A year ago, my father, now aged 99, was recovering from surgery when his doctor asked him — in order to check his orientation — who the president of the United States was.
“Effectively speaking, we don’t have one,” my dad said, joking.
Now that he has heard President Joe Biden will seek re-election, my dad wants to throw his own hat in the ring, claiming that age is no longer a factor.
“What will you do if you win?” I ask. “My first executive order will be to allow the importation of Cuban cigars,” he says.
While I think that would be a widely popular move, I am discouraging my father from running. He is clearly too old.
But age isn’t really the only issue when it comes to President Biden. There are many people over 80 with the mental and physical ability to lead.
Only about 11% of people Biden’s age show signs of significant dementia, according to last year’s National Health and Aging Trends Study.
That number, however, increases to close to 20% percent from 85 to 89, which is the age group Biden would be in toward the end of a second term.
And there are more subtle signs that may precede frank dementia that clearly interfere with complex decision-making.
Biden has exhibited many signs of possible cognitive slowing, including periods of concreteness (lacking abstract concepts), confusion, disorientation and apparent lapses in judgment.
Having not met him or examined him, it is impossible for me to fully assess his fitness.
But I am also concerned that if he is suffering from cognitive issues, they will only get worse as he gets older, especially given his neurological and cardiac history.
And not even half of Democrats and fewer than a third of all Americans want to see Biden run in 2024, with age being a main reason.
Dr. Kevin O’Connor, his physician, has asserted repeatedly in reports on yearly physicals that the president is fit, mentally and physically, and he has included reference to examinations by neurologists and orthopedists.
What is missing is any MRI report and full cognitive testing.
Many of us have repeatedly requested this.
O’Connor has mentioned Biden’s stiff-legged gait in two successive physicals and says it is getting worse — but hasn’t addressed directly a possible link between a worsening gait and a neurodegenerative process involving the frontal lobe of the brain or spinal cord or the possible buildup of fluid (normal pressure hydrocephalus), which could cause both a gait and a cognitive problem.
O’Connor did report the president was tested for Parkinson’s disease and found not to have it, at least according to O’Connor.
But Biden did have two brain aneurysms repaired surgically in 1988, which increases the risk of long-term cognitive problems.
And he does suffer from a heart arrhythmia, atrial fibrillation, which, though he is on blood thinners, increases his risk of cognitive problems.
Whereas President Biden is 80 years old and will be pushing 86 by the end of a completed second term, former President Donald Trump is 76.
When I interviewed Trump in July 2020 at the White House he suggested that Biden undergo cognitive testing, the way he had.
His description of his own cognitive exam was dramatic — “Person, woman, man, camera, TV” — and quickly went viral, but it didn’t undermine the fair point that an aging leader of the free world should undergo such a test to reassure the American public.
This statement seemed logical to me at the time, and it still does.
Presidential fitness isn’t necessarily something we can count on knowing about — after all, historically, we the public have been routinely lied to by seriously ill presidents from Woodrow Wilson to Franklin Roosevelt to Dwight Eisenhower to John F. Kennedy to Ronald Reagan.
Certainly, we are not in a position to assess presidential fitness via a video clip or past the smokescreen of a president’s handlers.
All we can ask for is complete transparency — especially when it comes to an aged president with multiple medical problems that could interfere with function — transparency that we clearly aren’t getting.
Marc Siegel, M.D., is a clinical professor of medicine and medical director of Doctor Radio at NYU Langone Health and a Fox News medical analyst.