Folks are gonna hate on me for positing what many will consider to be an ageist question, but as someone who has worked professionally in the field of aging*, I think it is a question voters should absolutely be considering.
Four of the remaining six viable Democratic presidential candidates range in age from 70 to 78 years old. That number alone should not give you pause, but other factors about certain of these candidates should. But first, let’s get a wee bit of historical perspective of how old our past presidents have been.
To date, only 3 of our 45 presidents have served in office over the age of 70. They would be Dwight Eisenhower, who turned 70 just a few months before leaving office in his second term, Ronald Regan, who turned 70 just a couple of weeks after his first inauguration, and our current POTUS, Donald Trump, who was well into his 70th year at the time of the 2016 election. If re-elected, Trump would finish a second term at age 78.
I don’t know about you, but I find that surprising. I guess I have always imagined our Presidents to be old men, and they have, but given shorter life expectancies, old men were perceived as older at younger ages through our nation’s history. My point being, for 2/3 of viable presidential candidates to be in their 70s and a full half to be much closer to 80 is, in fact, an age related aberration for a presidential candidate pool.
That is significant and something we should be talking about. Now let’s get more specific.
The oldest of the Democratic candidates is Vermont Senator Bernie Sanders. He suffered a heart attack just after his most recent birthday, which was confirmed in early October of last year by his campaign. While he had previously stated that he would release all of his medical records as a candidate, Sanders and his campaign are now walking back that pledge, maintaining that releasing medical records is a bit of a slippery slope and wonders where the requests for information will end.
I don’t know about you, but that gives me significant concern. There is online chatter that a heart attack does not matter, that even if Bernie dies or becomes incapacitated while in office, his VP will assume office. Except we don’t know who that VP is or what the health status of that person might be and the risk of subsequent heart attacks after a first one are significant. That said, Sanders appears robust and healthy on the campaign trail.
But speaking of VPs, let’s talk about former Vice President Joe Biden. No heart attacks in his health care closet, but you don’t have to look hard to see that 2020 Joe is a far cry from 2012 Joe, or even 2016 Joe. As someone who has worked with older adults professionally, I see a few red flags with Biden, but three are especially concerning for me.
One is his language. Biden’s language is disrupted and it appears to be getting worse. One of the primary and earlier signs of dementia is a change in language capacity. Aside from the “lying, dog-faced pony soldier” comment he recently made in Iowa, there are other signs of language disruption separate and apart from his well known issue of stuttering. His pauses are longer, his words and responses not always relevant to questions he is being asked. He is increasingly off topic and unresponsive and not completing sentences.
The second one is an uncharacteristic anger and loss of filter. These things are common when an older adult is struggling with changes in their frontal lobe, the part of our brain that acts as an innate censor for all of us. Biden appears angrier than his usual relatable, jovial self on the campaign path. Calling voters (plural, as this has happened more than once), not Trump or fellow candidates, a liar is a red flag for me. It is an impulsive, unfiltered response to stimulus he does not like. And it is a marked shift in personality.
Finally, there is a vacancy in Biden’s affect or expression, which is unmistakable for me. He looks lost more often than he looks in command of things. His wife, Dr. Jill Biden, is present and at his side much more often than in previous campaigns. Is she acting as cover? Is she a conscious or unconscious guide, helper for her loving husband? This is very possible and very common for older couples when one is starting to require more assistance.
These factors I have identified with Biden are nuanced and easy to explain away. Folks can become defensive when it is suggested and that is understandable. And let me stress that I am responding as someone with experience with an older population, but all of my feedback is anecdotal. That said, I can’t help but think of a current story arc from This is Us where the character of Rebecca has just been diagnosed with MCI, mild cognitive impairment. Her story line has encapsulated much of what I observe with Joe Biden and is consistent with my previous experience.
And lest folks accuse me of being ageist and discriminating solely on age, let me argue the opposite. I have seen no signs of alarm related to age from either Mike Bloomberg or Elizabeth Warren, again, both in their 70s, though Bloomberg does have a history of cardiac stent placement.
The thing about aging is that it happens to all of us, if we are lucky, and no two folks have the same experience or path. There are folks in their 90s running marathons and folks in their 60s living in nursing homes. But it is undeniable that being older puts all of us at greater risk for change, including changes in health status, and sometimes those changes are slow and progressive and sometimes those changes are sudden and acute.
It would be irresponsible not to consider the age and health of these candidates. And now, not after a candidate is chosen for the primary, or elected to office.
* I am trained as a clinical social worker and spent twelve years working in health care settings with older adults. First at a hospital in a program geared towards older adults and then at a retirement community where I was responsible for helping individuals cope with aging and the losses, cognitive and physical, related to aging. For eight years I worked alongside a geriatric psychiatrist who provided training in the neuropsychological assessment of older adults.