President Biden’s political standing has been rapidly deteriorating due to doubts over whether he is fit enough to serve a second term, after his disastrous debate with Donald Trump.
The most recent news about Biden’s health came this week in the form of a coronavirus diagnosis, with the president and his doctor insisting his symptoms were mild.
However, Biden’s neurological health has remained an unavoidable concern for members of his party and donors alike, after the 81-year-old president repeatedly appeared to lose his train of thought and paused for long periods during the debate last month.
At a press briefing on July 8, Karine Jean-Pierre, the White House press secretary, sparred with reporters over whether the administration had been forthcoming about Biden’s health.
Medical experts commented that the president’s tilting posture, open-mouthed expression and slow movements during the debate could be early signs of Parkinson’s.
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Jean-Pierre cited the president’s most recent comprehensive physical exam, taken in February, and quoted a letter from Kevin O’Connor, Biden’s physician, that said “an extremely detailed neurologic exam was again reassuring” in that there were no findings consistent with a stroke, multiple sclerosis or Parkinson’s. The letter added that no tremors or “motor weakness” were detected and that Biden “demonstrates excellent fine motor dexterity”.
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O’Connor concluded that Biden, who underwent surgery in 1988 after suffering a series of brain aneurysms, did not need to take the Neuropsychological Assessment Battery, a slate of 33 tests that looks for dementia and other brain abnormalities.
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She was asked about logs that showed Kevin Cannard, a neurologist who has conducted research into Parkinson’s, visited the White House eight times between July 2023 and March this year, and whether the January 17 meeting was related to the president’s care. She replied: “I can say that it was not.”
Jean-Pierre then said in a statement that the meeting was in fact with the president and it was the neurological element of his annual medical, the bulk of which took place at the Walter Reed military hospital in late February.
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“Because the date was not mentioned in the question, I want to be clear that the January 17 meeting between Dr O’Connor and Dr Cannard was for the president’s physical,” Jean-Pierre said. “It was one of the three times the president has seen Dr Cannard, each time for his physical. The findings from each exam have been released to the public.”
In interviews with ABC News on July 5, Biden declined to submit to a neurological exam, saying he had the equivalent of one every day thanks to the rigour of presidential duties.
In the February examination, O’Connor reported that the president suffered from more run-of-the-mill ailments, including sinus congestion, sleep apnea, gastric reflux and a “stiffened gait”. Last year Biden began using a continuous positive airway pressure, or CPap, machine at night to help with sleep apnea, and O’Connor wrote that the president had responded well to that treatment and was “diligently compliant” about using it.
Biden’s noticeably stiffer walk was the result of arthritis of the spine, pain in his hip and peripheral neuropathy, a condition defined by a loss of sensation in his feet.
O’Connor reported that the president exercised five days a week, weighed 178lb (80kg) and had a blood pressure of 132/78.
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Biden is teetotal, crediting his family’s struggles with addiction. He is not known to have been a smoker. He is said to prefer carbohydrates over vegetables, which causes friction with his wife, Jill. Some aides have noted that he eats “like a child”, with a preference for beige food. His positive Covid-19 test this week marks his third bout of the disease.
According to Jean-Pierre, Biden verbally checks in “a couple times a week” with his doctor “while he’s exercising”. His aides have said he works out regularly, lifting weights some mornings and using a Peloton bike.
Since the debate, Biden has been trying to prove he can do the job for another four years, participating in interviews, campaign events and meetings with prominent Democrats and donors.
During a private call with Democratic governors, Biden reportedly said he felt fine, before adding: “It’s just my brain.” The comment is said to have left Josh Green, the governor of Hawaii and a physician who asked after the president’s health, incredulous.
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Experts point to Biden’s memory loss as one of the more concerning questions, saying it appears to have accelerated in the past year to 18 months.
A special counsel’s report released in February on the investigation into Biden’s handling of classified documents described his memory as “hazy … fuzzy … faulty … poor” and as having “significant limitations”. It noted that Biden could not recall defining milestones in his life such as when his son Beau died (2015) or when he served as vice-president (2009-17).
In ruling out prosecution of Biden over his retention of highly classified materials as a private citizen, the report suggested he would seem too feeble to prosecute.
At an exclusive New York fundraiser last summer, the president recounted the racial violence in Charlottesville that inspired him to run for the White House in 2020. Minutes later, he told the same story again, almost word for word.
Biden’s team is said to have told the governors in the post-debate meeting that the president was on his best form between 10am and 4pm and started to struggle after 8pm. Aides promised to limit his late-evening campaign events so he could get some rest.
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Biden finds international travel particularly taxing. German officials, aware of Biden’s fatigue at night, are said to have sought to accommodate the president by planning a June 2022 event with Olaf Scholz, the chancellor, in the early evening. However, Biden did not turn up to the informal event at the G7 summit, according to the Wall Street Journal. Instead, Antony Blinken, the secretary of state, announced that Biden had to go to bed.
