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He believes he's on top of the world, the greatest and most powerful, so he says whatever comes into that pathological brain of his. Especially when giving a speech in front of what he assumes is his faithful flock, he's relaxed and confident and starts "weaving" random thoughts about poisonous snakes in Peru, or cheap sharpie pens, or a situation where he'd have to choose between getting electrocuted or eaten by a shark.

It is a form of insanity, but not dementia. It's a combination of giant ego and delusion, and it's getting worse as he ages. Subconsciously he may know he's in trouble politically, but his ego won't admit that so he becomes more disconnected from reality. Rambling off on bizarre tangents makes him feel good, but this is not dementia. Someone suffering from that disease could not ramble for eight full minutes about poisonous snakes, then come back to the purpose of the occasion for his speech.

Plus, he's really not very intelligent. He's a talented con man and pathological liar with no moral compass, confidently and repeatedly asserting lies to establish or reinforce false narratives that millions of voters have already been programmed to believe from sources like Fox News.

He never bothered to read or study or learn about subjects a president should know when making critical decisions. He prepared for his political career by watching a lot of television, getting the pulse of voters who were there just waiting for a con man unconstrained by the norms and traditions that still bound his Republican opponents in the 2016 presidential primary. He pushed hard on the pent up buttons of grievance, liberating the unfiltered ignorance and bigotry of those who felt repressed, and they absolutely love for it.

All the lies and false narratives are now the foundation of what has become the Party Of Trump. But a foundation detached from reality is bound to crumble, and we're beginning to see Trump crumble along with it.