National Institute of Health

Dementia, the elephant in the room that no one is talking about, is a serious consideration in Joe Biden’s ability to become the 46th president of the U.S. It is a diagnosis that can only be made by a trained physician. There have been many physicians that have weighed in on the question, including the White House physician, Admiral Ronny Jackson, who was there during the Obama/Biden tenure.  He agrees with the dementia diagnosis, but does say he has not examined him. It requires cognitive tests and occasionally imaging studies, all of which Biden has declined to do.  Incidentally, Trump has taken these tests and passed them. So how will we know if we are electing a demented man?

Election of a person with significant health challenges is not without precedence. In 1944 Franklin Delano Roosevelt ran for his fourth term, and despite his poor health that made it almost certain that he would die in office, was elected.  He died four months after he took office. The country was lucky that Truman turned out to be a good president at the termination of World War II. 

Biden is 77 years old. He will turn 78, November 20, 2020, the oldest president to ever assume office in our history.  At age 65 the risk of Dementia is 8.8% and doubles every five years.  At 78 the risk will be about 23%.  Dementia is in short, the loss of the ability to think. There are multiple cognitive functions that give us the ability to think. The key feature is memory impairment. Just one other brain function is required to make the diagnosis of dementia, aphasia (language deficit), apraxia (movement deficit), agnosia (deficit in recognizing things), and loss of executive function (mental control and self-regulation).

Biden has demonstrated deficiencies in every one of these brain functions.  He has flubbed on many occasions as to where he is or for what office he is running (memory). He mixes words up or forgets them– “we choose truth over facts” and “all men and women are created equal, by the, you know, you know the thing…”  (aphasia). He has mixed up his wife and sister (agnosia). He has developed a mild shuffling gate (apraxia), and has had several strange outbursts in interviews (loss of executive functions). Does that make him demented?  It is not a formal diagnosis by a qualified physician, but it does make me, who also happens to be a physician and who has seen a lot of dementia in 51 years of practice, seriously wonder.

The fact that Nancy Pelosi is dusting off the 25th Amendment, and emphasizes that it is not directed at Trump, but a template for whenever we might need it. That is in itself another concerning fact of the subtle hints we get.  The 25th Amendment gives Congress the ability to remove a sitting president for health reasons, physical or mental.  Dementia tends to have a rapid course of deterioration.  The average life span of a patient with dementia is 4.5 years.  If that is his diagnosis, he will be lucky to finish one term as president.  In the end, it often will be severe, inability to communicate, walk, and even swallow.  Of course, the VP will have taken over long before that.  Which is another issue of perhaps bigger concern.  Which evil would you rather have, a demented president or a Socialist president?