I invented America’s gold-standard cognitive test. This is why I’m calling on Biden to take it and make his results public
Dr. Ziad Nasreddine, a neurologist who invented the gold-standard cognitive test, says he would happily administer the test for Joe Biden or Donald Trump
The neurologist who invented America’s leading cognitive test is urging Joe Biden to take the test after his disastrous debate last week.
Doctor Ziad Nasreddine declined to comment on the president’s health despite widespread concerns about the 81-year-old’s slurred speech, stiffness and freezing attacks during his time in the White House.
But that changed last Thursday. Dr. Nasreddine said he had serious concerns about Biden’s mental acuity after watching his performance against Trump.
Dr. Nasreddine has the Montreal Cognitive Assessment, or MoCA, test.
You probably know it best as the test that Donald Trump, 78, often brags about successfully passing during his presidency.
The test is a simple 11-question exam and takes ten to fifteen minutes to complete. (scroll down to the bottom of this article if you want to try it yourself).
It involves asking patients to identify pictures of animals, repeat a list of numbers and words, or complete a pattern. The lower the score, the higher the risk of cognitive decline — a precursor to dementia.
Dr. Nasreddine, who lives in Montreal, Canada, said: “A neurological examination of the president is warranted to rule out neurodegenerative symptoms.”
Shortly after Biden began debating Trump last week, his team claimed the president was suffering from a cold, explaining his shaky voice, pale skin and incoherent responses.
But Dr Nasreddine said: ‘President Biden’s symptoms of slurred speech, confusion, stiffness and freezing attacks were present well before the debate.
“It is unlikely that this is caused by the flu or tranquilizers alone.”
President Joe Biden’s erratic performance during Thursday’s debate has raised concerns in many Democratic circles. But for now, his family insists he will keep fighting
The White House has repeatedly refused to allow Biden to take the MoCA test, despite calls from Trump, Rep. Nikki Haley and medical professionals.
The test measures memory and cognition, with patients able to score up to 30 points (the average score for older adults taking the test, usually around 70, is 27.3).
At an age under 26, mild cognitive impairment is considered, which can be a precursor to conditions such as Alzheimer’s.
But if it drops below 18, that indicates moderate impairment — a warning sign of disease. Anything below 10 indicates severe impairment.
The test is normally performed in a clinical setting, where there are no distractions, together with a physician.
If someone scores lower than 26, he or she is referred for further analysis.
This may include an MRI, which can detect fluid in the brain, or a blood test, which can detect proteins in the blood that indicate the buildup of amyloid beta or other proteins in the brain linked to Alzheimer’s disease.
Like many doctors, given the sensitive nature of the issue, Dr. Nasreddine did not want to second-guess Biden’s doctors, who had said in February that the president was “fit for duty” and did not need a cognitive test.
But last week’s debate changed his mind.
He said: ‘During the debate I saw a lot of problems with answering questions: they froze, didn’t finish sentences, mumbled and sometimes said things that made no sense.
‘Then I thought, “My God, this is exactly what’s been going on for months, many months — I suspect even longer.”
“This is concerning and indicates that he needs to undergo a cognitive test.”
He added that it is important to perform the test early so that treatments for conditions such as Alzheimer’s can be started.
There are medications such as Lecanemab that can slow the progression of the disease, but they only work in the early stages.
Biden appeared to walk away from other world leaders at the G7 summit last month (pictured). The White House has maintained that he waved to paratroopers who were pictured off-camera, but his movements were still unusual
There have also been a few moments when Biden froze, including during this Juneteenth celebration at the White House (pictured), where he remained deathly still as others around him clapped and danced.
Biden also appeared to freeze at a star-studded fundraiser in Los Angeles last month before being led off the stage by former President Barack Obama
President Biden was officially told today that he must withdraw from the 2024 presidential race after two Democrats left ranks and publicly called on him to resign.
The White House has scheduled a meeting with Democratic governors on Wednesday to convince them that Biden can win the election.
But five months before Election Day, many Democrats had initially hoped that Biden would be convinced by his family to step aside.
But instead, he appears intent on staying in the race, egged on by his wife Jill and son Hunter, who are among his biggest supporters.
Dr. Nasreddine developed the test in 2005 because diagnosing cognitive decline is difficult. Patients often have to undergo hours of testing.
Since then, more than 6,000 studies have been conducted on the test and it has been translated into 100 languages worldwide.
In the US, the test is also recommended by the American Academy of Neurology. According to this organization, everyone over 65 should have the test done annually.
Dr. Nasreddine said he believes everyone should get the test once at age 50, but that starting at age 60, they should get the test every two years.
This establishes a baseline for a person’s brain and can then track any decline in cognition over time.
It is best to have the test performed by a clinician who can interpret the results correctly, but there is also an online version available to patients called MoCA XpressOwhich you can follow online at home.
Dr. Nasreddine is also working on a MoCA Solo, a version of the test that people can take themselves in a clinic, without a doctor present.