Last Thursday was not a good day for Joe Biden. During the president’s shaky and occasionally incoherent debate performance, he looked the weakest and most frail the American people have ever seen him. Friday seemed to be a much better day. Footage from a campaign rally in North Carolina showed: His campaign was broadcast onlineThe president seemed like a different person, animated and energetic, speaking with an intensity he hadn’t shown on the debate stage.
Biden supporters and opponents alike have frequently spoken about this yo-yo phenomenon since the debate. The president has good days and bad days. Biden himself has Said He said the night of the debate “was not the best,” and his spokesman Rotate the performance It was the result of a cold, not a “seizure.” Indeed, Biden appeared sane throughout his State of the Union address earlier this year.
While many have pointed to Biden’s inconsistencies as a sign of something much deeper, a perhaps insurmountable challenge for the White House is the uncertainty of which version of Biden will emerge next. The president is scheduled to appear on ABC’s George Stephanopoulos for an interview on Friday, The New York Times report Today, Biden knows that one more poor performance could doom his candidacy. There are many reasons for swinging between good and bad days, some benign and some that threaten the presidency.
At 81, it’s natural for cognitive abilities to be a little uneven. That’s also natural for Donald Trump, who is 78. Stephen P. Woods, a psychology professor at the University of Houston, told me that as people get older, their brains slow down. Learning and remembering don’t come as easily as they used to. People still slip up, but executive function (the higher-level processes that allow for planning and cognitive flexibility) also tends to slow down. As a result, cognitive abilities become less consistent. The concept of good and bad days falls under the scientific category of cognitive fluctuations, which encompasses spontaneous changes in attention and awareness. As people get older, they experience more frequent and noticeable fluctuations than before. Parts of the brain involved in learning and complex functions can shrink, and communication between certain neurons can break down.
The big question, Woods said, is: “What happens when the fluctuations become abnormal?” What constitutes abnormal cognitive fluctuations depends entirely on a person’s overall health. A temporary dip in energy or focus is not, in and of itself, cause for concern, Woods said. The need for an occasional nap is not, in and of itself, a disqualifier for the country’s highest office. But it can be problematic when accompanied by ongoing cognitive changes, significant medical changes, or impairments in daily life. “If you have enough fluctuations to make your daily life unmanageable, even for a period of time, that’s abnormal to me,” Jeremy Prusin, a cognitive behavioral neurologist at the Banner Alzheimer’s Institute, told me.
Age-related changes are not all that serious. However, age is a risk factor for diseases that can worsen the changes, such as dementia and neurodegenerative diseases. Brain trauma, certain infections, and mood disorders are also associated with these changes. Changes can occur over a period of days, as well as within days. SundowningIt is primarily associated with Alzheimer’s disease and refers to cognitive problems that occur in the late afternoon and early evening.
A bad day could be part of a constellation of symptoms. For example, people with Parkinson’s disease may experience fluctuating cognitive functions, such as a softer voice, a shuffling gait, less fluid movement and less facial expression, Pulgin said. Cognitive fluctuations are also a key symptom of Lewy body disease, a form of dementia. People with the disease may “appear dazed for a while, then return to normal or near normal within a few hours to a day,” Pulgin said.
Biden has not reported suffering from any of these illnesses. After a routine medical checkup in February, the president’s physician said:Fit for the taskAlthough Biden did not take the cognitive test, he did question whether “there is something more serious wrong with the president.” But after the events of the last week, it is entirely understandable that many Americans would question whether there is something more serious wrong with the president.
Biden’s cognitive fluctuations aren’t necessarily a sign of disease or aging. Regardless of age, “we all have good and bad days,” Alexandra Fiocco, a psychology professor at Toronto Metropolitan University, told me. It’s common to leave your coffee cup behind, forget a colleague’s name, or stare blankly at your laptop. No one is “on” all the time. Fluctuations are just part of “normal human cognition,” Woods said.
External factors like lack of sleep, lack of exercise, too much stress, and certain prescription medications can play a role. The effects of a rotten tuna sandwich or a bad breakup can easily derail cognitive function. Some people naturally vary more than others due to many variables, including differences in biology and brain pathology. Psychologists call this “intra-individual variability.”
Unfortunately for voters, there are more questions than answers about what’s causing Biden’s slump. You can’t judge fluctuating cognitive abilities in a few media appearances or a lengthy debate; that usually requires a battery of tests and long-term observations. Fiocco told me that older people tend to assume they have dementia when less serious factors, like lack of sleep or dehydration, could be at play. “You need the whole picture to determine whether they’re just having a bad day or whether this dramatically bad day is part of a broader syndrome related to the disease,” Prusin noted.
Public skepticism about Biden’s health is understandable. Previous US presidents have a record of withholding public information about their health problems, including Grover Cleveland, Woodrow Wilson and Franklin D. Roosevelt. It’s certainly possible that Biden hadn’t slept enough, was especially stressed, or, as Biden’s team said last Thursday, was sick with a cold. But that possibility may coexist with another: he’s simply old.