The debate about Biden's age and mental fitness

President Joe Biden recently took a very public tumble after he tripped on a sandbag and fell while onstage at the U.S. Air Force Academy graduation. This has stirred up renewed speculation about his physical and mental fitness due to his advanced age.

The fall comes months after he formally announced his bid for reelection in 2024. The president entered the race amid lukewarm support for his reelection bid in polls. An April NBC News poll indicated that a Biden-Trump rematch in 2024 remained unpopular among most voters. Biden's announcement may have clarified questions about his candidacy, but questions about his mental competency and advanced age still loom. The president's age remained a significant issue for nearly half of the respondents against him running for a second term.

Biden said he respected that voters have questioned his health and mental faculties due to his age and insisted he took that into account when considering whether to run again. "I took a hard look at it before I decided to run, and I feel good, I feel excited about the prospects," Biden said when asked about his age days after announcing his campaign. The most recent report from the president's physician, Dr. Kevin O'Connor, said he was "fit for duty" and "fully executes all of his responsibilities without any exemptions or accommodations."

Why is Biden's age so noteworthy?

President Biden is 80 years old; at age 78, he became the oldest person to assume the presidency in U.S. history. By the end of his term, he'll be 82. Now that Biden has officially confirmed that he's running for reelection, he would be 86 by the end of his second term, eight years older than the average life expectancy for an American male. Ronald Reagan began his second term at the age of 73 and is widely believed to have suffered from Alzheimer's toward the end of his presidency. The median age of American presidents on Inauguration Day is 55.

Is he showing signs of cognitive decline?

Not necessarily. Biden frequently stumbles over his words, but that could be at least partially because of his history with a stutter. Journalist John Hendrickson described Biden's stutter, and his lifelong struggle to control it, as the president's "most visible weakness" but also "the main source of his grit and determination." Senior care experts note that some forms of dementia can lead to stuttering and that childhood stutters sometimes reemerge among elderly people, especially if they experience an increase in confusion or anxiety.

Last year, in an op-ed for The Hill, Marc Siegel noted that "at least 15% of those over the age of 75 have some cognitive impairment," that the president has several risk factors that could increase the likelihood of cognitive issues, and that the doctor's report following Biden's physical in November 2022 found "a significant worsening in the president's gait, which in some cases can be related to degenerative disease in the brain or the spinal cord." That report also concluded that Biden was "fit to successfully execute the duties of the presidency."

What are commentators saying about Biden's age?

It might be "deeply unfair" to make assumptions about Biden's capacity to do his job because of his age. In his case, "it's impossible to deny that politics and conspiracy theories, rather than facts, fuel at least some of the concern," The New York Times editorial board opined. Still, Biden and other candidates shouldn't pretend that "advanced age isn't an issue." As Biden runs for reelection, he "will need to provide explicit reassurance to voters; many of them have seen family members decline rapidly in their 80s."

Democrats should see Biden's advanced age "as a not ideal situation but one that's better than the likely alternatives," Matthew Cooper wrote in the Washington Monthly. While Biden's satisfactory health reports have been "less than reassuring," Cooper said he has "been able to do the job well, and he's done it in better physical shape than previous presidents who overcame worse infirmities," such as Ronald Reagan, Franklin D. Roosevelt and Woodrow Wilson. "Barring a cataclysmic health decline," Cooper added, "Biden will be in better shape in a second term than Reagan, FDR and certainly Wilson." Biden's age may be "unprecedented," but so would losing with his record, Cooper concluded.

Based on his unpopularity in recent polls, The Wall Street Journal's editorial board believed the public understands "that electing an octogenarian in obvious decline for another four years could be a historic mistake." Asking people to elect a man who's already the oldest president to hold office "is a risky act that borders on selfish." While the Journal contended that the White House hides Biden's "real physical and mental state," the editorial board said, "his decline is clear to anyone who isn't willfully blind. "

What does polling show?

When Biden was a candidate in the 2020 race, his relatively strong debate performances and pandemic-driven minimalist campaign strategy inspired confidence that, despite his age, Biden was still in full command of his faculties. Just before the 2020 election, voters "believed [Biden] was mentally fit by a 21-point margin," Politico. reported.

That confidence didn't last. By November 2021, 48% of voters said Biden was mentally unfit for office. Three months later, that number was up to 54%.

About three in four Americans surveyed in the April Associated Press-NORC Center for Public Affairs Research poll would prefer Biden didn't run again. Only 47% of Democrats polled want to see Biden on the ballot, yet 41% said they would support him if he ran, and another 40% said they might. "Interviews with poll respondents suggest that the gap reflects concerns about Biden's age," the AP explained, "as well as a clamoring from a younger generation of Democrats who say they want leadership that reflects their demographic and their values."

In the latest Washington Post-ABC News poll, 68% of Americans surveyed said Biden was too old for a second term in office. His overall job rating also sunk to 36%, down from 42% in February. Only 34% overall felt that Biden had the mental sharpness to serve as president, and just 30% felt he had the physical fortitude needed for the role. The poll was conducted from April 28 through May 3, 2023, with 1,006 respondents and a margin of error of +/-3.5.

In an NBC poll released in April, 70% of Americans surveyed said Biden should not run for a second term in office, while just 26% said he should. Among Democrats, 51% voted against Biden seeking a second term, while 48% of those against Biden running said his age was a major factor in that stance. Former President Donald Trump, who has also officially put in his bid, didn't fare much better with the poll respondents, with 60% against him running again. The survey was taken from April 14 through 18, with 1,000 respondents and a margin of error of +/-3.1.

Updated June 6, 2023: This article has been updated throughout.

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