Is Joe Biden Too Old To Be President? Is Donald Trump?

Joe Biden and Donald Trump are the oldest candidates affiliated with a major political party to ever run for President. Biden is older than every Baby Boomer, and both he and Trump were born before Bill Clinton or George W. Bush. They are both older than Ronald Reagan was when he left office.

Many voters have expressed concerns about the age of both candidates and their ability to make sound decisions. Worries about Biden’s cognitive capacity have risen sharply since his halting performance at the presidential debate last week. Many voters, politicians, and political operatives are now recommending that he step aside and make way for a younger candidate.

Which raises the question, is Joe Biden too old to be president? What about Donald Trump?

Trump is 78 years old. Using a methodology that I developed to estimate the likelihood having cognitive impairment at any age (and available at WhealthBot.com ), a person Trumps’s age has a 15% chance of having Alzheimer’s or another form of dementia, and a 16% chance of having Mild Cognitive Impairment (i.e., cognitive decline that goes beyond normal aging). Which indicates that, combined, almost one third of people Trump’s age are experiencing moderate to severe cognitive decline.

For most voters, Trump probably passed the cognitive “eye test” during the debate, with some caveats. He appeared vibrant and failed to lose his train of thought. However, his stamina appeared to fade as the debate went on, and some of his answers were of the rambling sort. But most voters likely did not walk away thinking he was cognitively not up for the job.

Biden, however, failed the cognitive “eye test”. His voice was weak, mouth often agape, and some of his statements were largely incoherent. He needed assistance from his wife to get off the stage.

Using the same approach to estimating cognitive capacity, a person Biden’s age has a 22% chance of having Alzheimer’s or another form of dementia, and a 23% chance of having Mild Cognitive Impairment. Not insignificant numbers.

Moreover, Biden’s performance in the debate contrasted sharply with the speech he gave at the State of the Union just a little more than 3 months ago where he appeared physically strong and mentally acute.

Everyone has good days and bad days, older adults perhaps more so. So that could explain the dissimilar performances. But like many medical conditions, cognitive changes can occur rapidly, and the state of a person’s mental health can decline noticeably in a short period of time. The “eye test” suggests that Biden’s overall condition has in fact deteriorated recently.?

So, what should he do now? My advice for Biden is the same as it would be for any 81-year-old adult who appears to be declining cognitively.

Get tested. The most important step for anyone in this position is to undergo thorough testing by a board-certified neurologist, a clinical psychiatrist, and possibly an experienced psychometrician. The state of a person’s cognitive capabilities should ultimately be assessed using examinations administered by trained medical professionals, not the “eye test”.

If Biden has not done so recently, he should submit to comprehensive testing. He has access to some of the best medical specialists in the country. These professionals should be able to determine the status of his decision-making capacity now, and what and how things might change in the future.

Build a team. Armed with this medical information, Biden should consult with close and trusted family members and friends. Medical decisions and their consequences for personal and professional actions can be complex and difficult. Like any older adult, Biden should not be making major medical, financial, or other decisions - like running for president – solely on his own. He should seek advice from the people he trusts and who also have his best interests in mind. The medical test results should form the basis for a plan moving forward.

Some news reports I have seen suggest that Biden’s inner circle has not been discussing the President’s possible cognitive decline. If this is true, that situation needs to change ASAP. It’s time for Biden’s team to have some serious, frank, and realistic conversations about his ability to lead the country for four more years during which time his cognitive faculties will very likely decline.

Practice self-awareness. The third piece of advice might be the hardest one for Biden to follow, but it might be the most important. The President needs to look at himself in the mirror and ask if running for president is the best thing for him and his county. He needs to be honest about his current health status and what might happen to him over the next four years.

For many politicians practicing self-awareness is not an easy thing to do. Like accomplished professional athletes, politicians tend to be excessively confident and exceedingly competitive. They don’t always know when to quit. Think Michael Jordan on the Washington Wizards or Willie Mays on the New York Mets.

But the stakes are obviously much higher for a man running for president than for an aging sports star. Biden needs to make an honest assessment of what he is capable of achieving at this point in his life. He has been one of the most accomplished US politicians of the past half century. There is no shame now in announcing that he is finished serving his country.

I would offer the same advice for Trump. He should get tested, consult with family members, and acquire some self-awareness (the latter being admittedly a long shot). In Trump’s case, testing should go beyond a simple assessment of cognitive capacity. During the debate, Trump lied incessantly, rambled occasionally, and demonstrated over-confidence in the extreme.

Behavioral issues like lack of impulse control, over-confidence, and high stress can have negative consequences for decision-making. Many of these conditions get worse with age. The “eye test” for Trump suggests he suffers from behavioral conditions that impair sound decision-making, and that voters have a right to be concerned that his behavior may only get worse.

So, are they too old to be president?

I am skeptical about imposing age limits on running for president. Everyone is different, and cognitive capabilities at any age can vary widely. I have known people well into their 80s who are energic and incredibly lucid. I have also known people in their 60s who have already experienced significant cognitive decline. So, it is hard to pick a single year and say after that date, that’s it. And I prefer as much as possible to leave the decision about who should be president in the hands of the voters.

(I think that terms limits can and should be part of the solution. Reagan was not eligible to run for a third term at age 77, not because of his age, but because he had already served two consecutive terms. Term limits for Congresspeople, Senators, and Supreme Court justices would help lower the average age of each of those bodies significantly.)

My wish is that Joe Biden gets the necessary medical attention he needs, and that he shares the results of comprehensive testing with trusted family members, friends, and advisors. After a few hard conversations with the people who care for him the most, I hope that the President can make an honest assessment of his health and ability to lead the country. The stakes are too high to do anything else.