President Biden, already the nation’s oldest president, turns 81 on Monday, but the White House is keeping the festivities low-key amid widespread concerns about his advanced age.
When Mr. Biden was born in 1942, the film “Casablanca” was a week away from its premiere, Hitler was running Germany, and the first nuclear reactor would not be created for two more weeks.
Flash forward nearly a century and Mr. Biden is running the world’s largest superpower and dealing with issues such as artificial intelligence, social media disinformation and other realities that seemed like science fiction when Mr. Biden was a young man.
If he wins reelection, he will be 82 at his second inaugural and 86 when his second term ends. The next-oldest president at the end of his term was Ronald Reagan, who left office in January 1989 at 77.
The White House declined to reveal Mr. Biden‘s birthday plans.
Voters say Mr. Biden‘s age is a glaring weakness. A Yahoo News/YouGov poll released just days before Mr. Biden‘s birthday found that 54% of voters think he no longer has the “competence to carry about the job of president.” That’s up from 49% who said that in February.
Less than one-third of respondents — 31% — said the president is still competent, a 4-point decrease from February. And an overwhelming 64% of respondents say they are concerned about Mr. Biden‘s “health and mental acuity.”
David Axelrod, one of former President Barack Obama’s top advisers, recently cautioned Democrats that poll after poll shows Mr. Biden‘s age is a problem for voters. What’s worse, he said, is that little can be done to fix it.
“That is one thing you can’t reverse no matter how effective Joe Biden is behind the scenes. In front of the camera, what he’s projecting is causing people concerns, and that is worrisome,” Mr. Axelrod said on CNN.
Mr. Biden‘s age means he could rapidly decline at any moment or he could be fine for years to come. That’s the gamble that worries voters.
“A lot of people fear that he could fade very rapidly and Kamala Harris is widely perceived as underperforming as vice president. They may not be as afraid of Biden‘s age as they would be to see Kamala Harris as president,” said Robert Rowland, who teaches presidential rhetoric at the University of Kansas.
Mr. Biden has sought to defuse concerns about whether he’s fit for office by responding, “Watch me.” In recent months, he’s tried to label his age as a strength by arguing it gives him experience and wisdom.
Michael Wasserman, a geriatrician and chair of public policy at the California Association of Long Term Care Medicine who has not treated Mr. Biden, said he doesn’t see any health concerns based on the president’s public appearances. While Dr. Wasserman acknowledges Mr. Biden does appear slower than he did when he took office in January 2021, there are no obvious signs that the president can’t do his job.
“Things like Biden being a little slower or forgetting a name don’t matter to me. None of that has any impact on his ability,” he said. “I look for his response when there are opportunities to be off the cuff and spontaneous and he still looks good to me.”
In general, health risks increase sharply after age 80. Roughly 85% of adults aged 80 or older have at least one chronic health condition and 60% have at least two chronic conditions, according to the Mayo Clinic.
The risk of Alzheimer’s disease doubles every five years and men in their 80s have a 24% chance of developing the disease, compared with a 4.9% chance for men in their 70s.
Kevin O’Connor, the president’s longtime physician, declared after the president’s physical examination in February that Mr. Biden is a “healthy, vigorous 80-year-old.” Dr. O’Connor did note that Mr. Biden‘s gait remains stiff because of “significant spinal arthritis” and neuropathy in his foot.
A letter released by the White House from Dr. O’Connor did not indicate whether Mr. Biden had undergone any cognitive assessment, which can be performed in a few minutes and is considered essential to catching changes linked to dementia.
Still, the president has had some embarrassing falls, including repeatedly stumbling on the stairs of Air Force One. Mr. Biden took a serious fall in June after tripping over a sandbag after delivering the commencement speech at the Air Force Academy. Last year, he fell off his bike in Delaware.
To avoid more embarrassing videos of Mr. Biden taking a tumble, the White House enlisted a physical therapist to help Mr. Biden improve his balance, had him wear tennis shoes with softer soles and installed shorter stairs on Air Force One.
Dr. Wasserman said such steps were “appropriate measures” to prevent any 81-year-old from falling.
The president’s staff is adamant about avoiding public falls, fearing it could hurt his electability especially as questions about his age continue to swirl.
Concerns about the president’s age are not limited to his physical issues. Voters are also concerned about his cognitive abilities after a year of gaffes and mental miscues.
In the past week, he referred to Vice President Kamala Harris as “president” and became exasperated trying to pronounce the name of a tech company before declaring he wouldn’t even try to say the name.
Other spells of forgetfulness have been more serious. In September, Mr. Biden left Brazilian President Luis Inacio Lula da Silva visibly annoyed by walking off stage without shaking hands. The accidental snub was part of a disastrous appearance in which Mr. Biden nearly knocked over the Brazilian flag and struggled to work his translation headset device.
The president this year fumbled softball questions from children at a Take Your Child to Work Day event at the White House. Mr. Biden couldn’t recall his last overseas trip despite having traveled to Ireland roughly 10 days earlier. He was also unable to recall the name of his favorite movie, where his grandchildren live or how many grandchildren he has.
Dr. Wasserman said he doesn’t see signs of Alzheimer’s or dementia based on the president’s public displays. He said the president doesn’t present the blank stare, loss of executive function, extensive forgetfulness or any other hallmarks of those illnesses.
Still, Mr. Rowland says the White House needs to confront worries about Mr. Biden‘s cognitive abilities head-on by putting him in more unscripted settings to demonstrate his command of the issues. He noted that Reagan would frequently do such off-the-cuff events to counter age questions, but those sessions stopped about two years into his second term.
“Putting Biden in these unscripted settings would be a way to change the narrative, but it would be high risk. If he has a bad day, that would be devastating,” he said. “Reagan had won reelection, so there was no longer a reward for putting him in those settings. With Biden, it would be more of a risk, but it would be a higher reward.”