WASHINGTON — President Joe Biden has said it is a “legitimate question to ask someone over the age of 70 if they are fit” to serve in the White House. For those who question his fitness, he has a stock answer: “Look at me.”
On Sunday, Biden turns 80 — a number he never tries to state publicly. “I can’t even say how old I’m going to be,” Biden said in a recent interview with MSNBC. “I can’t even get it out of my mouth.”
Also left unstated is that Biden would be 86 at the end of a second term should he run and win in 2024 — a fact that has seized on his critics and even has some Democrats thinking.
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But while the risk of life-threatening illness, dementia and death increases more rapidly with each passing decade of a person’s life, experts in geriatrics say that people in their 80s who are active, engaged and focused can remain productive and healthy – and that wisdom and experience are important factors to consider.
The New York Times spoke to 10 aging experts to paint a picture of what the next six years could look like for someone the president’s age. These experts did not examine or treat Biden, although they did look at publicly available information, including a White House medical report last year, a day before his 79th birthday.
Biden, these experts agreed, has a lot going for him: he is highly educated, has a lot of social interaction, a stimulating job that requires a lot of thinking, is married and has a strong family network – all factors that, according to studies. , are protective against dementia and promote healthy aging. He does not smoke or drink alcohol and exercises five times a week, according to the White House. He also has first class medical care.
His race is another factor. Life expectancy for the average white, 80-year-old male is another eight years, said Dr. John Rowe, a professor of health policy and aging at Columbia University. “And that’s the average,” Rowe said. “Many of those 80-year-olds are already sick; they are already in the nursing home.”
Scientists who study aging emphasize that chronological age is not the same as biological age – and that the two often diverge as people age. It is true that older people have a tendency to decline physically, and the brain undergoes changes as well. But in people who are active, experts say, the brain continues to evolve and some brain functions may even improve — a phenomenon experts call the “neuroplasticity of aging.”
“The idea that old age is only associated with decline is not true,” says Dr. Dilip Jeste, a psychiatrist who has studied aging at the University of California, San Diego. “There are studies that have been done around the world that show that in people who remain physically, socially, mentally and cognitively active, there is increased connectivity between specific networks, and even new neurons and synapses can form in selected brain regions with older ones. age .”
No one can predict how a single individual will fare. The White House medical report released last year was a summary of the findings of the president’s personal physician, Dr. Kevin C. O’Connor, who called him a “healthy, vigorous, 78-year-old man.” But the White House has not released underlying lab documents, as Biden did when he ran; Andrew Bates, the deputy press secretary, said Biden would receive another physical visit “in the coming months.”
O’Connor reported that the president takes prescription drugs to control his cholesterol and atrial fibrillation – an irregular heartbeat. He also noted two specific changes in Biden’s health: he had experienced “increasing frequency and severity of ‘throat clearing'” while speaking, likely due to acid reflux, and he had some stiffness in his gait.
Both are common in older people, said Dr. Dan Blazer, a professor emeritus and psychiatric epidemiologist at Duke University School of Medicine. The same, he said, applies to Biden’s verbal stumbles — including the time he went public with a congressman, apparently forgetting that she had died the previous month.
“The slipping of memory is something that’s common, but it’s not a real deficit,” said Blazer, who in 2015 led a committee of experts investigating “cognitive aging” for the National Academy of Sciences. He described such a derailment this way: “They forget, they remember that they forgot, and finally they remember what they forgot.”
Once people reach age 65, the risk of dementia doubles every five years, said Gill Livingston, a psychiatrist at University College London who led a 2020 committee on dementia convened by The Lancet, a medical journal. Overall, she said, in high-income countries like the United States, dementia will affect 10% of people ages 80 to 84 and 20% of people ages 85 to 89.
Biden did not undergo cognitive screening during his last physical exam, and experts are divided on the need for it for older adults. In 2019, the American Academy of Neurologists recommended annual screenings for those over 65 because “age itself is a significant risk factor for cognitive decline”. But in 2020, a federal panel of independent experts declined to endorse it, saying there wasn’t enough research to determine the “balance of pros and cons.”
Several experts say doctors typically only perform cognitive screening tests when there is evidence of a problem; Dr. Anthony Fauci, Biden’s chief medical advisor, who will turn 82 on Christmas Eve and soon retire from the federal service, said in an interview that he’s never had one.
As the baby boom group ages, the number of octogenarians grows into what experts have called a “silver tsunami.” In its 2020 Profile of Older Americans, the federal Department of Health and Human Services reported that the population age 85 and older is projected to more than double from 6.6 million in 2019 to 14.4 million in 2040.
There is no shortage of octogenarians in public life. Justice Ruth Bader Ginsburg was treated for colon cancer in her 60s and served on the Supreme Court until she died at age 87 from complications of pancreatic cancer. Seven US senators are in their 80s — including Bernie Sanders of Vermont, who ran for the Democratic nomination for president in 2016 and 2020, and Mitch McConnell of Kentucky, the Republican leader — and all you have to do is get to the chamber. looking to see the variability in how people age.
Senator Dianne Feinstein, D-Calif., is markedly reduced at 88; she has trouble remembering colleagues’ names and what happened in meetings. Senator Chuck Grassley, R-Iowa, just won reelection at 89; he will be 95 when he finishes his term. Grassley likes to tweet videos of his early morning runs and sometimes does push-ups at public campaign events.
“People in their 80s often experience decline; we shouldn’t be naive about that,” says Lisa Berkman, a professor of public policy at the Harvard School of Public Health, who studies health and aging. “And at the same time there is so much variety. People who do well and function at the highest level have the opportunity to last another 10 years, do very well during this time and make very important contributions.”
The White House says Biden is keeping a busy pace given his frequent travel during the campaign season and his recent three-country and two-continent visits to summits in Egypt, Cambodia and Indonesia.
Bates cited Biden’s legislative performance and the Democrats’ better-than-expected interim results as evidence of Biden’s strength, saying the president is in “good health and maintains an active lifestyle.” He also hit the theme of experience: “As Joe Biden has said since he became the most experienced president in American history, ‘watch him.'”
While experts are reluctant to diagnose Biden from afar — and there’s no way to predict the future — those who reviewed available White House medical records said he appears to be aging in a healthy way so far.
Jay Olshansky, a public health researcher at the University of Illinois Chicago, calls both Biden and former President Donald Trump, who is 76, likely fitting the profile of “superagers” — a “subgroup of people who lose their mental and physical function and tend to live longer than the average person their age.”
Olshansky also says it’s a misnomer to think anyone ages as president; in fact, former presidents are living longer, as an analysis he published in 2011 showed. Former President Jimmy Carter, who is active well into his 90s, turned 98 last month. President George HW Bush was 94 when he died in 2014.
Dr. Nir Barzilai, who leads a survey of centenarians and directs the Institute for Aging Research at Albert Einstein College of Medicine, put it simply: “Age,” he said, “is not something to consider in itself.”
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