Trump has been running on low sleep for many years and he confesses that he eats almost all fast food, some of the worst fast food to boot (McDonald's). This is all routine for him by now, and now is age 71. It's obvious by how he says things and what he says that he mostly can't form complete thoughts now. He'll move between subjects quickly or get outraged at specific things (usually brown/black people) and forget where he is and whose company he's in.
Thing is, Republicans don't care how many gaffes he makes or how far gone he is, Trump's a useful puppet for them as much as he is for foreign interests. As long as Trump takes all the heat, Ryan, McConnell, and the rest of the Republican leadership don't have to face any accountability.
But aren't the Republicans the party of self responsibility?