Experts on ageing caution against concluding that US president Joe Biden and his Republican rival Donald Trump are suffering from cognitive decline based on their verbal slip-ups, saying that mixing up names or dates does not necessarily mean a deterioration in mental acuity.
Mr Biden, 81, a Democrat running for re-election in November, and former US president Trump, 77, his likely challenger, have accused each other of mental decline. Mr Trump's last rival for the Republican nomination, 52-year-old Nikki Haley, has said both men are too old to occupy the White House and should be subjected to cognitive tests.
Five ageing experts interviewed by Reuters stressed cognitive assessments can only be made by doctors via special in-person examinations and tests, and warned that judging candidates' mental acuity from news clips and interviews can be dangerously inaccurate and misleading. They said that the US public and media risk becoming a nation of armchair gerontologists.
"We make mistakes. The probability of slip-ups rises as we get older. That has nothing to do with judgement," said S Jay Olshansky, a professor in the School of Public Health at the University of Illinois at Chicago.
"Someone commenting on Trump turning right when he should have turned left? Big deal. Tripping? Join the club. A misspoken word? It happens to all of us. None of us would survive a 24/7 camera."
Election issue
Age has nonetheless become a major issue in this election, especially for Mr Biden, the oldest person ever to occupy the Oval Office.
Some 78 per cent of respondents in a new Reuters/Ipsos poll published Tuesday - including 71 per cent of Democrats - think Mr Biden is too old to work in government. Mr Trump suffers less from voter scepticism over his age; 53 per cent of respondents consider him to be too old for government work.
Some 62 per cent of respondents, and 37 per cent of Democrats, said Mr Biden was not mentally sharp and able to deal with challenges.
Some 47 per cent of respondents and 19 per cent of Republicans said Mr Trump was not.
The age issue was thrust front and center again after special counsel Robert Hur, a Republican former US attorney in Maryland during Mr Trump's administration, said in his report on Mr Biden's handling of classified documents last week that Mr Biden was a "well-meaning, elderly man with a poor memory" who was not able to recall to investigators when his son, Beau Biden, died.
Mr Biden angrily denied Mr Hur's allegations about his memory, saying in a White House appearance that "my memory's fine." However, in the same speech, he confused the president of Mexico for Egypt's.
Officials including vice president Kamala Harris and homeland security Secretary Alejandro Mayorkas say that Mr Biden appears sharp and on top of things in calls and meetings.
Mr Trump has recently made some verbal slip-ups too. During a speech on January 19th he confused Ms Haley with former Democratic House speaker Nancy Pelosi. He also suggested former Democratic president Barack Obama was still in office.
Elliott M Stein, a geriatric psychiatrist based in California, said misstatements can be due to a number of things, including a bad night's sleep or being distracted.
"This is especially true of someone who is under time pressures or situation pressures, or being interviewed or in the public eye," Mr Stein said.
Mr Trump regularly gives speeches of one to two hours, during which he frequently veers off his teleprompter.
Dr Eric Lenze, head of the department of psychiatry at Washington University School of Medicine in St Louis, said the focus should not be just on mistakes.
"It's also what someone gets right. Did they say 25 things right and one thing wrong, then that's pretty darn good. Look at what they're getting right, especially in spontaneous speeches," said Dr Lenze.
Medical records scrutinised
Mr Biden is, by the numbers, a remarkably healthy American man. He exercises five times a week, has never smoked or drank and his blood pressure and body mass index, at 126/78 and 24.1, respectively, according to his 2023 physical, would be great numbers for a much younger man, medical experts say.
At Monday's White House briefing, spokesperson Karine Jean-Pierre said Mr Biden would have a physical exam, as previously scheduled, but said she didn't have a timeline for it.
When asked whether Mr Biden would be taking a cognitive test, Ms Jean-Pierre appeared to say he would not. "The president proves every day how he operates, how he thinks — right? — by dealing with world leaders, by making really difficult decisions on behalf of the American people."
Mr Trump's physician wrote in a note released in November that the former president is in "excellent health" and that "he will continue to enjoy a healthy active lifestyle for many years".
The note, which was signed by Bruce Aronwald, an osteopath from New Jersey, provided very few details. A Trump physician, Harold Bornstein, who produced a similar note released in 2015, said that Mr Trump had dictated its contents.
A 2020 paper published by University of Illinois' Olshansky and colleagues analysed Mr Trump and Mr Biden's medical records and concluded that they were both in broadly good health and had family histories of longevity.
"There is suggestive evidence that both candidates are likely to be 'super agers,'" the researchers said. However, the paper noted that Mr Biden appeared to have better diet and exercise regimens than Trump.
Olshansky said he hoped to repeat the study over the summer, pending fresh medical records.
Asked for Mr Trump's most recent medical records and whether he would be taking a cognitive test, the Trump campaign pointed to the physician's note in November. Spokesperson Steven Cheung added that Mr Trump will “out work” Mr Biden.
