On Pelosi's best day, she is a functioning moron. A true gift, thank God!
Her behavior suggests she has dementia, likely due to her age. Dementia is "loss of intellectual functions (such as thinking, remembering, and reasoning) of sufficient severity to interfere with a person’s daily functioning."
With dementia, she likely can't make memories from day to day, has trouble finding the words she wants to say so stumbles with words when speaking.
She likely does, as those who have dementia due to age do, retain long term memory, can remember her many years of history in the House of Representatives and how it operates. No one knows that better than she does and that is why they once again made her the House Speaker. Repeating, she knows how it works, more than any other person. She runs the day to day business of the House. Surely, she won't run again, but I didn't think she would run again this time.
Here is the way to the Presidency - she is third in line to be President. Something happens to Trump and Pence and she is President.