When President Joe Biden announced his plans to run for a second term this week, he reignited the debate about his advanced age and the capacity of individuals of that age to serve in the highest office in the land.
“We — you and I — together we’re turning things around, and we’re doing it in a big way,” Biden said.
“It’s time to finish the job. Finish the job,” he said.
Biden — who turned 80 last fall, on Nov. 20, 2022 — surpassed former President Reagan as the nation’s oldest serving president.
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His re-election campaign has many people wondering: Is there an age that is too old for someone to be president?
“I think it’s a legitimate thing to be concerned about anyone’s age, including mine,” Biden himself told MSNBC back in October.
He added, “But I think the best way to make the judgment is to watch me.”
When the Founding Fathers, who were mostly in their early 40s, were discussing and deciding the age of the president in 1787, they were more concerned with someone appearing “too youthful” than too old, according to History.com.
Article II of the U.S. Constitution specifies a minimum age — 35 — for someone to be president of the United States without setting a maximum age limit, the same website also notes.
‘Vigorous 80-year-old male’
President Biden received a clean bill of health in February from White House physician Dr. Kevin C. O’Connor, who concluded that Biden is “a healthy, vigorous 80-year-old male.”
President Biden has a past medical history significant for non-valvular atrial fibrillation, gastroesophageal reflux, seasonal allergies and mild sensory peripheral neuropathy of his feet, according to his February 16, 2023, health summary.
What is atrial fibrillation?
The heart is composed of two upper chambers, called the atria, that pumps blood into its two lower chambers, known as ventricles, per the American Heart Association.
It normally contracts and relaxes to a regular beat. But in atrial fibrillation — or aFib — the atria beat irregularly so that blood does not flow into the ventricles efficiently, the association added.
This can lead to blood clots.
Biden is on the blood thinner called Eliquis.
“If a clot breaks off, enters the bloodstream and lodges in an artery leading to the brain, a stroke results,” the cardiology association noted on its website.
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Depending on people’s risk factors, including advanced age, some are prescribed blood thinners to prevent this complication — including Biden, who is on the blood thinner called Eliquis, as of February 2023.
‘Stiffened gait,’ throat clearing
The medical report addressed his stiffened gait, noting that the condition has not worsened since last year.
A team of specialists concluded the gait is the result of degenerative or “wear-and-tear” arthritic changes in his spine.
A detailed neurological exam was “reassuring” in that there were no findings to suggest a neurological disorder, such as a stroke, multiple sclerosis, Parkinson’s disease or ascending lateral sclerosis.
The report also attributed his persistent coughing and throat-clearing due to his acid reflux.
A comprehensive neurologic exam reconfirmed the mild peripheral neuropathy in his feet.
Basal cell cancer
Biden also had a suspicious skin lesion removed on his chest during his physical in February, with the final biopsy result revealing basal cell carcinoma.
Basel cell cancer is the most common cancer in the world, according to the American Academy of Dermatology Association (AAD).
Biden continues to undergo “dermatological surveillance.”
Because it tends to grow slowly and rarely spreads to other parts of the body, it is not life-threatening for most people, the association added.
“You have a greater risk of developing this skin cancer if you’ve seldom protected your skin from the sun throughout your life or used tanning beds,” the AAD noted on its website.
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Biden spent a lot of time in the sun during this youth, the health summary noted. All cancerous tissue was removed, the biopsy site healed appropriately, and Biden continues to undergo “dermatological surveillance.”
Oldest presidents in office
Former President Ronald Reagan, the nation’s 40th president, was almost 78 years old at the end of his second term in January 1989, according to the History.com website.
While in office, he survived an assassination attempt as well as surgery to remove a cancerous polyp in the colon — proving resilience is a quality not reserved for only the youth, History added.
Reagan famously deflected attention away from his age with humor during the 1984 debate with Democratic opponent Walter Mondale, joking, “I am not going to exploit, for political purposes, my opponent’s youth and inexperience.”
