WWhen I interviewed President Ronald Reagan about his health in 1980, he was 69 years old and on the verge of becoming the oldest person to be elected president. Regan was mentally sharp during our conversation. In a light moment, he pretended to hurt his back and asked what I (the doctor) would do about it.
When I asked about my mother's health, she told me that she had symptoms of dementia before she passed away. I asked him what he would do if he contracted the same disease as president, and how would he know he had the same disease? He said his doctors would monitor him and resign if they found evidence of cognitive decline. Years later, these statements would have been especially noteworthy.
The meeting was perhaps the first time a future president and his doctors spoke positively about the leader's health. (That cooperation didn't last long. President Reagan's aides said that when he ran for re-election after what some viewed as a poor performance in a debate with Walter Mondale, They did not allow reporters to interview Mr. Reagan or his doctors.)
For 52 years, I reported on the health of U.S. and foreign political leaders for The New York Times, bringing my experience as a physician to a new field of journalism. The last presidential candidates to respond to my interview requests were George W. Bush (just 10 minutes) and John F. Kerry (a separate, full conversation with Kerry and his doctor) in 2004.
A question I've pondered for a long time is, “How old do you have to be to be President of the United States?”
The question is especially important now because the candidates from the two major parties in November's election will be the oldest pair of rivals in history. President Biden is 81 years old and former President Donald Trump is 77 years old. If re-elected, Mr. Biden will be 86 years old (my current age) and Mr. Trump will be 82 when he retires in 2029.
that too old This question is impossible to answer. One reason is that the Founding Fathers did not address this issue. The Constitution sets a minimum age of 35, but there is no upper age limit. Maybe it's because in the early days of the republic, no one could have predicted the advances in medicine that would allow an octogenarian to become president.
Had now-standard medicines such as the polio vaccine and blood pressure-lowering drugs been available to presidents like Franklin D. Roosevelt, they might have survived much longer. Similarly, imagine if antibiotics had been available for assassinated James A. Garfield and William McKinley, or statins to help prevent heart attacks for Warren G. Harding and others.Better public health measures may also have contributed to his 18-year damageth and 19th For centuries, presidents suffered from rubella and other infections caused by inadequate plumbing, sewage, and sanitation in the White House and Washington Wetlands.
A survey of the health status of political leaders found that sitting presidents suffer from gout, heart and circulatory diseases, cancer, phlebitis, pneumonia, Covid-19, abscesses, and many other illnesses. I know what you're experiencing. In 2006, a systematic review of historical accounts of 37 presidents from 1776 to 1974 found that 10 (27%) had evidence of mental illness while in office.
However, there is no direct correlation between leader ability and leadership ability. Health and performance at the office. Many historians underestimate the accomplishments of a healthy President Carter (now 99 years old). President Franklin D. Roosevelt was paralyzed by polio in 1921 at the age of 39, and after years of high blood pressure and coronary artery disease, he died of a stroke at the age of 63. Still, Roosevelt is considered one of America's greatest presidents.
That's because age is more of a physiological state of health than a chronological number. This condition is difficult to measure and can be interpreted in many ways. People age in different ways at different times and in different patterns, making chronology and physiological age distinct entities. Because candidates rarely disclose their actual medical records, the most reliable way to assess who can withstand the physical and mental demands of the White House is through extensive interviews with candidates and their doctors. I found out that I can get it. The lack of such information leaves it up to candidates to convince voters that they are fit to serve a full term.
Opinion polls show that many voters want a younger candidate to face them in the 2024 presidential election. Voters perceive candidates' health status in different ways. Many people accept at face value the medical evaluation of the doctor who examined the candidate. Some people form opinions based on news reports and visual sightings on television or social media, or based on personal experiences with older family members and friends.
Both Trump and Biden have released recent information from their current doctors certifying that they are in good health. Biden released a detailed summary of his final medical exam in 2023 by a team of Bethesda doctors. In late 2023, President Trump released a one-page memo from his current doctor with few details, but shared a White House report on a 2017 multi-doctor team exam in Bethesda. did.
