I think it's more that he doesn't like reality, so it's simply not true to him... but he's not shy about lying, and is clearly losing his mind - ladies and gentlemen, I give you the disaster that's a coin flip away from running the global hegemon ...again.
If avoiding prison was all he wanted he could just release his medical records. The one who definitely don't say he had a series of strokes.
He's a powerful narcissist, with probable dementia, surrounded by yes-men very heavily invested in this election. I'm not even sure he even has the capacity to fear legal repercussions for his actions.
We took my grandmother out for her 80th birthday. Her dementia had progressed, but was still not too far along that we could still have conversations with her. She'd often forget who, where, or when we were and would frequently go on very charming, albeit confusing tangents.
At one point on the car ride home, my sister tells her, "Happy birthday!" My grandmother asks, "it's my birthday?" Giddily, my sister replies, "yes! It's your 80th birthday!"
My grandmother gets a sudden moment of lucidity and says, "I'm 80?? That's terrible news!"
Whether Trump is just saying shit or has forgotten his age, there's no excuse for saying that he's not that close to 80 where he comes out sounding okay. Then again, his supporters seem to want a racist Alzheimer's patient for president...