In high end circuses, the clowns are the most experienced acrobats and performers. There's a decent chance the clowns are the coaches for the new performers doing the fancy stuff. It takes a ton of practice and experience to do acrobatics and gymnastics "badly" without getting horribly injured.
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Disclaimer: I am not diagnosing anything and I am not a physician, just a medical student.
My guess: Congestive heart failure, possibly with dilated cardiomyopathy, and AFib that's throwing clots into cerebral circulation causing microvascular damage and TIAs. They put you on pretty hefty blood thinners (WAY more than aspirin) if you have AFib and signs of previous embolism/stroke.