There is no way to escape now.
We are a deeply divided country in the midst of a presidential campaign in which the mental acuity of an 81-year-old sitting president will be one of the central issues until November, possibly overshadowing the economy, climate change, immigration and reproductive rights.
This is happening amid unprecedented demographic change, just several years after the first time in human history that people 65 and older outnumbered those 18 and younger, and many millions of People suffer the distressing experience of memory loss.
It is a moment that can serve as an opportunity to invest in more research, educate the public about early detection and treatment, and strengthen resources for patients and their loved ones. Or it may be a time to exploit and politicize cognitive loss or even mock it, as Republican candidate Nikki Haley has done with her new “Grumpy Old Men” ad campaign.
Questions about President Biden's physical and mental health, as well as that of the civilly challenged former president and likely opponent Donald Trump, who is 77, were already part of the political conversation, with Biden's critics calling him no suitable. But the issue was magnified after Thursday's report on Biden's handling of classified documents, in which a special counsel called the president a “well-intentioned old man with a bad memory.”
Trump's team attacked, with strategist Chris LaCivita telling the New York Times that the special counsel's report is “damning and defining.” Well, okay, but if the problem is mental fitness, let's not forget that the guy from LaCivita decisively lost the last presidential election, but he still believes he won.
Biden didn't help his cause Thursday night when he proclaimed “my memory is fine,” then referred to the president of Egypt as the president of Mexico. This followed two similar recent gaffes involving the leaders of France and Germany.
We could be at this for months, exploring new frontiers in the post-sanity of American politics. When Biden speaks, you hold your breath. When Trump speaks, you shake your head.
Biden's mistakes are alarming, to be sure, especially considering that if he is re-elected in November, he will be in office in his mid-80s. But what are the options for Democrats? In theory, it should be fairly easy to defeat a former president who broke virtually every major campaign promise: health care reform, a national infrastructure plan, the return of manufacturing, draining the cesspool of corruption, and a paid-for wall. for Mexico.
If Biden's advisers hide it, that could hurt. If he gets shoved in front of the cameras, that might hurt more. Is the plan to keep a low profile, hope for a victory, and then hand the baton to Vice President Kamala Harris?
We simply don't know, but it's worth noting that the special counsel who diagnosed Biden is a lawyer, not a doctor. And frankly, we don't know if what we're seeing in Biden's public moments is normal brain aging or what's called mild cognitive impairment, which can be an early sign of a disease that can lead to dementia.
“Confusing someone or speaking badly does not mean you have dementia,” said Dr. Zaldy S. Tan, director of the Cedars-Sinai Healthy Aging and Memory Program.
As we age, Tan said, “we have some changes associated with information processing. The speed… decreases. That's part of normal aging. Mentally, we won't be able to extract that information as quickly as we could before if someone is asked a quick question or questions. “We need more time to process that information.”
Without a complete examination and neurological testing, as well as a look at how Biden operates behind the scenes on a day-to-day basis, Tan said, it is not possible to make a clinical diagnosis.
“I think it's important for the public to know that someone in their later years may not be as fast and agile as someone younger, but that doesn't mean they're not capable of doing a job. It depends on what the job is and whether speed of thinking is paramount, or whether experience and wisdom are more important, Tan said.
Debra Cherry, a clinical psychologist and executive vice president of Alzheimer's Los Angeles, echoed Tan on the danger of remote diagnoses.
“I have no reason to believe that Biden has any signs of cognitive decline, and I have no reason to believe that Trump has cognitive decline,” Cherry said.
However, there once was a president who was a little easier to evaluate.
“I think back to when Ronald Reagan was in office and he was showing many more signs of cognitive decline before he was finally diagnosed,” Cherry said.
Professor Margaret Gatz, an Alzheimer's researcher who has worked at USC since 1979, said she objected to the special counsel calling Biden old and forgetful, as if one guaranteed the other. One person may be confused at 60 and another sharp at 90.
Gatz said people with cognitive impairment or even mild dementia find ways to compensate and continue normal functioning; For example, they might put their car keys in the same place every time they return home.
“If you ask someone to remember a list of 16 words and see how many they can say, even if they can't do it very well, it may have little or no implication for their decision making in other areas of life.” Gatz said. “If Mr. Biden cannot recite the names of the capitals of all the countries he has been to, that has no implications for whether he can think clearly, creatively and decisively about how to handle crises and political decisions.”
Gatz added, however, that in the abstract he worries “about someone who is 80 years old being president of the United States,” because “as we age, everyone loses a step here and there.”
Well, it seems almost certain that someone 80 or older (Biden or Trump) will be the next president.
Perhaps instead of a series of debates, we should demand a battery of neurological tests.
