.”

Days later, Trump posted an AI-generated portrait of himself as a kind of American Jesus. When this caused a wave of criticism and outrage (much of it from fundamentalist Christians), he insisted he was portraying himself “as a doctor, making people better”.

Rather than helping Republicans in the upcoming midterm elections by, for example, embarking on an “affordability tour” (as White House aides have urged him to do), Trump has been on a “revenge tour” against Republican members of Congress he deems insufficiently loyal – a gambit that may cost Republicans dearly in the midterms.

Yet Trump insisted at a cabinet meeting that “I don’t care about the midterms”. He was referring at that moment to Iranian officials who “thought they were going to outwait me” by relying on mounting political pressures to force him to give up, but he might as well have been talking about the blowback from his revenge tour.

Trump ended the cabinet meeting with further evidence of his mental decline, in another rant against Somali Americans. “The Somalians, what they’ve done to Minnesota, the Somalians, crooked as hell. Ilhan Omar, crooked as hell,” he said, in reference to the Democratic representative from Minnesota. “They’re all crooks, and we got them, we got them. Now we’re putting the clamps on.”

His antipathy toward Somali Americans is growing, along with his troubling and erratic behavior. In December, weeks before ICE went on a rampage in Minneapolis, Trump had claimed that Somalis made Minnesota a “hellhole”, saying: “The Somalians should be out of here. They’ve destroyed our country.” Of Somalia-born Omar, Trump said: “She shouldn’t be allowed to be a congresswoman, and I’m sure people are looking at that. She should be thrown the hell out of our country.” A day earlier, he called the representative “garbage”, saying he didn’t want Somalis in the US.

Can you imagine any other president of the United States singling out a group of foreign-born Americans like this? Of course not.

The evidence continues to mount. Trump is clearly incapable of satisfactorily discharging the duties of president of the United States.

The sooner the 25th amendment is invoked, or he is impeached, the safer are America and the world.

• Robert Reich, a former US secretary of labor, is a professor of public policy emeritus at the University of California, Berkeley. He is a Guardian US columnist and his newsletter is at robertreich.substack.com. His new book, Coming Up Short: A Memoir of My America, is out now in the US and in the UK