Here is what the letter says. "This is a form of dementia that is characterized by impairments in judgement, impulsivity, impairments in communication, and difficulties with thinking and memory".
so it would not be insanity, but diminished capacity. The letter goes on to state he does not believe she be reasonably held accountable for many of her actions due to her underlying medical condition.
So based on that...??? Either way, we can put her on the stand, and watch her try to get up every few seconds, and not be able to answer even a single question. I am guessing we could shame the courts.