If former Vice President Joe Biden secures the nomination, Americans might be forced to choose between two men who are sundowning and showing significant cognitive decline.

It is important to note that the information needed to actually diagnose Biden (or Trump) is not something that can be gleaned from the public eye, but a recent string of confusions and misstatements should be seen as concerning given the early symptoms of late-in-life mental impairment.

In just the past week, Biden has claimed he was visited while Vice President by the Parkland survivors (Parkland happened a year after Biden left office), conflated blackness with poverty, referred to former British Prime Minister Theresa May as Margaret Thatcher, and misidentified the mass shootings last weekend as being in Michigan and Houston (they were in Dayton, Ohio and El Paso, Texas).

His cloudy debate performance at the end of July also directed viewers to “Joe 30330“, an apparent combination of his website and the text message code for the campaign, 30330.

Contrasted with the vital and encyclopedic performance of Senator Bernie Sanders (I-Vermont) — who is older — both in Detroit and on Joe Rogan’s podcast, the picture of Biden’s mental state raises alarms.

In fairness, Biden has a longstanding reputation as a gaffe machine, often saying things that get him into political trouble. From a message of mourning for a politician’s mother who was very much alive to calling then-political opponent Barack Obama “articulate and bright and clean,” Biden’s list of missteps is long. But there’s a certain character to his recent blunders — confusion.

In particular, the confusion between two similar figures — Theresa May and Margret Thatcher — is telling. May and Thatcher are both conservative women who had a reputation of stoicism that sparked intense criticism for their actions in office. The difference between them is thirty years of time. Being disoriented temporally is a major symptom of dementia. So, too, is being forgetful of recent events like the locations of the Dayton and El Paso shootings.

In particular, the events-in-the-evening nature of campaigning has made comparisons between Biden’s mental state and a particular form of dementia called Sundowning, where cognitive performance diminishes later in the day. Sundowning is aggravated by the unusual schedule presidential candidates keep and the fatigue of a rigorous schedule.

It also bears mention that Biden’s early warning signs for dementia resemble the early days of President Ronald Reagan’s decline. A 2015 study of Reagan’s speeches published in the Journal of Alzheimer’s Disease found that there were red flags very, very early in his tenure as president, and Reagan’s son observed signs of his father’s decline while he was in office.

Again using Reagan as a measure, though, President Donald Trump has much more in common with late-term Reagan. Adding to Biden’s seeming confusion and disorientation, President Trump displays a general apathy to his work as president, doesn’t read briefs and spends a lot of time watching television based on accounts in books like Fire and Fury and Fear. Even former Trump aides have described a dramatic cognitive decline.

But President Trump has an asset that Biden doesn’t — a base who won’t ever abandon him. In a contest between two aging, declining men, that base could help Trump stay in office.

There’s also reason to worry that being elected would speed Biden’s decline. Stress management and quality sleep are both part of keeping the progression of this decline at bay, and both are notoriously unavailable to a president. Being president places a person under conditions that are extreme enough the changes can be hard to believe compared side-by-side. Democratic candidate and venture capitalist Andrew Yang has even called for a White House psychologist to help with the mental and emotional toll of the job.

It’s impossible to know Joe Biden’s physical or mental fitness. For all the insight we have into candidates, they still remain closely shielded by their campaigns. It also is inadvisable to diagnose someone based on public information. It would be impossible and reckless to say that Biden is definitely suffering from an early stage of dementia. But to not call attention to the signs and potential dangers of Biden’s sundowning would also be reckless.

Moreover, a career like Biden’s deserves a more dignified end than a very public descent into night.

(Featured image: KCCI 8/Fair Use)


Katelyn Kivel is a contributing editor and senior legal reporter for Grit Post in Kalamazoo, Michigan. Follow her on Twitter @KatelynKivel.


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