Using critical methods drawn from clinical ethics and the humanities, the author considers the posthumously published The Reagan Diaries and suggests that they show evidence of an incipient dementia. In the wake of Berisha et al.'s analysis of presidential press conferences during the Reagan presidency, published in the Journal of Alzheimer's Disease, that were suggestive of cognitive impairment, this reading of the president's diaries merit additional scrutiny. Diary entries from Reagan's second term differ from the first years of his presidency. They demonstrate less text, more laconic analysis, word finding difficulties, evidence of spatial confusion and suggestions of disinhibition, all possibly early signs of cognitive impoverishment during the same period when the transcripts of his second term press conferences showed evidence suggestive of incipient Alzheimer's Disease. While a definitive analysis of the president's diaries can not be performed on the abridged published text, edited by the historian Douglas Brinkley, these findings are suggestive and warrant additional scrutiny. By melding quantitative approaches analyzing language use from Reagan's presidential press conferences with methods from clinical ethics and literary criticism, future scholars can gain a fuller understanding of the president's health while he was in office.