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How Old Is Too Old?

As the economy picks up steam and Republicans are the ones blocking a border deal, the only issue left for Donald Trump to campaign on is Joe Biden's age, even though at 77 Trump is no spring chicken himself. Lawrence Altman is a physician who has been reporting in The New York Times on the health of American and foreign leaders for 52 years. He has interviewed both candidates and their doctors. It is a bit of a niche, but is of considerable interest this time around.

A question he has long pondered is: "How old is too old to be president of the United States?" Now he has written an article addressing this issue. If reelected, Biden would be 86 at the end of his term—Altman's current age (and he is still at work writing about age); Trump would be 82.

The too old question is not addressed in the Constitution, which sets a minimum age for being president at 35, but no maximum age. James Madison was only 36 and Alexander Hamilton was about 31 when they worked on the Constitution, so old age probably wasn't much on their mind. It is definitely on Altman's mind. In his studies of sitting presidents, Altman has learned that they have suffered from gout, heart disease, cancer, phlebitis, pneumonia, Covid-19, abscesses, and many other diseases. He also believes that 10 of them exhibited signs of mental illness. Being president is not a cushy job and doesn't make you immune, in a biological sense.

His conclusion is that there is no correlation between age, health, and performance. Many historians give Jimmy Carter (now 99) low marks for performance, yet Franklin Delano Roosevelt, who had polio, was confined to a wheelchair, and died of a stroke at 63, is generally considered one of the best presidents. He believes that there is so much variation between individuals that chronological age doesn't really indicate much about job performance. He also notes that both Biden and Trump have made factual errors when speaking off the cuff, but that really doesn't mean much. He is very dismissive of Robert Hur's comment that Biden is an elderly man with a poor memory as Hur is a lawyer, not a doctor, and is not qualified to make such statements. What is needed to make such a call is a full medical report written by a qualified physician, something neither Biden nor Trump has released.

An interesting case in point is Ronald Reagan. After he left office his wife reported that he had Alzheimer's disease. But during his term in office, none of his doctors reported any symptoms of it. When Bob Dole ran for president in 1996, he would have been the oldest president, had he won. He suffered enormous injuries during World War II, was a quadriplegic for over a year, and never recovered the use of his right arm. He also lost a kidney and had prostate cancer. Yet he was majority leader of the Senate and a vigorous candidate with an extremely sharp wit.

Finally, studies have shown that 17% of Americans aged 75 to 84 have some form of dementia, which means that 83% do not. Also, 32% of Americans 85 to 100 and up have it, which means over two-thirds do not. Old does not mean demented and there are health issues to consider other than dementia. These are things to keep in mind. (V)

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