Joe Biden’s eligibility to run for a second term is in question after ‘senior moments’ during last night’s TV debate over the ‘car crash’ sparked a wave of concern.
The president’s muddled words and generally frail appearance put him in stark contrast to Republican hopeful Donald Trump, commentators said.
Last night was just the latest in a series of incidents that have led many to speculate about Biden’s health. His tenure has been marked by falls, gaffes and unusual behavior, particularly in recent months.
To compound his problems, there are reports that some Democrats are now calling for him to withdraw from the presidential race altogether – a suggestion firmly denied by the Biden camp.
Can any firm conclusions be drawn about what could be wrong with the 81-year-old based on his performance? We asked one of Britain’s top dementia specialists, who watched the debate, for his opinion.
After Biden lost track at one point and stared blankly into space, Donald Trump said: ‘I really don’t know what he just said’
Speech: muddled words, lost sentences and incoherence
In what has become a much-discussed moment of the TV debate, Biden produced a rambling response to a Medicare question.
He said, “We made sure everyone was eligible for what I was able to do with the Covid, excuse me, everything we’re dealing with… look… I finally defeated Medicare…” before driving away.
Another serious blunder arose when Biden spoke about the situation at the US border.
“We had a significant increase in the number of asylum agents. By the way, the Border Patrol has supported me, supported my position.
“In addition, we are in a situation where, when he was president, he separated babies from their mothers and put them in cages,” he said.
This led Trump to respond: “I really don’t know what he said at the end of that sentence. I don’t think he knows what he said either.’
Professor Robert Howard, an expert in geriatric psychiatry at University College London, said: ‘Doctors cannot make a diagnosis without examining someone, but based on the footage of the debate I have watched, I am concerned about fact that Biden is struggling to keep his attention.
‘He’s fine 98 percent of the time, but there are times when he seems to have lost his train of thought, and there are times when he can’t stop himself from wandering.
‘These fluctuations and dips in attention are an important symptom of Parkinson’s.’
Parkinson’s is a condition in which: nerve cells in the part of the brain responsible for producing the essential chemical dopamine no longer work properly.
Dopamine regulates a range of functions, including movement and attention. Medications can relieve symptoms, but the disease is incurable and gradually worsens.
Memory: Weakening, confused blunders and freezes
Biden’s memory and ability to continue his views also came to the fore in the recent debate.
At one point, when specifically describing restrictions on abortion in US states, he confusingly referenced immigration and referred to a “young woman who had just been murdered” by an immigrant.
Viewers said it was unclear what he was trying to say.
Other commentators have pointed out several occasions when he was seemingly frozen, such as an incident earlier this month where he was apparently staring at him He stared blankly ahead as Vice President Kamala Harris danced next to him.
But there have been many occasions when Biden has appeared disoriented and frozen in public.
At the ceremony commemorating the 80th anniversary of D-Day in France, Biden was seen crouching awkwardly as if preparing to sit down before briefly freezing.
The move appeared to prompt First Lady Jill Biden to cover her mouth, raising questions about whether she was quietly trying to advise him that it was not the right time to sit down.
He also appeared speechless for about a minute during the Juneteenth celebration, as others danced to the beat of a lively band.
There is much speculation that the president is suffering from dementia, as a result of these incidents.
However, Professor Howard said: ‘People with dementia have these symptoms all the time, not intermittently.
‘If you put someone with dementia in front of a neuropsychologist and test him or her, he or she will do poorly.
‘A person with variable attention will only perform worse as his attention decreases.’
He said this appears to be what is happening to the president.
“It’s just really unfortunate that Biden seems to be bothered by it when he’s seen,” he said.
“It’s going to be hard for the people around him too. If he had dementia, they could test him and say, look, you’re not fit to continue as president or as a candidate.
‘But when it fluctuates, it’s only those moments that cause concern. He’ll be completely fine the rest of the time.’
Although both dementia and Parkinson’s can affect the brain, Professor Howard said they manifest in different ways.
“The difference is that with dementia it’s like the lights in the house going out: there’s nothing you can do to turn them back on,” he said.
‘But with something like Parkinson’s disease, the current drops and the lamps sometimes flash and burn weaker.
‘Biden just has a hard time keeping things going all the time.
‘He looks expressionless and his face looks like a mask. We often see that with Parkinson’s disease.’
He added that people should not ignore such symptoms as they are not just a sign of aging.
“If (Biden) has Parkinson’s disease — and I’m not saying he does — you can be sure he’s already been to the best doctors and he’s already getting optimal treatment,” he said.
Biden appears to freeze during Juneteenth concert at the White House
The 81-year-old president reportedly “frozen” for about a minute before his speech became slurred during the event in Washington
‘These types of complaints are not part of the normal course of aging.’
Walking: general stability and multiple stumbles and falls
Shaking hands may be one of the best-known symptoms of Parkinson’s disease, but experts say not all patients develop it.
Falls, to which Biden has become increasingly vulnerable, are another sign of the condition.
The president has had a number of unfortunate falls in recent years.
Perhaps the most iconic moment came when he tripped repeatedly on the stairs while boarding Air Force One in March 2021, and then again in May 2022.
In another incident, this time in June 2022, Biden lay on the ground for 10 seconds after falling from an exercise bike while speaking to reporters.
Other falls have also been filmed and recorded at various events over the past year.
Biden looks back at a sandbag after falling on stage during the Air Force Academy Graduation Ceremony in Colorado
MARCH 2021: Biden’s first stumble as he stormed up the steps of Air Force One. The White House blamed the wind for his struggles
Professor Howard said falls are not uncommon in people with Parkinson’s disease.
“People with Parkinson’s disease have moments when they physically freeze,” he said.
‘They are more at risk of falling because their legs are stiff and their movements are slow.’
The brain chemical dopamine, which patients with Parkinson’s disease have less of, acts as a messenger between the brain and the parts of the nervous system that control and coordinate body movements.
A lack of this can cause movements to become slower or abnormal, putting patients at greater risk of falling. It can even cause them to freeze completely, as if glued to the spot.
Parkinson’s disease affects one in twenty people over the age of 85. Age is considered the greatest risk factor for developing the disease.
Professor Howard said that while he could not comment on Biden’s long-term health, if he had Parkinson’s it would only get worse over time as the condition became more progressive.
It’s a terrible dilemma, since he’s right most of the time.
“But you can’t predict when those moments will come and he won’t be able to function at the level he should be,” he said.
“These things don’t get better as time goes on. They are progressive. Medicines only treat the symptoms, they do not prevent the disease from progressing.
“If you look ahead to the next three or four years, it’s only going to get worse.”