...from the attached Opinion by an Internal Medicine/Geriatrics physician, with nearly 40 years experience, who's also dealt with an Alzheimers afflicted father...
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For almost 40 years I practiced internal and geriatric medicine in my own office and in emergency departments, hospitals, skilled nursing facilities, rehabilitation units, and long-term care communities. This means that I have had thousands of face-to-face interactions with folks from all walks of life: I’ve observed them, diagnosed and treated their conditions, and monitored their medical journeys over years, even decades. I have spent a lifetime paying attention to people’s medical needs.

In a restaurant or the post office, at a school reunion or sitting in an airport, I cannot help but pick out among my fellow travelers in this life those who have a Parkinsonian posture, a hemiparetic or neuropathic gait, or the jaundiced conjunctivae indicative of liver disease. I spot hundreds of clinical clues that I have long watched for in my patients.
I myself am a septuagenarian, and I shepherded a father with Alzheimer’s disease and a mother with diabetes, chronic lung disease, a stroke, frailty, and finally a fractured hip through to their ends at home, each dying in their own bed at 87 and 93 years of age. I know what it is to watch aging up close — and now to age in my own body.

I’ve watched President Joseph R. Biden age. When he was elected to the Senate in 1972, I was a medical student in Philadelphia. During his years as vice president, I was deep into my medical career. The year he was elected U.S. president, I had recently retired from active practice. My work life was exhausting; I can only imagine what his must be like, especially now that he is 80. If he runs again and wins, he will be 86 at the end of his second term. In gerontological speak, at that age he will be among America’s “oldest old.”

He’s a bit stooped, his gait stiffer, and his voice less forceful. His lifelong stutter is mild but manifests at times. In addition, he has some difficulty with throat clearing. According to the publicly available records, his physician of 15 years, Dr. Kevin O’Connor, performed a comprehensive examination on the president on November 19, 2021, and again in early 2023. In his reports, Dr. O’Connor addresses all these issues in turn thoroughly, including appropriate consultations and procedures by ear, nose, and throat, orthopedic, cardiac, neurological, and gastrointestinal specialists.

President Biden’s stiffened gait is explained by arthritis of the spine, old sports injuries, and a relatively recent right midfoot fracture. A neurological examination showed “no findings which would be consistent with any cerebellar or other central neurological disorder, such as stroke, multiple sclerosis, Parkinson’s or ascending lateral sclerosis.” His workup did reveal that the president has esophageal reflux — a benign, common condition — as a cause of his throat-clearing.

Dr. O’Connor did note that the president has “a mild sensory peripheral neuropathy.” Appropriate potential causes were investigated — including diabetes, certain vitamin deficiencies, and thyroid problems — but none were identified. Another potential cause, excessive alcohol intake, is not an issue in this president because he does not drink. As Dr. O’Connor notes, “in up to 46% of cases [of mild peripheral neuropathy] a specific cause is not identified.”

But does he have dementia? This has become the focus of media attention on the president’s current age and health.

All but the most partisan of us can make a reasonably objective assessment of President Biden’s cognitive capacity by watching him on television. His 2023 State of the Union speech showed him to be lively, feisty, and able to engage appropriately and extemporaneously with the audience — as he also has done during interviews since that time. To this geriatrician, he is not exhibiting signs of dementia. Should he have formal cognitive testing as part of his yearly comprehensive physical examination? Of course he should, and the results should be made public. Indeed, why not ask for the same from all members of Congress over a certain age?

But, really, how long can Biden last — and remain mentally intact? This is the bottom-line question that his detractors, and even many of his supporters, want answered. And it’s a reasonable question because if one looks at standard actuarial tables of life expectancy based on age, one finds that an 80-year-old man will — on average — live another nine years. And the average 80-year-old man will — on average — have a 30% chance of exhibiting some dementia by this age, which increases by 3% yearly thereafter (Demography 2017;54:1897–1919).

But none of us are exactly “average.” The particulars of our backgrounds — sex, genetics, race, family history, tobacco and alcohol use, diet, and current health habits — have a collective impact on our life expectancy and on our likelihood of developing dementia. If one takes the time to enter what is known about the president’s health status (including laboratory results from his last two examinations) into a predictive algorithm, the results are quite different from average estimates.

President Biden’s life expectancy is 95 years (Thomas Perle, MD, MPH, Living to 100: Life Expectancy Calculator, https://www.livingto100.com). His risk of a dementia diagnosis in the next five years is 16% (Project Big Life, “Dementia Calculator,” https://www.projectbiglife.ca/dementia). There are a number of such predictive algorithms, and gerontologists may debate which ones may be more accurate than others. We might all benefit from their discussion.

Many in our society will look at a man (or woman) with thinning white hair, wrinkled skin, stiff posture, and throat-clearing episodes and judge that person to be “over the hill” or demented. But this is ageism at its most elemental and detrimental. This prejudice will damage each and every one of us as we age.

Geriatricians have long noted that one of the best predictors of how well the patient sitting before us will age in the future is how old and how healthy our patient is at that moment. Given the current health information available to us, President Biden is a healthy, mentally intact 80-year-old man.

None of us is able to predict with any certainty what may happen tomorrow. But we can cease being ageist: we can look at the objective evidence before us and use the tools available in an attempt to make some reasonable predictions. I hope politicians and pundits of all political persuasions will endeavor to do this with the goal of making America a fairer, healthier society.

