The Dementia Election
Maybe it's time to stop joking about senile politicians and do something about the issue.
POLITICO founding editor John Harris dubs 2020 “the dementia campaign” and laments how casually we joke and otherwise toss around charges that President Trump and his fellow septuagenarian challengers are suffering cognitive decline.
The debate reflects the raucous, attack-oriented character of modern political culture. Genuine concerns about the capacities of people who want the world’s most powerful job mingle bizarrely with insults, jokes, and self-confident pronouncements from people with no evident qualifications to be speculating publicly about other people’s neurological health.
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Concerns about the physical and mental frailties of older presidents are far from a new phenomenon.
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But discussions of presidential health in those earlier times were made with a kind of hushed solemnity that now seems eons away. Modern media often takes the sort of conversations that political operatives and reporters have always had and loudly amplifies them for a mass audience.
Welcome to the era of 24/7/365 news and commentary.
Most of the column is similar kvetching about how much better it was in the good old days, interspersed with examples of the behavior in question. Some of them are rather funny.
The substantive point, rather buried amongst all that, is this:
The problem for “the media,” like for voters generally, is that there is no solid consensus about how to assess cognitive health, what types of medical records should be in the public domain especially for aging candidates, and no way to enforce that consensus if it existed. The issue is especially acute now that so much power in American government is held by people over age 65. While rates of dementia are going down gradually in the United States, 65 is the age at which geriatric researcher Kenneth Langa at the University of Michigan found that 20 to 25 percent of people have mild cognitive impairment and 10 percent have dementia. Six members of the Supreme Court are over 65, House Speaker Nancy Pelosi will turn 80 on March 26, and Senate Majority Leader Mitch McConnell last month turned 78.
We are increasingly a gerontocracy. Maybe it’s time to get past the joking about cognitive decline and actually start doing something about the real dangers of critical decisions being made by people who are likely suffering from it. It would not be at all unreasonable to require people who want to be in those positions to be evaluated regularly and have the results part of the public record.
Bringing back mandatory retirement, while politically unfeasible, may be advisable. Many US states require judges to retire when they reach 70, for example. And while the Age Discrimination in Employment Act makes mandatory retirement illegal, it makes exceptions for Bona Fide Occupational Qualification (usually, public safety—law enforcement officers, pilots, etc.) and for “Bona Fide Executives” or those in a “High Policymaking Position” over 65.
Certainly, the President of the United States is both a bona fide executive and a high policymaking position.
I’m generally opposed to term limits but would be fine with an age limit. The current situation drives the point home.
Despite what we think of ourselves as a country, when considered as an unbroken political tradition we are very old. Decrepit, even. And we’ve been showing clear signs of national cognitive decline for well over a generation. I now take it as axiomatic that change is no longer possible because we are no longer up to any challenge. We are grumpy, sclerotic, frightened, belligerent, unconcerned for the future, and convinced that après nous le déluge.
I’d like to see open evaluation of all candidates’ mental and physical health. At any age. Simply picking a random age is crude and unjust. Test for the condition, don’t just assume it. My father-in-law just died of COPD and old age (89) and he was coherent well into his 80’s, and surprisingly coherent even when his oxygen levels were down to around Mt. Everest levels.
I’ve been expecting to see mental decline in myself, partly I suppose because the job I do, I do without knowing how I do it. Which is unnerving at the best of times. I keep expecting to come to a plot point and not know how to resolve it, but it’s as easy as ever. Between 60 and 65 I wrote eleven books and random other bits and bobs, and the words continue to appear on my screen when I type. In down times I’ll play speed solitaire, watching the scores to see whether my processing speed is slowing down. Not so far.
But it would be silly to ignore the possibility, I mean, my knees aren’t what they used to be, and the percentage of guys I could take down (a vital statistic) has declined steadily over the years, so it’s reasonable to assume that the three pounds of pink goo in my skull will likewise see some diminution of capability. But come on, it m ay not be possible yet to accurately diagnose Alzheimers, but there are tests to show general mental ability.
@Michael Reynolds:
Yes, I think that’s right. But, of course, the probability goes way up for those in their 70s and 80s and there’s going to be a lot of pressure to fudge the testing for a sitting President or Speaker.
@Michael Reynolds:
Writers in general hang onto their marbles longer than non-writers. Don’t ask me to cite a source; I’ve heard and read this so often that there has to be some truth to it.
Biden, Sanders, and Trump are acting just like they always have. The voters had their opportunities in 2016 and today to pick someone else. They chose these people.
@95 South:
I have only paid attention to Sanders since the 2016 cycle and he seems to me to be the same guy now as then. Biden has clearly declined somewhat from even 2012, and I say that as someone who voted for him last Tuesday and expects to do that again in November. And, while Trump has always been a narcissist, he is a shadow of the man he was when he came onto the radar screen in the 1980s. I’ve seen old interviews with him in recent years and it’s shocking how sharp he used to be.
The age problem becomes most acute for members of the executive branch. By definition decisions by the legislative branch are collective, so poor judgement by an elderly leader(s) is corrected by others. But on the executive side… Having a ignorant, know-it-all like Tiny as the excec makes the situation even more dangerous.
@CSK:
There is a fair amount of research that shows that individuals who continue to be physically and mentally active maintain higher levels of cognitive performance further into life. Which is why you see the ads for the mind games aimed at seniors.
This wouldn’t apply to those whose mental deterioration is the result of specific diseases such as Alzheimer’s or Parkinson’s
And in the FWIW category, Blue Cross reports an increase in early dementia diagnosis whether its better screening, cosmic rays who knows.
@95 South:
As James notes, this is simply not true. Both Trump and Biden show obvious signs of cognitive decline relative to what they were like as recently as five years ago. Voting for Biden in his current condition would be utterly irresponsible if Trump weren’t the only alternative.
Reagan was not right by the end of his presidency, but Republicans still got what they wanted, tax cuts and huge deficits.
Yes, the prez should be checked for cognitive issues. By who? We’ve seen the president’s personal physician provide reports on Trump’s physicals that are obvious BS. And from his personal physician before he was elected.
This is the primary weapon that the Biden campaign can deploy against Trump and his minions whenever they want to question Biden’s mental state…for anything that kooky Uncle Joe has done, there is a far worse example from the deranged Orange Menace…
@James Joyner:
He’s slower on his feet, and his stutter is more pronounced, but he doesn’t seem senile. Just more easily tired.
(When I’m not sleeping well, I mix words up, or parts of words, and I’m not suffering from dementia… I think)
Trump campaign has ads deceptively edited to make Biden look impaired.
Russians are pushing disinfo to that effect as well.
Democrats should return the favor, and in Trump’s case, little or no deceptive edits will be needed to make him look impaired…
If you’re wondering about this, I think this article is worth a look. There is no evidence of dementia, and Biden’s verbal stumbles can easily be explained by his stutter.
@Kari Q: It looks like the attacks will be even worse than what was in the article you linked to…
And this isn’t helped by Bernie himself, whose words on this matter sound a lot like his weak denunciation of some of the Bernie Bros…
It’s clear to me that Sanders is the only one of the three that is a liberal, and also that Sanders is the only one of the three that is also not suffering from dementia.
One has to ask, why must Biden be seated for the next debate, while Sanders, who recently had a heart attack and two stents, is just fine standing behind a lectern? There’s something amiss. A president must be able to think on his or her feet. It’s a stressful job.
Here’s a millennial’s perspective on Biden’s political leaning and mental competence:
https://www.youtube.com/watch?v=sSu3khaJunE