Health professionals are calling for cognitive screening tests to play a greater role in assessing candidates' health. Trump boasts that he passed the Montreal Cognitive Assessment in 2017. However, he did not report whether his current attending physician repeated similar tests. If so, when. And the result. Additionally, neither candidate has made their doctors available to journalists for in-depth interviews.
Since their first confrontation in 2020, both men have shown changes due to their age, such as misspelling the names of domestic and foreign leaders and various countries. While such mix-ups are common and embarrassing among people who make spontaneous statements, their significance in assessing a candidate's health is uncertain.
Recent news stories have shown the limitations of not having reliable medical information to assess the president's health. In a report explaining why Biden will not be indicted for misusing classified information, Special Counsel Robert K. Hur called Biden a “well-intentioned old man with a poor memory” whose “abilities have diminished with age.” This caused a political uproar. information.
However, Mr. Heo is a lawyer and not a doctor with expertise in assessing cognitive decline. His assessment was based on five hours and 10 minutes of contact with Biden over two days. In his opinion, “it would be difficult to convict 'Biden' of serious felonies that require a deliberate state of mind.” No notes or video recordings of the meeting between Mr. Xu and Mr. Biden have been made public.
Without that material, it is impossible to judge how valid Mr. Huh's evaluation is. The way you speak, your tone, and your expressions are valuable clues when assessing your cognitive abilities.
To truly evaluate a candidate's suitability for office, we need more than a special counsel's report or a quick clip of a recall dispute. Because the public has a right to be informed, it is wise for leaders and their doctors to fully and transparently disclose their health information. Too often, the public learns, belatedly, that candidates and their doctors have not proactively disclosed health information. In fact, some people have distorted the facts, if not lied.
Almost six years after leaving office, Reagan announced that he had been diagnosed with Alzheimer's disease, but in retrospect, questions arose as to whether the disease affected his performance during his time in office.
Doctors in President Reagan's White House, who examined him daily and tested him regularly, repeatedly said they had never detected any symptoms of dementia during his two terms in office. Still, the timing of the dementia problem remains largely unresolved because President Reagan's medical records, like those of other presidents, cannot be analyzed by independent medical experts.
After President Reagan, there were four Americans: George H.W. Bush (age 64 when he took office), Bill Clinton (age 46), George W. Bush (age 54), and Barack Obama (age 47). elected a young president. They were fairly representative of the age range of most presidents, who were in their 40s, 50s, or 60s before President Reagan took office.
In 1996, Clinton's opponent, Bob Dole, agreed to an interview and allowed me to speak to his doctor. He wanted the public to know that he was healthy “other than physically,” despite his well-known medical problems. Mr. Dole was 73 years old at the time and would have been the oldest president. He was injured as an infantry officer in Italy during World War II, making him the most severely disabled presidential candidate. Dole was left a quadriplegic for more than a year as a result of injuries sustained in the war. Although he gradually regained the use of his legs and left arm, he had little use of his right arm. He also lost a kidney. The rest of his one is compensated by getting bigger. In 1991, Dole underwent surgery to remove his cancerous prostate. Testing showed no evidence of recurrence.
Nevertheless, Dole coped with the issue of age by saying that he “didn't forget a lot” and kept his memory sharp by training his memory by thinking about Senate matters.
Dole lost, of course, but in recent years the age pendulum has swung back toward older leaders. In 2016, 70-year-old Trump defeated 69-year-old Hillary Clinton.
Although you should be careful about your age, anyone can experience illness regardless of their age. An indisputable fact is that with increasing age, the risk of developing many diseases increases. Of particular concern is the incidence of Alzheimer's disease and other dementias in older adults. Research shows that 17% of Americans between the ages of 75 and 84 and 32% of those over 85 have dementia.
But that means more than two-thirds do do not have I have dementia.
Voters and political journalists would have a duty to keep that in mind.
Lawrence K. Altman is a physician, clinical professor of medicine at New York University, and former New York Times reporter and Doctor's World columnist. He researches and writes books about the health of political leaders.
