For months, the discussion about the future of the United States presidential election has focused on the age of the candidates.
Regarding this, a few days ago, a report from the US Department of Justice was released that mentioned the evaluation of President Biden's mental state, treating him almost like a demented old man.
More words, less words, the Prosecutor in charge said that Biden has diminished mental faculties in reference to his poor memory.
The situation deserves at least putting some issues on the table, especially a critical look at exclusively medical aspects.
President Eisenhower in 1956, at the age of 64, renounced the possibility of re-election, citing his advanced age.
At that time life expectancy in the United States was 66 years for men, today it is 74. When President Trump took office in 2017 he was the oldest person to do so;
record that was surpassed by today's President Biden in 2021.
Today, Trump is 77 years old and if he wins he will be 78, while if Biden wins at the end of his second term he would be 86 years old compared to the Republican's 82.
On the other hand, the average age in 2023 of North American senators was 64 years old, while the average of its Supreme Court is almost 70 years old.
Political power is a clearly “major” issue in that country.
Research today shows that some intellectual attributes increase and even improve with age, but when they begin to decline they do so rapidly.
For example, crystallized memory, which allows us to connect ideas and better analyze situations, can improve even after 70.
Now, how can we know if a confusion or a memory lapse could be the beginning of a cognitive decline or not?
The first thing is to differentiate what is normal and what is not.
Not remembering details of a conversation or event that took place long ago is reasonable.
Not remembering the name of an acquaintance or forgetting specific things or events, as well as not finding the correct word occasionally, are logical facts.
Today the diagnosis of cognitive impairment is clinical.
There is no laboratory or imaging resource that gives us a valid diagnosis as in other medical situations.
This means a series of tests that must be performed over a period of time, in a medical setting, and where memory or its loss is only one of the domains evaluated;
where longitudinality in patient assessment is essential, without mentioning, just in case, the relevance that these studies must be carried out in medical facilities.
Experts in the United States who analyzed the background of both candidates mention that they both come from long-lived families and good socioeconomic status, but when they dig into the health profiles, the chances of Biden finishing his second term are greater than those of Trump, for whom his overweight and lack of physical activity work against him, an important issue to consider because a stroke or heart attack can leave a president incapacitated.
In medicine we often say that two plus two does not equal four;
but diagnoses made without medical training, with just an interrogation in a non-medical environment, as the report shows, should raise serious questions.
Dementia has a very clear evolutionary pattern and we doctors know that well, much more than a prosecutor.
Lack of replacement or new leadership?
Good, thank you.w