“I am not going to exploit, for political purposes, my opponent’s youth and inexperience.”
Biden’s predecessor, former President Donald J. Trump, was 74 years and 200 days old when he left office, according to History. In an exclusive interview with Fox News medical contributor Dr. Marc Siegel in July 2020, Trump said he could successfully recall a sequence of five words on a cognitive screening test.
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James Buchanan left office after only one term, at 69 years and 315 days old.
Dwight D. Eisenhower was 70 years and 98 days old when he left office in January 1961.
He survived a massive heart attack scare the year before he won re-election, per the History.com site.
But James Buchanan, our nation’s 15th president, had his health deteriorate while in office because of the stress of the job. He left office after only one term, at 69 years and 315 days old, the same source noted.
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A 2011 study on the aging of U.S. presidents found that the men in the White House tended to live longer once inaugurated, compared to men of the same age — “even if they hypothetically aged at twice the normal rate while in office.”
The study noted, “All living presidents have either already exceeded the estimated life span of all U.S. men at their age of inauguration or are likely to do so.”
Experts call for ‘full cognitive testing’
Not all experts, however, agree that the medical report in February 2023 adequately assessed Biden’s functional and mental status.
“Dr. Kevin O’Connor, his physician, has asserted repeatedly in reports on yearly physicals that the president is fit, mentally and physically, and he has included reference to examinations by neurologists and orthopedists,” Dr. Siegel, professor of medicine at NYU Langone Medical Center, wrote not long ago in The New York Post.
“What is missing is any MRI report and full cognitive testing.”
Siegel argued that Dr. O’Connor hadn’t “addressed directly a possible link between a worsening gait and a neurodegenerative process involving the frontal lobe of the brain or spinal cord or the possible buildup of fluid (normal pressure hydrocephalus), which could cause both a gait and a cognitive problem.”
He advocated for Biden to have a comprehensive cognitive neuropsychiatric test — as Trump did with the Montreal Cognitive Assessment while in office — and to release it publicly, as his predecessor did.
Factors worth considering in addition to age
Other experts suggest Biden will continue to function well despite being in his golden years.
“Is there a gait or balance disorder that could lead to a fall due to normal [age-related] changes in walking?”
“I see many [80-year-olds] who are healthier and have better physical and cognitive function than others in their 60s and 70s,” Dr. R. Sean Morrison, chair of the department of geriatrics at the Icahn School of Medicine at Mount Sinai in New York, told Fox News Digital.
“What I can say is that age alone is not a factor in determining a person’s ability or job performance,” added Morrison, who emphasized he couldn’t comment on any individual person.
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“Throughout our lifespan we experience normal age-related changes in our physiology,” Morrison explained.
“As such, for anyone over the age of 70, there should be a focus on four key components in a health care evaluation.” This includes: 1) mobility; 2) evaluating for chronic conditions; 3) mental fitness; and 4) what is most important to the individual at that stage in life, Morrison said.
When reviewing the patient’s history for mobility issues, Morrison said he would ask, “Is there a gait or balance disorder that could lead to a fall due to normal [age-related] changes in walking?”
As people age, the risk of developing specific diseases and chronic conditions increases, so these diseases, such as arthritis, high blood pressure, diabetes and osteoporosis, need to be appropriately identified and treated, Morrison said.
A person’s “mentation” should be assessed — as “Alzheimer’s and other related dementias increase in prevalence with aging and should be screened for the same way we screen for high blood pressure or diabetes,” he added.
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But the health care exam should be personalized to “what is important to you [and] what matters most for your health care.”
Dr. Siegel acknowledged that experts who don’t personally examine President Biden “are not in a position to assess presidential fitness via a video clip or past the smokescreen of a president’s handlers.”
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He said, “All we can ask for is complete transparency — especially when it comes to an aged president with multiple medical problems that could interfere with function — transparency that we clearly aren’t getting.”