Dr. Winakur practiced internal and geriatric medicine for 36 years and is an adjunct faculty member in the Division of Geriatrics at UT-Health San Antonio. In his memoir-manifesto, Memory Lessons: A Doctor’s Story, he writes about caring for his father with Alzheimer’s disease, and the changes he has witnessed in the practice of medicine. The author’s views do not represent those of the Society or any other entity.
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For an 80 yr old man, JB is clearly above average in physical health and mental acuity, thus the expectation of his living well into his mid-90's...as many of us have seen others do...but then, there are always the "most partisan" among us who will never take an objective perspective.


Link: https://www.caringfortheages.com/article/S1526-4114(23)00188-9/fulltext

There are websites with endless lists of them that are used by attorneys to find ones that will provide supporting testimony for our clients' cases.

You keep posting links to expert opinions that support your own point of view.

It's kabuki!

In the end, we all see what we want to see.


Link: https://www.dailymail.co.uk/news/article-13520061/Sadly-impossible-deny-Joe-Biden-powerful-man-world-increasingly-loopy-getting-worse-writes-FREDDY-GRAY.html

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...the MAGAs are too addled to learn ;-)...

This year's SOTU speech...no dementia that night...

Unfortunately my login timed out and it was lost, so I'll go with the short version.

A year old article does nothing to refute what people are saying and seeing now. It means nothing, because there are new data points to consider that can change the view of the author. You do this constantly, posting something outdated and act like it actually matters. It would have been an important piece to read last year, it means nothing this year.

You are the absolute king of finding one piece of data that supports your opinion and acting like it trumps everything. That is what most scientists would call bad science. You have to look at all the evidence Ty, not just the things that make you feel all warm and fuzzy.

be honest...the claims of dementia against Biden didn't just start this year...Trump's been pushing that meme since the 2020 election campaign, so that year old article is totally relevant and not at all "out dated". Also, I provided this year's version of the SOTU speech as well, which the Geriatrician cited as evidence for JB's mental competence. You just blew your credibility on that one.

As for your second paragraph, the evidence is clear...YOU didn't consider all the evidence going back to 2020...

Frankly, I'm glad I didn't have to read your long version of a poorly researched and disingenuous post...but take heart...you're not alone in that regard on this Forum ;-)

Claims against dementia - I don't honestly care about any of the nonsense before, my point which you I guess don't understand is that the report is over a year old. It is outdated. You don't see that because you need it to validate your opinion, which is fine. It's your opinion that Biden standing around like a lost scarecrow while everyone is dancing is far less relevant than an article by someone from over a year ago because he mentioned the State of the Union, and you even posted the video proof that he had a good night! Hey, at least he had a good night.

I have looked at all the posts, from both you and your friends on the left, and Baron and his friends on the right. I guess I'm just a guy who sees a lot more evidence for some type of mental issue over the last 4 years than a guy who is still sharp as a tack. We can agree to disagree Ty.

By the way, you were a lot more fun when you started and you were less condescending, but I guess your true colors are coming through more and more lately. The long version was mostly questions directed at you, that you would have dodged anyway, so no loss there.

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...then, using that assessment, it's reasonable to assume for his opponent...DJT's physical health (weight, lack of exercise, eating habits...Morbid Obesity) and inability to make coherent statements ...leads one to expect a much shorter life span. It is what it is...

All but the most partisan of us can make a reasonably objective assessment of President Biden’s cognitive capacity by watching him on television. His 2023 State of the Union speech showed him to be lively, feisty, and able to engage appropriately and extemporaneously with the audience — as he also has done during interviews since that time. To this geriatrician, he is not exhibiting signs of dementia.

vs...your totally partisan hack attempt....

The Las Vegas one is a perfect example.

Plus the dude can’t read off the prompter anymore. Truly failing and the Dad died of dementia.

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What a pathetic defense.

...he can't seems totally unable to hold a consistent thought...never exercises...and eats nothing but burgers, fries, sodas and chocolate cake...no surprise his BMI is north of 40...i.e. "Morbidly Obese"...which means that his odds of making it to 95...like JB...are very long indeed.

The choice between Biden and Trump based on age, physical condition and mental acuity is now much clearer...BIDEN by a mile!

Functional cognitive decline starts from age of 60 for almost everyone and gradually speeds up as people age. This is true to anybody regardless you have clinical dementia or not.

Tell me in modern world who in which country becomes president at age of 82?

attached article produced by people who make their careers out of such studies...but I'm not sure you're smart enough to even grasp the reality.

btw, take a look at Dr. Fauci's recent 4 hr Congressional Hearing...he took on Congressmen/women half his age (he's 83) and not one of them landed a 'punch' on him. Do you really think YOU could match his "Fund of Knowledge" for Infectious Diseases, Virology, Microbiology, Epidemiology, Government Requirements, International organizations and their scientists, etc., etc... Very few people are as mentally capable...at any age..as he is right now.

Not all 77-80 yr olds are created equal...witness Donald J. Trump and his bizarre word salads on the campaign trail.


Link: https://www.nia.nih.gov/news/cognitive-super-agers-defy-typical-age-related-decline-brainpower#:~:text=Although%20it's%20normal%20for%20brainpower,a%20natural%20part%20of%20aging.

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