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The Biden-Trump Debate Spoke Loudly About Their Mental Health
A diagnostic and ethical perspective on discussing the candidates’ age, dementia, ADHD, Parkinson’s and personality disorders.
More than 51 million viewers watched the June debate between two geriatric politicians, Joe Biden and Donald Trump. Biden’s embarrassing performance has sparked most of the post-debate discussion about whether he is up to the job of President of the US.
Biden’s defenders have dismissed his apparent troubles thinking and speaking as just “one bad evening.” But this wasn’t some pop quiz. Rather it was, so to speak, a mid-term exam, announced in advance. It was incumbent on Biden, his aides and doctors, to present his best self to the voting public. While the debate was just 90 minutes, we have numerous appearances by both men in recent months, as well as more remotely in time, all preserved on video, to provide context.
General impressions are important. But diagnostic information from trained medical professionals can provide a deeper understanding of what transpired at the debate.
Doctors, including psychiatrists, make diagnoses for three reasons:
- to comprehend what is going on now
- to provide general predictions for the future
- to guide the selection of appropriate treatments.
The debate has much to teach us about aging, dementia, ADHD, Parkinson’s disease, personality disorders, and performance enhancing drugs. I will attempt to be transparent in describing what we can conclude about Trump and Biden, what criteria are used for certain diagnoses, and the degree of certainty around those assessments.
In addition, I’ll address why such a discussion is ethically appropriate, and what we might do to improve our presidential candidate selection process.
Ageism and dementia
The best predictor for dementia is advanced age. Yet the majority of elderly individuals, through at least age 90, do not have dementia. The language capabilities of both Trump and Biden have substantially deteriorated since the last election four years ago. Both have had numerous…
