Joe Biden’s fitness to run for a second term is in doubt after “moments of exultation” during last night’s television debate, which was a “car accident”, unleashed a wave of concern.
The president’s slurred words and generally fragile appearance put him in stark contrast to Republican challenger Donald Trump, commentators said.
Last night’s incident is 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 add insult to injury, there are reports that some Democrats are now calling for him to drop out of the presidential race entirely, a suggestion Biden’s team has firmly refuted.
So can any firm conclusions be drawn about what might be wrong with the 81-year-old based on his performance? We asked one of the UK’s leading dementia specialists, who was observing the debate, for his opinion.
After Biden lost his train of thought at one point and stared blankly ahead, Donald Trump said, “I really don’t know what he just said.”
Speech: confusing words, lost phrases and incoherence
In what has become a much-talked-about moment of the television debate, Biden gave a confusing answer to a question about Medicare.
He said: “We’ve been making sure that we can make every person eligible, which I’ve been able to do with Covid, sorry, everything we have to do with… look… I finally beat Medicare… ” before falling silent.
Another serious mistake occurred when Biden spoke about the situation on the border with the United States.
“We’ve had a significant increase in the number of asylum agents. By the way, Border Patrol has supported me, has supported my position.
“On top of that, we find ourselves in a situation where when he was president he was separating babies from their mothers and putting them in cages,” she said.
This prompted 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 old-age psychiatry at University College London, said: “Doctors can’t diagnose someone without examining them, but from the footage of the debate I’ve seen, the freezing and confusion worries me. Biden struggles to maintain attention.
“He’s fine 98 percent of the time, but there are times when he seems to have lost his train of thought and other times when he can’t help but wander off.”
‘These fluctuations and lapses in attention are a key symptom of Parkinson’s.’
Parkinson’s is a disease in which Nerve cells in the part of the brain responsible for producing a vital chemical called dopamine stop working properly.
Dopamine regulates a variety of functions, including movement and attention, and although medications can help relieve symptoms, the disease is incurable and gradually worsens.
Memory: getting lost over time, confusing errors and crashes
Biden’s memory and his ability to continue scoring points were also highlighted in the recent debate.
At one point, when mentioning abortion restrictions in some US states, he confusingly made reference to immigration and referred to a “young woman who has just been murdered” by an immigrant.
Viewers said it was unclear what point he was trying to make.
Other commentators have pointed to several occasions where he appeared to freeze, such as an incident earlier this month where he appeared to be staring blankly. front while Vice President Kamala Harris danced next to him.
Following these incidents, there has been widespread speculation that the President is suffering from dementia.
However, Professor Howard said: “People with dementia have these symptoms all the time, not intermittently.”
‘If you sit someone with dementia in front of a neuropsychologist and examine them, they’re going to do badly.
“Someone with fluctuating attention will only do poorly when their attention drops.”
He said this seems to be what is happening with the President.
“It’s really bad luck that Biden seems to be affected when he’s on the show,” he said.
‘It will also be difficult for those around him. If he had dementia, they could do tests and say, ‘Look, you’re not fit to continue as president or candidate.’
“But if it fluctuates, only those moments are a cause for concern and the rest of the time it will be absolutely fine.”
While 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 go off in the house: there’s nothing you can do to turn them back on,” he said.
‘But with something like Parkinson’s, the power drops and the light bulbs flicker and dim a little from time to time.
‘Biden just has trouble keeping the lights on all the time.
“He seems expressionless and his face has the appearance of a mask.” This is something we also often see in Parkinson’s disease.’
She added that people should not dismiss symptoms like these as they are not simply a sign of aging.
“If he has Parkinson’s, and I’m not saying he does, you can bet he’s seen the best doctors and is already getting optimal treatment,” he said.
Biden appears to freeze during a June 16 concert at the White House
The 81-year-old president reportedly “froze” for about a minute before his speech became garbled during the event in Washington.
“These types of symptoms should not be considered a normal part of old age.”
Walking: general stability and multiple trips and falls
Shaking hands is perhaps one of the best-known symptoms of Parkinson’s, but experts say not all patients develop it.
Falls, to which Biden has become increasingly vulnerable, are another sign of the disease.
The President has had several unfortunate falls in recent years.
Perhaps the most iconic was when he repeatedly tripped on 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 a stationary bike while speaking to reporters.
Other falls were also filmed and recorded at various events over the past year.
Biden looks at a sandbag after falling on stage at the Air Force Academy graduation ceremony in Colorado.
MARCH 2021: Biden’s first stumble as he climbed the stairs to Air Force One. The White House blamed the wind for his struggles
Professor Howard said falls among Parkinson’s sufferers are not uncommon.
“People with Parkinson’s have these moments where they freeze physically,” he said.
“They are more likely to fall as their legs may be stiff and their movements slow.”
Dopamine, a brain chemical that Parkinson’s patients have less of, acts as a messenger between the brain and parts of the nervous system that govern the control and coordination of body movements.
Lack of this can cause movement to become slow or abnormal, increasing patients’ risk of falls and even causing them to freeze completely as if stuck in place.
Parkinson’s affects one in 20 people over the age of 85, and 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 was progressive.
‘It’s a terrible dilemma because most of the time it’s spot on.
“But you can’t predict when those moments will occur and he won’t be able to function at the level he needs to,” he said.
‘These things don’t get better with time. They are progressive. Medications only treat the symptoms, they don’t stop the disease from progressing.
“If we think about the next three or four years, the situation will only get worse.”