When President Joe Biden stepped onto the debate stage last week, it was evident from his opening remarks that his performance would not meet expectations. As a specialist in neurology, I found it troubling to observe, and I wasn’t alone in this sentiment. In the days following the debate, I received numerous communications from fellow medical professionals specializing in brain health. While the observations we made weren’t entirely novel, the extent of their prominence right from the debate’s outset raised concerns.
From a neurological perspective, our concerns stemmed from his disjointed speech patterns, abrupt lapses in concentration mid-sentence, hesitant speech, and lack of facial expressiveness, occasionally leading to a blank, open-mouthed look. It’s important to clarify that these are observations and not indicative of any deeper diagnosis. None of the medical professionals involved intended to imply otherwise.
Medical Consensus Urges Comprehensive Cognitive and Movement Disorder Testing for President Biden, Experts Say Public Disclosure Necessary
In light of recent discussions among medical professionals specializing in neurology, there is a growing consensus that President Biden should undergo thorough cognitive and movement disorder testing. The results of these tests, they argue, should be transparently shared with the public.
Having extensively covered advancements in dementia treatment over the past five years, including Alzheimer’s disease, Lewy body dementia, and vascular dementia, I have firsthand experience with the rigorous testing protocols involved. For my documentary “The Last Alzheimer’s Patient,” I underwent comprehensive cognitive assessments, examining aspects such as executive function, judgment, and memory, alongside blood tests to measure brain protein levels and B12 levels, as well as genetic risk factors and sense of smell assessments. While such testing isn’t typically routine for most individuals, every neurologist I consulted emphasized its importance in President Biden’s case.
Biden’s Medical Background: A Closer Look
The most recent official health summary released in February affirmed President Biden’s fitness for duty, compiled by a team of 20 doctors, including a neurologist, who conducted a thorough physical examination. According to the summary, an extensive neurologic evaluation found no signs consistent with neurological disorders, and there was no indication of Parkinson’s disease to explain symptoms like stiffness and reduced facial expression.
However, the report did note findings of neuropathy and arthritis in his feet, conditions that can cause numbness, weakness, and discomfort. Notably absent from the report was any mention of cognitive testing, raising questions about whether such evaluations have been conducted.
Following a recent debate where concerns about Biden’s cognitive performance arose, the White House stated that a subsequent medical check, prompted by a cold, was brief and not a full physical examination. When pressed about the necessity of cognitive testing results, White House press secretary Karine Jean-Pierre indicated that Biden’s medical team deemed it unnecessary.
These developments underscore ongoing discussions and uncertainties surrounding President Biden’s health disclosures and the extent of medical evaluations conducted.
Both President Biden, at 81, and former President Donald Trump, at 78, have exceeded the average American male lifespan of 74.8 years, a testament partially attributed to their access to top-tier healthcare and abstention from drinking and smoking. Biden’s medical history includes two brain surgeries for aneurysms, with the rupture of one on the left side potentially posing a risk for delayed cognitive issues later in life. Conversely, Trump, whose father suffered from Alzheimer’s disease, lacks other known risk factors for cognitive decline.
Trump, who has occasionally exhibited similar cognitive signs to Biden such as nonsensical speeches and confusion over names and current events, claimed to have aced the Montreal Cognitive Assessment (MoCA) in 2018, with subsequent exams in 2023 reportedly showing exceptional results, according to Dr. Bruce Aronwald. However, Trump has not disclosed his full medical records, and past health memos have used atypical language for medical documentation.
While the MoCA serves as a preliminary screening tool, experts emphasize a more comprehensive cognitive evaluation for Biden, suggesting it could provide valuable baseline data for assessing cognitive changes. The absence of such a baseline examination for Biden raises questions about the thoroughness of his cognitive health assessments compared to Trump’s documented tests.
Episode or Condition: Understanding the Difference
According to Jay Olshansky, a professor at the University of Illinois-Chicago’s School of Public Health, older individuals often possess a form of intelligence known as crystalized intelligence. This encompasses accumulated wisdom gained through learning and life experiences, which can be particularly valuable in roles such as the presidency.
As we age, certain cognitive abilities like processing speed, attention span, and memory may naturally decline. This is a normal part of aging and typically doesn’t hinder someone’s ability to perform their job. However, for a minority, this decline can be more pronounced and may indicate conditions like dementia, where the distinction lies between forgetting where you placed your keys and not comprehending their purpose.
Diagnosing dementia isn’t straightforward and other factors, such as poor sleep, low blood sugar, viral illnesses, or medications, can contribute to temporary cognitive impairment, often referred to as brain fog.
Recently, after a debated performance, Biden’s aides attributed his performance to a ‘bad night’ compounded by a cold, without medication. White House spokesperson Karine Jean-Pierre noted Biden’s jet lag and late-night presidential duties and debate preparation. Following discussions with Democratic governors, Biden adjusted his schedule to end events by 8 p.m. to prioritize sleep, an effort to manage fatigue from the late-night debate start at 9 p.m. Eastern time.
Seeking Clarity: Finding Answers
As the November election approaches, questions linger about President Biden’s health without definitive answers. The White House has declined press requests for additional medical records and interviews with Biden’s physician, Dr. Kevin O’Connor. According to Biden’s press secretary, Dr. O’Connor observed the debate and had no post-event concerns.
Like all citizens, elected officials are entitled to privacy regarding their medical information under federal healthcare laws. There is no legal provision for accessing personal medical details without authorization, even for the president, and disclosure of such information is not mandatory for presidential candidates. Over my 23 years of reporting on these matters, only Senator John McCain, one of the oldest presidential candidates in US history, chose to share his complete medical records with both myself and the American public.
The belief that observing a candidate on the campaign trail provides the best insight into their physical and cognitive health is commonly held. In 2020, Biden himself asserted that the rigorous demands of running for president were a constant test of his capabilities, stating, “All you’ve got to do is watch me.”
As the nation watches now, concerns have arisen from this assessment, prompting a clear call for transparent testing to address these concerns definitively.
